Insurance Information

At Cary N. Goldstein, DDS, Inc., we work hard to control the cost of dental care. It is part of our philosophy that quality care should be available to everyone. Prior to initiating treatment, we will go over our estimate of charges with you. We accept most insurance plans that do not require you to go to a specific network. In general, insurance usually covers 100% of preventive services like examinations, X-rays, and cleanings; 80% of basic services like simple fillings, root canals, and gum treatments; and 50% of major work like crowns, porcelain onlays, and bridges. Insurance caps out annually at a set amount, usually $1,000. Unfortunately, this amount has not risen since insurance began in 1960. So in essence, insurance will cover your 2 preventive cleanings and X-rays a year, and maybe some small fillings, or even 1 root canal or crown/onlay (not both). It will not cover any major reconstructive work to your teeth, bite, and smile.

Estimating co-payments is often a difficult task because some insurance companies try to prevent you from obtaining your maximum benefits in an effort to control costs. They may use a technique called down coding or the alternate benefit clause to prevent you from getting the services you require and desire. They may substitute less desirable and less expensive treatments like a silver/mercury/amalgam filling instead of a more appropriate porcelain onlay or crown. (A silver/mercury filling costs $200.00 vs. a porcelain onlay or crown which may cost $820.00). Only the Dentist can determine what treatment is appropriate for you. We will not perform a service that is not desirable for you just because the insurance will cover it. Furthermore, insurance companies often set a maximum allowable limit on a covered service, even though it is well below the accepted usual fee in our area. Then they try to jeopardize our relationship by telling you that the dentist charged too much. When you realize how much annual premium you pay the insurance company, and that the maximum that they will pay is only $1,000.00, you begin to realize whose interest they hold.

As a courtesy, we will submit all insurance claims and provide written narratives when needed to try to maximize your benefits. We may need you to get involved in processing your claim. We cannot force the insurance company to pay what they should pay. You and you alone are responsible for any unpaid balances on your account. After all, insurance is a relationship between you, your employer, and the insurance company. The better the insurance plan, the more it will cover.

Please bring your insurance information with you to the consultation so that we can expedite reimbursement.