In-Network vs. Out-of-Network: What it Means for Your Dental Coverage

When you have dental benefits from Delta Dental of Arizona, you can visit any licensed dentist. However, your benefit plan might have limited coverage for services provided by out-of-network dentists. To ensure you’re saving the most money and receiving your full benefit, it’s always best to visit a dentist in the Delta Dental network.

Here are three things you should know about visiting an out-of-network dentist:

1. Basic care may not be covered. Many dental insurance plans cover most, if not all, preventive services at 100 percent (including basic exams and cleanings) when you see an in-network dentist. If your dentist is not contracted with your insurance carrier, you could pay significantly more for preventive care.
2. Out-of-pocket costs will be higher. One of the benefits to buying dental insurance is, your insurance company (such as Delta Dental) negotiates rates with the dentists in its network to provide you with the lowest cost possible for dental care. This means that the dentist agrees not to charge patients more than the fees determined by the contract. However, out-of-network dentists don’t have this type of agreement with your insurance company. This means out-of-network dentists can charge patients at any rate. Your insurer may not cover these charges, which could result in higher out-of-pocket costs for you as a patient.
3. You may get stuck with extra costs. Because out-of-network dentists are not under contract, they could charge for extra for services that should be included in the cost of restorative treatment, such as local anesthesia and dental impressions. But when a dentist is in-network, they agree to avoid hidden or unbundled fees.

Ready to find a dentist in Delta Dental’s network? Visit Delta Dental online for more information.

Tiffany DiGiacinto is the Director of Marketing and Communications at Delta Dental