Insurance Information

Did you know even if we are out-of-network with your insurance, your plan’s out-of-network benefit may cover you at the same or similar level as in-network? We have many patients who use their out-of-network without paying additional fees. We are happy to check your coverage information, so please don’t hesitate to call us at 281-947-6111 with your insurance information.

We are in network with most PPO insurance plans. For a complete list of in-network insurances, please contact our office.

  • 90 Degrees Benefits

  • Aetna Dental PPO

  • American National Insurance PPO

  • Ameritas PPO

  • Blue Cross Blue Shield of Texas Dental PPO (DNOA)

  • Boon Chapman PPO

  • Cigna Dental PPO

  • GEHA PPO

  • Guardian PPO

  • Humana PPO

  • Lincoln PPO

  • LineCo PPO

  • Mutual of Omaha PPO

  • Plumbers & Pipe Fitters Local Dental PPO

  • Principal PPO

  • UMR PPO

  • UNUM PPO

  • United Healthcare Dental PPO

As a service to our patients, we check with your dental insurance company to get your coverage detail before your appointment. (So please have your dental insurance information ready when you make your appointment!) We can also submit a pre-treatment estimate to your insurance provider on your behalf if necessary.

Please understand that we file claims as a courtesy to our patients and we do not have a contract with your insurance company–only you do. Because insurance policies vary greatly, we can estimate your coverage in good faith but cannot guarantee it due to the complexities of insurance contracts. Please reach out to your insurance provider directly for any specific questions regarding your coverage and benefit information.

Dental Insurance Fact 1 - NO INSURANCE PAYS 100% OF ALL PROCEDURES

Dental insurance is meant to be an aid in receiving dental care. Many patients think that their insurance pays 90%-100% of all dental fees. This is not true. Generally, most insurance plans will cover preventive and diagnostic care at 100% and provide partial benefits for other services, which can range from 50% to 80%. The percentage paid is usually determined by how much you or your employer has paid for coverage or the type of contract your employer has set up with the insurance company.

Dental Insurance Fact 2 - BENEFITS ARE NOT DETERMINED BY OUR OFFICE

You may have noticed that sometimes your dental insurance company reimburses you or the dentist at a lower rate than the dentist's actual fee. Frequently, insurance companies state that the reimbursement was reduced because your dentist's fee has exceeded the usual, customary, or reasonable fee ("UCR") used by the company.

A statement such as this gives the impression that any fee greater than the amount paid by the insurance company is unreasonable or well above what most dentists in the area charge for a certain service. This can be very misleading and simply is not accurate.

Insurance companies set their own schedules and each company uses a different set of fees they consider allowable. These allowable fees may vary widely because each company collects fee information from claims it processes. The insurance company then takes this data and arbitrarily chooses a level they call the "allowable" UCR Fee. Frequently this data can be three to five years old and these "allowable" fees are set by the insurance company so they can make a net 20%-30% profit.

Unfortunately, insurance companies imply that your dentist is "overcharging" rather than say that they are "underpaying" or that their benefits are low. In general, the less expensive insurance policy will use a lower usual, customary, or reasonable (UCR) figure.

Dental Insurance Fact 3 - DEDUCTIBLES & CO-PAYMENTS MUST BE CONSIDERED

When estimating dental benefits, deductibles and percentages must be considered. To illustrate, assume the fee for service is $100. If your insurance company allows $100 as its usual and customary (UCR) fee and covers 80% for this particular procedure, this is what your breakdown will look like:

  • $50 Deductible (this is an average value)

  • 80% coverage of $100= $80 from insurance; the patient responsibility will be $20.

  • The total due from the patient = $70 ($50 deductible + $20 co-payment).

Of course, if the UCR is less than $100 or your plan pays only at 50% then the insurance benefits will also be significantly less.

We are here to help and answer any questions or concerns you might have. Please don’t hesitate to contact our office!

 

Out-of-Network

 

Many plans provide out-of-network benefits, at the same or similar level as in-network coverage. It means, depending on your insurance plan, you may not need to pay an additional fee or co-pay to see us as an out-of-network provider. We are happy to check your out-of-network coverage information if you are interested in becoming our patient. Please contact our office with your dental insurance information.

While we do not accept any HMO plans, TMHP, and Medicaid through United Health Care at this time, we can provide care as a non-participating provider. Please give us a call at 281-947-6111 to inquire.

 

Secondary Insurance

If you have secondary coverage, both insurance plans must know about each other. When making your appointment, please provide both insurance information. Additional forms may need to be signed at check-in.

Please note we do not coordinate benefits with any Medicaid.

 

Financing Options

The fact of the matter is many dental services are not covered or only partially covered by insurance. When more extensive dental treatment is necessary, financial arrangements may be made with our office.

We accept CareCredit and BHG More Mastercard, which are special financing options for health, dental, and wellness. Please contact us to learn more.