Private Insurance Dental Benefits

If your employer provides you with group dental benefits, congratulations.

According to the most recent Canadian Health Measures Survey on Oral Health Statistics, you’re one of only 62% of Canadians with private dental insurance.  Dental benefits reimburse you for a portion of your oral healthcare costs, but these private plans vary greatly and there are no “standard” benefits  or coverage amounts.  Your benefits package was chosen for you, by your plan administrator, HR department or employer.

It is important to understand that while these plans are beneficial dental patients, at Toothworks it is our duty to make recommendations based on your oral healthcare needs, the costs of which may outweigh the limitations of your private insurance.

Furthermore, private insurance plans are an agreement between the insurance carrier and the member. While we make every effort possible to assist you in understanding your benefits, increasingly strict privacy laws may prevent your insurance carrier from providing your dental office with the details of your plan.

For this reason, it is important that privately insured individuals become familiar with their own benefits plans. All major insurance carriers provide their members with online portals where they  can see their insurance coverage details and amounts, remaining balances and pre-determination responses.

At Toothworks, we are able to electronically submit your dental services directly to your insurance plan and if permitted by your insurance carrier, you may choose to be reimbursed directly, or request to have our office accept payment from your insurance. If you choose the latter option, you are responsible to pay for any remaining balance, not paid by insurance.

Regarding Your Dental Insurance Co-Pay