Baytown Texas Dentistry
Dr. Zach Holder and
Dr. Jesse Kirkpatrick

Why is my benefit different from what I expected?

Many patients express concern that that their insurance didn’t provide the benefits that they were expecting to receive. There are many reasons why your dental benefit may vary:

  • Maximums limit what a carrier has to cover each year. You may have already used up a portion of the benefits available under your insurance coverage.
  • Your plan only pays for a percentage of a particular procedure.
  • Your plan limits how many certain types of procedures it will cover, like cleanings, exams, and x-rays.
  • The treatment you received was not a covered benefit.
  • Your deductible has not yet been met.
  • You are ineligible for coverage because you have not yet reached the end of your plan’s waiting period.
  • Your insurance may be structured so that you need to choose from a list of your carrier’s preferred providers.       
  • Your plan may contain specific limitations for certain procedures.

Dentists deal with thousands of plans and hundreds of types of treatments each year. Most carriers refuse to release the details of their plans. They change policies and reimbursements constantly and without our notice. If you have questions about your coverage, it is always best to check with your carrier first. 

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