Insurance Tips

Dental Implant Coverage

  • Many patients have opted out of pursuing dental implant treatment due to a lack of understandingwhen it comes to their respective dental benefits.
  • Although some dental policies state that there is no implant coverage under the plan, many patients are not aware that in some instances,  their respective dental plan will have what insurance companies refer to as "Alternative Benefits Clause"
  • Alternative Benefits Clause or ABC may allow a reimbursement towards an expense that would normally not be covered or may limit a reimbursement to the cost of a less expensive dental service.  

* For more information, please contact Museum Dental


Accidental Dental Coverage

  • Outside of your regular dental benefits, most healthcare benefits package have what is called a "Dental Accident Benefit"
  • "Dental Accident Benefit" covers most dental treatments from as simple as a filling to major treatments such as crowns and bridges.
  • A dental accident report must filled out by your dentist in order to make a claim.
  • By utilizing this component of your benefits, you do not tap into any of your regular dental benefits.

*For more information, please contact Museum Dental.


Frequency of Hygiene appointment or better known as “Cleaning appointment” 

  • Taking good care of your mouth, teeth and gums is a worthy goal in and of itself.  Good oral and dental hygiene can help prevent bad breath, tooth decay and gum disease and can help you keep your teeth as you get older. Thus, consistency and frequency of dental hygiene visits are very important.
  • Many patients require a 6 month routine for dental hygiene/cleanings but have opted to lessen the frequency based on what their dental benefits dictate.
  • This is where the importance of understanding your respective dental benefits come in.
  • When inquiring about your eligibility and how often you are allowed to have cleanings, it is important to ask the right questions.
  • Dental hygiene appointments/cleaning are billed based on units of time (each unit represents 15 minutes).   Therefore, it is helpful to know the number of scaling units your specific dental plan allows.
  • For example; if a plan allows 12 units of scaling per calendar year, this means that a patient can have cleanings as often as necessary as long as they do not exceed the scaling units allowed.  With that said, the allowed dollar maximum must also be taken into consideration.