Is Dental Insurance Limiting Your Care?

San Francisco Dentist Serving San Rafael, Oakland, Berkeley &
Nearby Bay Area, California


Dental insurance benefits Effective dentistry creates healthy, beautiful smiles. Dental insurance policies do not always pay for the treatments that will be the most effective for you. Our dentists will prioritize what is best for your dental health when they make recommendations. Your dental insurance policy may cover a portion of the costs or it may not, but know that we will not let insurers dictate your care. You are our number one priority!

Dental Insurance Shortcomings

At the DENTAL STUDIO, we want each of our patients to get the tailored dental care they deserve. We utilize your dental insurance to the fullest extent possible, but our main concern is your best oral health. There are a few limitations when it comes to dental insurance and the dentistry you need:

Dental insurance is a discount for care. Dental insurance is different than other insurance. It works like a coupon. You receive a discounted price on a limited number of services.

Dental insurance doesn't always cover necessary dentistry. It can be frustrating, as a patient, to learn that your dental insurance won't pay for a treatment or procedure you need. We understand our patients have certain financial restraints, and we do our best to help you navigate your policy. It's also important to know that you are your best advocate as the policyholder. You have the most sway in getting the benefits you are entitled to in your policy.

While dental insurance is far from ideal, it's not all bad. Below, we describe how it can be a great way to receive a discounted rate on certain types of prevention.

Preventive Services: The Most Important Insurance Policy

One of the favorable aspects of dental insurance is that just about all of the policies provide a discounted price for routine cleanings and checkups. This bedrock care identifies and prevents a host of problems, including:

  • Cavities
  • Gum disease
  • Fractured teeth
  • Chipped teeth
  • Gum recession
  • Tooth abscess

Preventive care is itself insurance against bigger dental problems. By catching and preventing dental disease and tooth damage in early stages, the dentist can stop their advancement. You will save money, time and hassle in the long run. For example, a small cavity is easier to treat and repair than advanced decay requiring root canal treatment.

How To Get the Most from Dental Care

Couple smiling after cosmetic dentistryHere are a few tips to insurance as it results to your dentistry care:

  • Review the details of your plan. Look up the annual maximum, which is usually $1,000 or $1,500. Review whether preventive care is 100 percent covered, and which treatments and restorations are not covered. Call the insurance company at the number listed on your card if you have questions about your plan.
  • Discuss your dental health and what is best for you with the dentist. Our dentists are personally driven by helping each of our patients achieve great dental health. Your dental plan does not necessarily have that same goal. After meeting you and learning more about your dental history, the dentist will recommend those treatments that will serve you best, and he will discuss with you the reasons why.
  • Consult our office about your options. Our staff works with dental insurance every day. We know the lingo and can help you figure out what is covered and whether there are other ways to make the most of your coverage.

We are here for you. Don't let insurance coverage be the last word on the care you receive. Get tailored recommendations based on your unique needs, and then let our office help you plan for the cost.

Financing Your Dentistry

When you are considering a restoration or procedure not included in your plan, talk to our office about how to make up the difference. Or, you may decide you'd like to finance the entire procedure. This option can be convenient for cosmetic dentistry like porcelain veneers and teeth whitening, which are not covered under the vast majority of plans but can dramatically rejuvenate your smile.

At the DENTAL STUDIO, we currently accept financing plans from:

  • Lending Club
  • Alphaeon
  • You can apply easily online. Consult our team for more information.

Dental Insurance FAQs

  • How do I find out if my insurance covers the treatment my dentist says I need? You can get an estimate, also called a pre-determination, from the insurance company. We will submit the request to your insurance company. It is important to note this is only an estimate, not a promise or guarantee. You may ultimately be billed for the treatment based on several factors, including if your yearly maximum has been reached and when the request for payment is submitted to the insurance company.
  • Is it my insurance company's responsibility or my responsibility to pay for my dental treatment? The patient is responsible for payment of services rendered. If the insurance company ultimately denies coverage, you will need to advocate for your benefits directly with the insurer.
  • Can the dentist's office deal with my insurer, instead of me dealing with them? As the policyholder, it is your responsibility to deal with the insurer. We will submit forms on your behalf as a courtesy, at the time of treatment. But you will need to contact the insurer if any issues arise.
  • My dentist said I need three cleanings a year. My insurance pays for only two a year. Why is this? This goes back to the main issue at hand: Dental insurance provides a discount for some things, but it is not designed to meet your unique oral health needs. If your dentist is recommending three cleanings yearly, it is for the good of your oral health. Paying for the extra cleaning out-of-pocket may be the right thing to do, because it is probably necessary in order for you to avoid problems like gum disease or tooth decay.

Arrange Your Consultation in San Francisco

Our experienced dentists care for patients from San Francisco and across the surrounding Bay Area, including San Rafael, Oakland and Berkeley. To arrange a consultation, or to schedule your next checkup and cleaning, please call the DENTAL STUDIO at 415-392-5025.