Frequently Asked Questions
We welcome your questions! Below, we’ve assembled a growing list of our most asked questions with answers. Don’t hesitate to reach out if your question isn’t answered here.
What is a deductible?
A deductible is the total amount that a patient must pay before your dental benefits carrier (insurance) helps with the costs of treatment.
For example: Say you have a $100 deductible and you need a crown that costs $600. You will need to pay your share (the deductible of $100) before your insurance pays its portion of the remaining $500.
Do I need to pay my deductible at every visit?
No. You are only responsible to pay your deductible once every plan year. So, after you have met your deductible, your coverage will kick in immediately if you need other services before the calendar year on your benefit plan ends.
Under most plans, you do not have to pay your deductible to receive preventative care such as exams, x-rays, and cleanings. Your plan benefits will likely cover these services 100% – at no cost to you.
Make sure you schedule regular preventative checkups! 🙂
What is my Co-Insurance?
Co-insurance is a percentage of the cost you are responsible to pay for dental treatment.
For example: If you are using an in-network dentist and you co-insurance is 20%, then your dental befit plan will cover the remaining 80% of your bill. So, a $100 service will cost you $20 out of pocket if you have met your plan’s deductible already. Your plan will then cover $80.
When do I pay my Co-Insurance?
Co-Insurance payments are due at the time of service. Innovative Smiles, along with other providers, have a contractual obligation to collect co-insurance payments at that time.
What is a CO-PAY?
A CO-PAY is a fixed dollar amount that you pay for a covered service. Typically, only dental HMO plans require a co-pay. This amount doesn’t change, no matter how much Innovative Smiles charges.
For Example: If your CO-PAY is $20 and Innovative Smiles’s fee for a covered service is $200, then you still pay $20 while your benefit plan picks up the rest of the bill.
CO-PAY’s are due at the time of service as Innovative Smiles has a contractual agreement with your insurance to collect it at that time.
Do I have to pay a CO-PAY and Co-Insurance?
Sometimes. This will depend on your insurance benefit plan and other factors. We can help you understand what your payment obligations will be, but it’s always best to ask.
Have a Different Question?
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Or call — 216 721 0500