Have questions about your dental insurance? You’re not alone!
We’ve compiled some of the most frequently asked questions we get about insurance below. Feel free to reach out to us at anytime if you have questions. Zara is our financial coordinator and she can help!
Do I have to have dental insurance to make an appointment?
You do not have to have insurance to make an appointment.
How do I know if I’m covered at PKD?
Often times, your insurer will have a place to search for your preferred dentist on their website.
We accept most insurance plans, including BlueCross Blue Shield, Delta Dental, MetLife, Medicaid, Cigna, Assurant, Aetna, Ameritas and more. If you are not sure, give us a call and we can help.
What is the difference between PKD being in my insurer’s network and out of my insurer’s network?
In-network means that your insurance provider has agreed to discounted services provided by PKD to you. Although you will still have a copay for restorative, you will pay less than you would if there is no agreement between your preferred dentist and your insurer.
We are a preferred provider for many insurance providers so PKD will likely be in-network. But it is important for you to check with us first, just in case.
Generally, all of your cleaning appointments whether in or out of network are covered at 100% so don’t forget to schedule that appointment with us=)
What services can I expect from a routine checkup at PKD?
Most routine dental checkups are covered 100% by your insurer. A routine dental checkup includes a cleaning, an exam, fluoride, and x-rays. Most insurers cover up to two per benefit year. This is also referred to as preventative work / coverage in your dental plan.
What’s the difference between preventative coverage and restorative coverage?
As mentioned above, preventative dental care includes the services you get from routine dental checkups at dentist visits once or twice a year. Cleanings, evaluations, and x-rays are most often included in preventative coverage.
Restorative coverage includes services that go beyond a routine checkup. Depending on your plan, this may include fillings, crowns, and extractions ( getting teeth removed).. The best way to prevent having to get this type of work is to be diligent in making your routine appointments twice a year!
If my child needs restorative work done, how will I know how much I will have to pay?
Depending on what work your child needs, you should expect to have some type of copay for restorative work. But the amount will be dependent on which restorative services are covered in your plan. To make it easier for you to get an idea of how much you will pay, we will provide you an estimate once we’ve completed an initial exam.
Please note that while our experience allows us to accurately predict the cost of your services, your coverage is an agreement between you and your dental insurance provider, and you are responsible to pay what they bill you, regardless of if and how much it differs from our initial estimate.
Is orthodontic work generally covered by my dental insurance?
Most standard dental plans do not cover orthodontics unless braces are “medically necessary”. Even then, coverage differs by state, providers and specific plans.
We recommend that you add orthodontic coverage to your plan..
What information do I need to have prepared when providing my insurance information to PKD?
New patients and existing patients who have changes to their insurance should be prepared to provide the following to us on your next visit:
- Insurance Provider’s Name
- Policy Holder’s Name
- Date of Birth
- SSN or ID # on Insurance Card
Please be aware that these FAQs are here to provide general information on dental insurance and are not specific to your coverage. Plans can vary depending on multiple factors. The best way we can help you find out about your dental coverage is to give us a call at 843-284-6497 and talk through it with us!