Insurance has a reputation for being incredibly confusing – but it’s primarily the terminology that makes the system difficult to navigate. If you’re hoping to get full dentures but want to know more about whether your insurance will cover all or part of the cost, you just need to know the right questions to ask. Here’s how to verify coverage before you start the process.
How to Verify Insurance Coverage for Full Dentures
Step 1: Contact your insurance company. On the back of your insurance card is a customer service number. Call that number to speak with a representative.
Step 2: Take notes. When you get through to a representative, ask for their name or representative number so you can follow up if needed. Keep a pen and paper in front of you and take notes throughout your conversation. Don’t be afraid to ask clarifying questions if needed, or to call back with additional questions if they come up.
Step 3: Ask if your policy covers full dentures. This will likely not be a straightforward answer and will require lots of follow-up questions on your part. Make sure you’re taking good notes so you understand exactly how the process works.
Step 4: Ask about the pre-approval process. More than likely, if your insurance covers full dentures there will be an approval process that needs to happen first. Ask specifically about the conditions that would warrant the approval of full dentures, what documentation your insurance company needs, and how long the approval process takes.
Step 5: Verify that your preferred provider is contracted with your insurance company. While you’re still on the phone with your insurance company, inquire as to whether your preferred denturist is contracted as a preferred provider. Even if your insurance covers full dentures, there could be significant financial consequences if you use a provider that is not contracted.
Step 6: Check the level of coverage. Ask about how much of the cost of full dentures your insurance will cover. They may cover the full cost, or they may cover a percentage of it. You may have a deductible you need to meet first, after which they will cover a portion. Also ask about the maximum cost they will cover.
Step 7: Work with your denture provider to get approval, verify coverage, and give you an out-of-pocket cost estimate. Once you’ve done your portion of the work, have your denture provider contact your insurance to begin the pre-approval process and to verify coverage on their end. Also ask for a breakdown of costs, including what they believe insurance will cover and how much of the cost will be your responsibility.
Step 8: Make a plan for payment. If your insurance will not cover the cost of full dentures or your out-of-pocket portion is not affordable for you, see if your denture clinic offers payment plans to help make dentures more financially accessible.
Always Do Your Homework
Most denture clinics will work directly with your insurance company and verify coverage – however, never let that be a substitute for doing the legwork yourself. It’s important that you call directly to get as much information as you can, and to make sure that information matches the estimate given to you by your clinic. After all, at the end of the day you are responsible for the final cost so it’s important that you do your homework prior to getting dentures.
Affordable Dentures in Everett, WA
If you’re ready to get dentures, European Denture Center is ready to help. We will work directly with your insurance company to verify coverage and give you a transparent pricing estimate before any work is done. We also have experience with and accept many types of insurance, including Medicaid, and offer a number of payment plan options to help keep your costs affordable. If you’re ready to learn more contact us today for a free, no-obligation consultation. Make this the year you get your smile back!