32 E. North Ave
Northlake, Il 60164
708 562-1105
fax 708 562-1283
kpr2thfxr@drrojek.com
Keith P. Rojek DDS PC
Caring about you and your Oral Health.......

Dental Insurance

Dental Insurance: The Basics

Many people have not been informed of the basics of Dental Insurance. This page tries to explain what you can expect from your Dental benefit coverage

To all our valued patients:

We have recently noticed a trend of dental insurance coverage and benefits provided to you by employers being reduced. This means insurance companies and your policy may be covering treatment at reduced percentages. This is a way to cut benefits to you and reduce costs to the employer by giving you insurance that covers less. We have seen reductions from 100% for preventative treatment to 80%, and routine restorative from 80% on average to 70% and even 50%. Increases are being made in deductibles, and Insurance plans are also changing the frequency of when some benefits are paid.

WE HAVE NO CONTROL OVER THE BENEFITS THAT YOUR EMPLOYER PURCHASED FROM YOUR INSURANCE COMPANY. Insurance plans are not all alike. Just like you may buy different cuts of meat, an employer can buy different plans providing different amounts of coverage and different items being covered or not for different premiums. The amount of coverage is set forth in a contract between employer and insurance company, and cannot be changed. This is why you may see more out of pocket expense to you even though we have had no fee increases.

It is important to review your benefits policy and your explanation of benefits (EOB) when you receive it as well as any random notices by insurance companies to see if the insurance company is providing you with proper benefits. You can and should request help with your policy from your employer that provided it, and we can explain benefits if you bring us the EOB. We do not always receive the EOB from the insurance company issuing benefits which makes it difficult for us to determine what was paid. As always we will submit your claim, with all necessary information, and follow up with supporting narratives or letters supporting your claim.

We feel you should receive all benefits coming to you and we will do all we can to help you within the legal framework of that contract.

Dr. Rojek has always felt that the best treatment for the patient should be determined by the patient and independent doctor after thorough examination and discussion of available treatment availability and options, not determined by someone who has not examined you and does not understand your individual needs. This prevents the insurance company from limiting any type of treatment available by profit motives and leaves the decision to the patient.

 

 

YOU ARE IN CONTROL OF YOUR OWN HEALTH. YOUR HEALTH IS THE MOST VALUABLE THING YOU OWN. CHOOSE TREATMENT THAT IS BEST FOR YOU AFTER TAKING INTO CONSIDERATION ALL OPTIONS. In these difficult economic times, it is important to manage all your health, be wise with your choices, continue to practice prevention, and to address problems when they are small and more easily and cost effectively handled.

For those Patients who do not have dental insurance or are about to lose dental insurance, we have a membership plan to help you with your dental needs:

for info on the new Smart Dental Discount plan go to :
http://smartdental.info/

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