Dental care and treatment can be very expensive and unaffordable for most individuals and families. However, dental insurance can save the day, especially for treatments that you cannot pay out of pocket. Dental insurance refers to health insurance coverage that pays part or all of the cost of your dental or oral care. Sadly, many people are unaware of how dental insurance works. We can help you with that at Northridge Dental Implant Center. We will ensure you understand what dental insurance is, available insurance plans, your options, and how to make the best choice for your or your loved one's oral health in Northridge.

In-Network Insurance Plans:

  • Dentical
  • Aetna PPO
  • Aetna HMO
  • Anthem PPO
  • Cigna HMO
  • Delta Care USA
  • Delta PPO
  • Delta Premier
  • MetLife HMO
  • MetLife PPO
  • UHC / DBP Fee Schedule
  • GEHA / Connection Dental
  • Humana PPO
  • Humana Medicare
  • Humana EPO
  • Liberty PHP
  • HealthNet PHP / DentaQuest

Out-of-Network Dental Insurance Plans

We also work with patients who have out-of-network dental insurance benefits. Our office can file claims directly with your insurance provider on your behalf to help you maximise your available benefits.

Depending on your specific plan and coverage, you may be responsible for the difference between our office fees and the amount your insurance company allows. Our team will review your benefits before treatment and help you understand your estimated out-of-pocket costs.

Have questions about your coverage? Contact our office to request a benefits check before your appointment.

Dental Insurance Plans We Do Not Accept

While we work with a variety of dental insurance providers, certain plans may not be accepted at our office, including select Medicaid, state-sponsored, Medicare, DHMO, and other excluded plans.

Insurance participation can vary depending on your employer, specific plan, and coverage details. We recommend contacting our office before your appointment so our team can verify your exact plan and confirm whether it is accepted.

Important: Not all plans offered by the same insurance company have the same coverage or network participation. We verify the specific plan listed on your insurance card rather than relying solely on the insurance company's name or logo. This helps ensure you receive accurate information about your benefits and coverage before treatment.

Reasons to Consider Dental Insurance

Oral health is as important as your general health. That is why dentists emphasize taking good care of your teeth, gums, and jawbone, receiving regular dental examinations and checkups, and treating any oral or dental issues before they escalate. However, all this can be very expensive, especially if you need regular dental care or treatment. You may also need to pay more if you are in charge of your family’s dental care. Fortunately, you can enjoy some financial relief if you have dental insurance.

Dental insurance gives you financial protection, so that you can access regular dental care without worrying about the cost. Just like any other insurance plan, you pay a small amount regularly, and your insurance provider covers part of your dental care costs, or the full amount, depending on the type of dental care you need and your insurance plan. It is also an excellent way to pay for unexpected or emergency dental costs.

Dental insurance gives you access to preventive dental care. Most insurance plans cover regular preventive services like dental examinations and checkups, professional dental cleanings, and X-rays, which are typically done biannually. Your insurance provider can pay for preventive care without requiring an additional out-of-pocket payment. Preventive dental care ensures you enjoy excellent oral health throughout your lifetime.

It also covers early detection of dental and oral issues. Remember that dentists encourage regular examinations and checkups to spot minor and major dental problems at their earliest stages. Early detection is necessary to prevent major dental issues like cavities and gum disease. If left undetected and untreated, these issues can quickly escalate into painful and expensive-to-treat conditions.

Dental insurance aims to lower your treatment costs. Remember that you pay a small amount monthly to receive full or partial coverage when you need treatment. In most cases, dental insurance plans share the financial burden of dental treatment, especially for major services. The exact way this is done depends on your insurance plan and the insurance company you use.

Dental insurance also covers emergency care. Remember that dental emergencies happen when you are least prepared to pay for treatment. If you or a loved one suffers a sudden broken tooth, dental trauma, or severe infection, you can receive the required urgent treatment without worrying about the finances.

What Is Covered by The Dental Insurance Plans Accepted at Northridge Dental Implant Center

If you seek treatment at our Northridge Dental Implant Center, first determine the benefits you will receive with your dental insurance. This helps you make the final decision regarding the treatment you or your family needs. Generally, most dental insurance plans cover the following:

Preventive Dental Care

These include services that prevent dental and oral issues like enamel wear, gum disease, and cavities. In addition to habits you can adopt at home to protect your teeth, gums, and jawbone, such as brushing and flossing, we offer professional preventive services at our facility. They include routine checkups and examinations of your teeth, gums, jawbone, and other areas within your mouth. These help us spot early trouble before it becomes difficult and expensive to treat.

Our professional preventive dental care also includes dental cleanings that remove stuck food, buildup, and stains from your teeth. They also lower your risk of gum disease and cavities.

