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Dental Dollars: Maximizing Benefits with In-Network vs. Out-of-Network Coverage

November 16, 2023

Filed under: Uncategorized — drgray @ 10:25 pm
A dentist going over dental insurance with their patient

With the end of the year approaching, it’s time to think about how you’ll use up your dental insurance benefits. Policyholders in the US annually leave over 100 billion dollars in unused benefits on the table. This money goes back to the company, and never into your pocket. So, it’s in your best interests to use it all up!

Making sure your dentist is in-network is a great first step. If you want to learn how to maximize your benefits through in-network dental providers, continue reading.

What Makes a Dentist In-Network vs. Out-of-Network?

Dental insurance providers often establish networks of dentists who agree to provide services at pre-negotiated rates. In-network dentists have contracts with the insurance company, leading to potentially lower out-of-pocket costs for patients.

On the other hand, out-of-network dentists operate independently of these agreements, which may result in higher costs if they decide not to work with your insurance provider’s rates.

How to Maximize Benefits with In-Network Dentists

Choosing an in-network dentist will often result in lower co-pays, reduced deductibles, and more predictable costs. By selecting an in-network provider, you can maximize your dental benefits and possibly save money. This is especially true of smaller, preventive treatments like fillings and cleanings that are often covered 100 percent by insurance.

Even some more involved treatments like dental crowns can be covered by 80 percent. That’s a lot of money you can keep in your bank account by choosing the right practice!

The Downside of In-Network Providers

While in-network providers offer cost advantages, they can come with some drawbacks. Not all in-network providers will cover the treatments you need. You’ll also be more limited in the dentists you can choose to work with. If your current dentist happens to fall out of network, you may be forced to change dentists or agree to pay more.

This doesn’t always happen. Some out-of-network providers may still work with your insurance company so you can receive coverage, but you should always ask to be sure. When choosing your dentist, it’s important to weigh the benefits of your preferred dentist against the potential additional costs.

The choice between in-network and out-of-network dental coverage comes with many considerations. The potential costs, choice flexibility, and your dentist-patient relationship are all important to think about. As the year-end approaches, take steps to use your benefits wisely for a healthier, happier smile.

About the Practice

At Mark Gray DDS Cosmetic and Family Dentistry, Dr. Mark Gray and Dr. Marlayne Newman work together to provide top-notch dental care in a relaxing environment. They utilize the latest dental technology and techniques to craft treatment plans that are tailored to your needs. To schedule an appointment, call (281) 493-9395 or visit the website to learn more about their in-network dental insurance providers.

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