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Dental Insurance – Pittsburgh, PA

Exceptional Dental Care – Affordable Pricing

Closeup of female patient during dental exam

At the Pittsburgh dental office of Colleen Cain, DMD, we understand that the cost of dental care is a major concern for many of the families who entrust us with their oral health care. We always strive to provide the highest quality of care at an affordable price. In addition to keeping our fees fair and reasonable, our knowledgeable team members are the go-to experts in dental insurance benefits, and we’ll be happy to help you make the most of these benefits. If you need help understanding your dental insurance plan or want to find out more, don’t hesitate to call our Pittsburgh dental office team. We will do our best to answer your questions and help you to better understand your dental policy.

How Dental Insurance Works

Smiling woman in dental chair

Every dental insurance policy is unique to the individual. You will be given the opportunity to choose between insurers, plans, premiums, and even specific treatments in many cases. In order to provide an accurate estimate of coverage, we will want to review your individual policy and/or apply for preapproval through your insurer. In most cases, patients will receive some combination of the following coverage:

  • 100% preventive care covered
  • Minor restorative care around 70%-80% covered
  • Major restorative care around 50%

What is the Difference Between Dental & Medical Insurance?

Dentist and patient looking at digital x-rays

There are numerous differences between dental insurance and medical benefits. Probably the most obvious difference is what treatments are covered. Medical benefits are used most often for continuing care for chronic and serious illnesses as well as emergency services. Dental benefits focus coverage on prevention. The majority of dental health concerns can be completely avoided with regular preventive care, so by visiting us twice a year, you’ll maximize your insurance coverage and keep your smile healthy.

In-Network VS Out of Network Dentistry

Smiling young boy in dental chair

While every dental insurance policy is different, most plans will provide coverage for patients who visit in-network or out of network dentists. We are happy to process and file both in and out of network claims. Keep reading to learn more about the difference between in-network and out of network benefits in our dental office.

In-Network Coverage

If we’re in-network with your dental insurance provider, we have agreed to pricing that falls within the limits set by their benefit plans. Many people don’t realize that dental insurer’s offer coverage for treatment up to a maximum price. For instance, if the plan covers 80% of the cost of specific treatment, the insurer will cap the price they cover, and in-network dentists agree to charge this price or a lower fee, so you are only responsible for the out of pocket percentage of the cost of care. We are in-network with the following dental insurance providers:

  • United Concordia
  • Humana
  • University of Pittsburgh Medical Center Insurance
  • Aetna
  • Delta Dental
  • MetLife
  • Guardian
  • GEHA
  • Cigna

Out of Network Coverage

Even if we’re not in-network with your dental insurer, we will do our best to charge fees that fit their treatment maximums, but if we do have treatment charges that are higher, you may need to pay the difference in pricing as well as your out of pocket percentage of treatment costs. We do our utmost to minimize out of pocket costs, but if you’re ever concerned about your coverage or treatment pricing, please let one of our team members know. We’ll do our best to help.