401 W Felicita Ave, Escondido, CA 92025
760-233-5887
Insurance
Insurance
Insurance Plans We Accept
We gladly accept PPOs, HMOs and Denti-Cal insurance plans. Some of the plans we accept are Metlife, Delta Dental, DeltaCare, United Concorida, Principal, Dentemax, Ameritas, First Dental Health, Connection Dental/GEHA , Careington, Liberty, Humana, Dental Benefits Provider, United Health, Blue Cross, Guardian , Cigna, and many more. Please call us if you have questions about your insurance.
How Dental Insurance Works
1.
Checking Coverage
Before your visit, we'll check your insurance plan to see what's covered.
2.
Planning Treatment
Our insurance benefits expert will work with you to get the most from your insurance and keep your costs down.
3.
Submitting Claims
After your treatment, depending on your insurance company, we may send the claim to your insurance company as a courtesy.
4.
Handling Payments
We'll explain what your insurance will pay for upfront and help you determine any copays.
How Dental Insurance Works
1.
Checking Coverage
Before your visit, we'll check your insurance plan to see what's covered.
2.
Planning Treatment
Our insurance benefits expert will work with you to get the most from your insurance and keep your costs down.
3.
Submitting Claims
After your treatment, depending on your insurance company, we may send the claim to your insurance company as a courtesy.
4.
Handling Payments
We'll explain what your insurance will pay for upfront and help you determine any copays.
How PPO Dental Plans Work
Preferred Provider Organizations (PPOs) are a very common type of dental insurance, offering a network of dentists for members to choose from. Dentists in this network agree to lower their fees, which means you save more money. PPO plans typically cover a portion of your treatment costs, often paying 50% for major treatments like crowns and bridges, 80% for basic care such as fillings, and up to 100% for preventive services like exams and cleanings. These plans often have annual maximums between $1,000 and $2,000 and help with the insurance billing process.
Understanding your HMO
A Health Maintenance Organization (HMO), also known as capitated or prepaid insurance, is a type of dental plan where you must select a primary care dentist from a network of providers. This primary dentist will coordinate all aspects of your dental care and any referrals to specialists within the HMO network. HMO plans typically offer lower monthly payments and fixed copayments for covered services, but your choices for dentists outside the network are limited. Additionally, HMO plans may require you to get approval in advance for certain treatments, and they usually don't cover care received outside of their network, except in emergency situations.
Dental Insurance FAQs
Got questions? We have answers! Check out our FAQ section to learn everything you need to know about navigating dental insurance coverage.
What is optional treatment?
Optional treatment is any procedure that is either not included in your fee schedule or is more extensive than the basic treatment needed to restore your tooth's original function.
What's a covered benefit?
A covered benefit is a dental treatment that your dentist recommends, is listed in your plan's fee schedule, and is accepted according to the terms of your group's insurance plan.
What's the difference between indemnity, PPO, HMO, & discount insurance plans?
Indemnity or traditional insurance pays either the member or the dentist based on the dentist's UCR (Usual, Customary & Reasonable) fee. This allows you to visit any dental office without being restricted to a specific network of dentists.
