Insurance and financing

Does the office take my plan?

Call the office with the name of your insurance company and your plan. Both are usually on your insurance card. The plans the office has confirmed are listed on this page, but plans change, so check before your visit even if you see yours.

You can also ask your plan directly whether Dr. James Minici at Dental Academy is in network.

How dental insurance usually works

Dental plans differ, but most use the same few terms. Knowing them makes your plan’s paperwork easier to read.

In network and out of network. An in-network dentist has a contract with your insurance company and agrees to its fees. If a dentist is out of network, your plan may pay less, or nothing at all, and you may owe the difference. It depends on your plan.

Deductible. This is the amount you pay each year before your plan starts to pay. Many plans don’t apply the deductible to checkups and cleanings.

Coinsurance. After the deductible, your plan pays a share of the cost, and you pay the rest. Plans usually pay a larger share for preventive care, like cleanings, and a smaller share for bigger treatment, like crowns or dentures.

Annual maximum. This is the most your plan will pay in one plan year. Once you reach it, you pay the full cost until the plan year starts over.

Waiting periods. Some plans won’t pay for certain treatment, such as crowns or dentures, until you’ve been enrolled for a set time, often several months or longer.

Frequency limits. Plans often limit how often they pay for a service, such as two cleanings a year or one full set of X-rays every few years.

Preauthorization. For larger treatment, your dentist’s office can send your plan a treatment plan and ask what it will pay before you start. Some plans call this a predetermination. The answer can take a few weeks, and it’s an estimate, not a promise to pay.

Medicare. Original Medicare doesn’t cover most routine dental care. Some Medicare Advantage plans include dental benefits. If you have one, call the office with the plan’s name.

Questions to ask your plan

• Is Dr. James Minici at Dental Academy in network for my plan?
• What’s my deductible, and how much of it have I met this year?
• What’s my annual maximum, and how much is left?
• How much of the cost do you pay for cleanings, fillings, crowns, and dentures?
• Do I have a waiting period for any treatment?
• How often will you pay for cleanings and X-rays?
• Do I need preauthorization for the treatment I’m planning?
• When does my plan year start over?

What the office will do

After your exam, if you need treatment, we’ll explain what we recommend and help you understand an estimate before anything starts. The estimate is based on what we know about your plan at the time. What your plan actually pays can be different, so ask about anything that isn’t clear.

If cost is a concern, tell us early. There’s often more than one way to treat a problem, and it helps to know before we talk through your options.

If you don’t have dental insurance

Many people don’t have dental insurance. Call the office before your visit to ask about payment. The payment methods the office accepts are listed on this page.

Financing

Financing lets you pay for treatment over time instead of all at once. It’s usually offered by a separate company, not the dental office. You apply with that company, often with a credit check, and pay it back in monthly payments.

Read the terms closely before you sign up. Some financing plans have a promotional period. If the balance isn’t paid in full by the end of it, interest may be charged from the start. The financing options the office works with are listed on this page.