Dental insurance is a fact of life for us. At least half of our patients have it, the ones that don't would like it. We do our best to work with all the different companies and policies that you bring us. Each company and policy is different and we, by we I mean Cheryl, spend at least 50% of our time each day dealing with insurance issues.
Patients always ask; I have MetLife. Is that good insurance? Blue Cross is good insurance, isn't it? The simple answer is that MetLife and Blue Cross, as well as all the other insurance companies, have some plans that are very good and some plans that aren't. Which plan you have depends on how much your employer was willing to spend to provide dental coverage for you. If your employer is a generous guy and is willing to go the extra mile you may have very good coverage, no exclusions and a high annual maximum. If you employer wants to get by as cheaply as possible you may have a plan that doesn't cover everything and has a low annual limit.
Some of the more common exclusions from coverage are orthodontics; tooth colored fillings and porcelain crowns on back teeth. Most policies will not pay for a bridge or an implant to replace a tooth that was extracted years ago before you had dental coverage. Many policies do not pay for implants at all, although this is starting to change. Age limits are common for procedures such as sealants and fluoride treatments, apparently sealants and fluoride work, but only until you are 18, after that they are no longer effective.
We don't make the rules for your dental insurance, we only follow what the insurance companies lay down. Remember, just because something isn't covered doesn't mean its not needed or that you can't have it done; it just means that you may not have a very good policy. If you don't like your coverage talk to the HR department at work, if enough people complain, maybe things will get better.
Next time... Why I don't consider dental insurance to be insurance at all.
Have a great weekend!!