Most dental insurance providers also cover diagnostic services like dental X-rays, which are necessary for regular examinations and diagnoses. These can reveal serious issues that can go undetected, like hidden cavities, dental fractures, or jawbone loss.

Your insurance plan may also include fluoride treatments, which remineralize your enamel every six months, and dental sealants that reduce your risk of dental decay.

Basic Dental Procedures

Most dental insurance plans also cover basic dental procedures like tooth extractions and fillings. Although these are not very expensive, a need may arise when you are least prepared to pay for it. Insurance also makes such services accessible for individuals and families. Generally, dental insurance plans cover up to 80% of the cost of these basic procedures. This means you pay way less for basic dental care than you would without insurance.

Some Major Procedures

Dental insurance also covers some major dental procedures like dentures, bridges, and crowns. If you need a major procedure for preventive or curative purposes, your insurance provider may be willing to pay part of your treatment. Generally, major procedures are expensive. Insurance coverage makes them affordable for families and individuals who would otherwise be unable to afford them. However, there may be waiting periods before you are approved for coverage of a major procedure.

Some Orthodontics and Implants

Remember that dental insurance plans primarily cover procedures that provide preventive or curative benefits. This means that some treatments like orthodontics, implants, and cosmetic dental procedures may not be covered under your insurance plan. However, this mainly depends on your plan. Always talk to your insurance provider before signing up for a major procedure to find out whether your treatment is covered under your plan and how much you need to top up out of pocket.

Note: Dental insurance plans typically have annual maximums ranging from $1,000 to $2,000. A typical coverage can pay from 80 to 100% of your treatment for preventive care, and from 70 to 80% for a basic procedure. If you qualify for coverage for a major procedure, your insurance provider can pay up to 50% of your total treatment costs. These percentages are only general examples and do not guarantee coverage. The actual coverage will depend on your specific plan, exclusions, policy limitations and how your benefits are determined.

Preparing for a Dental Insurance Visit

If you have dental insurance, it is important to start using it immediately after a need arises. However, you have to inform your dental care provider that you have insurance and determine how much your plan will pay for your treatment before starting the treatment.

When you come to us for treatment, we will ask for proof of your dental insurance. Most dental insurance patients have a card as proof of insurance. Our dentists will accept pictures of the front and back of your insurance card. Then, they will verify your eligibility for coverage, depending on the kind of insurance plan you have. The card provides details of your insurance plan, annual maximum, and coverage limits for different types of treatments, such as preventive, minor, and major procedures.

Depending on your eligibility, your deductible, and the remaining amount from your annual maximum, we will estimate how much you will pay out of pocket for the treatment. This is important to determine early, so that you will be prepared to make full payment once the procedure is done.

Our dentists will then discuss your options with you. If you choose to proceed with the treatment, we will submit an insurance claim to your insurer after this visit. Then, we will wait for your insurance provider’s approval before starting the treatment.

Remember that although some major dental procedures like implants, crowns, and orthodontic treatments could be covered under your insurance plan, you may need prior authorization from your insurance provider before submitting your claim.

If you recently obtained dental insurance, you could be subject to a waiting period of three to 12 months. This is the waiting period you must wait before you can use your coverage for a basic or major dental procedure. Your insurance provider will provide you with the exact timeline of your dental insurance plan to support effective planning and decision-making.

What To Carry To Your Dental Insurance Appointment

If you have a dental care need and would like to use your dental insurance to pay part or all of the cost of your treatment, you need to know what to bring to your next dental appointment. This is important to ensure that you have the right documents and insurance items with you. The items you need include the following:

  • Your physical insurance card or digital proof of dental insurance. This proves to your dental care provider that you have insurance coverage. The digital proof could be a picture of the front and back pages of your insurance card.
  • You must also provide a photo ID or national ID to verify your identification. Your dental and insurance providers will prefer a national ID card, driver’s license, or passport.
  • If you want a dental procedure that requires prior authorization from your dental insurance provider, you need to provide pre-authorization documents from your insurance provider. This is also needed if you need a dental procedure that will likely be costly, such as a dental crown, implant, or root canal therapy.
  • If your employer sponsors your dental insurance through a group plan. You need to provide your employer’s name to verify this information. Remember that your dental care provider will proceed with the treatment once they receive confirmation that the treatment you need is covered under a dental insurance plan.

In addition to these requirements, it is always important to have a medical and dental care history when going for a dental checkup or treatment. This provides your dentist with information they may need to give a proper diagnosis or treatment recommendation. You could have a written list of all the medications you are taking, including over-the-counter drugs and their respective dosages. You also need to provide information about any allergies and underlying medical conditions you have. If you have undergone any diagnostic tests recently, like dental X-rays, bring copies of the test results to this appointment.

