Out of Network Basics
Dental insurance plans help pay dental costs by setting up a network of dentists, under contract to the insurance
company, to provide services at a discounted fee. While patients are free to choose a dental provider within the
network, many plans also allow patients to seek a dentist outside of their network. Patients who opt for an out of network
dentist are often able to use the available benefits from within their existing dental insurance plan to help offset
costs.
The common theme today when insurance denies or reduces benefits, is to imply that the care is not needed or the fee was too high. This is typical, as insurance provides only average care with the lowest cost alternatives to help maintain their plan
premiums. Unfortunately, many patients are losing the freedom to make their own choices regarding the selection of their
healthcare providers.
Dental insurance was first introduced in California in 1954; at this time benefits were $1,000 per year. Today, many
plans range from $1,000 to $2,500 per year. If you were to adjust this amount for inflation, dental benefit maximums
should be at $10,000 per year.