When selecting a dentist, there are many considerations, such as what school did the dentist attend? Have they had a solid reputation? How far is the office from my house? And most importantly, do they accept my dental insurance?
Insurance corporations have conditioned us to think that we can only see doctors who accept our insurance, also known as “in-network providers.” What does that imply, though? The distinction between in-network and out-of-network dental providers will be briefly explained in this article in plain terms that everyone can comprehend.
A network is a collection of healthcare organizations. A provider accepts a negotiated cost for services rendered to the member when an insurance company partners with that provider. A provider who is in-network is one like this. On the other hand, when a service provider doesn’t work with your insurance carrier, your insurer is forced to pay the total cost of their services, increasing both your costs and theirs. An out-of-network provider is one like this.
In-Network VS Out-of-Network Dentistry: Which is Better?
Most customers think that going to an in-network dentist gives them free visits. Said this is untrue! Every insurance policy has specific guidelines or restrictions that apply to its coverage. For instance, some people operate on a charge schedule, meaning they will only pay a portion of a service. Others offer yearly benefits, which means they give you a predetermined cap on how much they will contribute to your dental treatment in a calendar year.
Some have deductibles that must be fulfilled before the insurance provider would pay, and the majority only cover preventative visits. Before enrolling in dental insurance, always read the fine print and ask questions to know what will be covered.
Additionally, by employing scare tactics, insurance providers terrify customers into believing that out-of-network providers are “bad” and more expensive. On their websites, they employ phrases like “avoid paying large out-of-pocket expenditures” and “beware of out-of-network providers.” They fail to mention that even with insurance, out-of-pocket expenses will still apply and that your treatment may be denied or reduced by your insurance provider.
Does this imply that the cost of using an out-of-network service will be higher? This depends, as everything relies on your insurance policy, the care you require, and the conditions established by the insurance provider regarding which treatments they will cover and when. When visiting an out-of-network provider, there may often be an out-of-pocket cost for preventative checkups like cleanings and exams. Contrary to what insurance companies claim, it is typically not a significant sum, and the cost is justified by the long wait times and higher-quality service received.
What is the final verdict, then? As usual, you must put your health and well-being first. However, it is always good to know that you are NOT compelled to see only those inside your insurance company’s network and that you can choose any dental professional. Whether a practice is in-network or out-of-network, you can only go right if you pick one where you feel safe and well-cared for.
The debate about whether in-network dentistry is better or out-of-network, however, totally depends on one’s preferences and how one wishes to be treated. Additionally, each insurance company offers a different set of facilities and benefits, so based on the benefits one provides, their choice can also vary.