Additionally, if you need the procedure done sooner rather than later, be prepared to make any out-of-pocket payment expected of you. This way, you will undergo treatment as soon as your insurance provider approves your claim.

What Happens If You Do Not Have Dental Insurance?

Not having dental insurance does not disqualify you from receiving dental care. You will be treated like every other patient, but will pay for the services out of pocket or through other payment options, except for insurance coverage. Having dental insurance helps cover part of your treatment, so you only pay a small percentage of the total cost, depending on your plan. Thus, you can visit your dentist’s office even without dental insurance.

This also applies to patients with dental insurance whose dentist does not accept it. If you need services and your dentist does not accept your insurance, you can still pay out of pocket or through another acceptable payment plan. Discuss your options with your dentist beforehand to ensure you are well prepared when it is time to pay.

If you fall into any of these categories, our skilled dentist at Northridge Dental Implant Center will begin by explaining acceptable payment options for prior preparation. You can pay for the services in cash or using a credit or debit card. If this is your preferred mode of payment, they will go ahead to examine you, develop a treatment plan, and provide the estimated or actual cost of treatment.

Some dentists also accept in-house membership plans, whereby you can pay small amounts in manageable installments based on the total treatment cost and your income or financial capacity. If you really need an expensive dental procedure and cannot fully pay for it, this is an excellent option to explore.

Our skilled dentist will also discuss other financing options available to you, such as CareCredit services. In this case, a financier pays for your treatment, and you then repay them in reasonable installments with a predetermined interest rate. With so many options available for you, you can still receive adequate dental care for any personal or family need even without dental insurance.

However, it is always good to explore these options before starting your treatment. Remember that there are many available options. You want to understand what each entails to choose the most appropriate one for your needs and financial ability. Thus, discuss payments first, even before booking your treatment appointment.

Answers To Your Most Frequently Asked Questions

Here are the responses to some of the frequently asked questions about Northridge Dental Implant Center:

Do You Take Delta Dental, Cigna, MetLife, or Aetna?

At Northridge Dental Implant Center, we accept most dental insurance. We accept Delta Dental, Cigna, MetLife, and Aetna, and any other PPO insurance plan. However, we do not accept Medi-Cal, HMO, or Denti-Cal plans.

Are you an In-Network or Also an Out-of-Network Provider?

We are fully in-network with all major Delta insurance networks, including those mentioned above. We maintain an active in-network contract, which helps keep our patients’ costs down. Thus, we strictly do not handle claims out of network.

Do you Verify Client Dental Insurance Details Before An Appointment?

We are always ready and willing to review your insurance plan and verify your benefits before your appointment. This helps you make an informed decision about the kind of treatment you should pursue. It also prepares you for what to expect once the services are rendered.

Do you Accept Dental Plans Like DHMO and HMO?

We do not handle DHMO and HMO claims. This is because we are strictly an in-network provider, offering services only to patients with insurance plans with PPO tiers. This means that we do not accept claims from outside the PPO network.

Are Medicaid and Medicare Acceptable?

Fortunately, we accept programs like Medicare, Medicaid, or state medical programs like Denti-Cal and Medi-Cal. Although most private dental clinics are not registered as providers for a government medical program, we are an exception.

What To Do if I Have Exhausted My Plan’s Annual Maximum?

If, after evaluation, we establish that you have maxed out your insurance coverage for the year, we will discuss alternative treatment options available for you. This is because your insurance provider will not pay for your treatment until your benefits reset. This means that you will still receive treatment, but on different payment terms. Since we are in-network, you can enjoy lower, pre-negotiated insurance rates instead of paying the usual rate.

Can I Receive Treatment if You Have Not Listed My Insurance Plan?

Everyone who comes to us for treatment is eligible for our services, even if they do not have dental insurance or their insurance plan is not accepted in our facility. The first thing we do once you come in is determine whether you have insurance and what your payment options are. Thus, if your insurance is not acceptable, we discuss other payment options available for you.

Find a Reliable Dental Implant Center Near Me

Dental implants are an excellent solution for your missing teeth, as they provide stability, permanence, and longevity for your tooth replacements. However, they are very costly and unaffordable for many individuals and families. Having dental insurance helps cover part of the cost or the entire cost of your treatment.

If you or someone you love needs a dental implant in Northridge, we can help at Northridge Dental Implant Center. We offer quality dental services through our highly skilled, experienced, and certified dentists and periodontists. We also offer affordable dental care for all patients, whether or not you have dental insurance. Call our office at 818-925-9181 to learn more about our dental insurance services.