Health Net Dental PPO Missing Tooth Clause, Limitations, Frequencies, and Exclusions
Health Net Dental PPO insurance has one of the largest dental networks in the state of California. Sunnyvale Dentist Dr. Antonious participates in this dental network and welcomes patients with this coverage. At Sunnyvale Dental Care patients who have insurance policies from Health Net Dental PPO insurance receive lower fees for treatment than they would if they sought out dental care from a dentist who was not an in network provider. Sunnyvale Dental Care offers a wide variety of general and specialized services for patients of all ages.
Most dental insurance carriers including Health Net Dental PPO have rules that affect coverage for certain services. It is important to understand these rules in advance to avoid the unpleasant surprise of having a bill denied. Each individual plan even within the same insurance company has different variables. For instance, it is common for many dental insurance plans to have a missing tooth clause. If this clause exists with your plan, the insurance carrier would not pay any portion of the cost to replace a tooth that was lost prior to the plan start date. This would include implants with crowns attached, fixed bridges, partial dentures, and full dentures. Limitations and frequency rules exist with almost all dental insurance plans. A patient may be limited to two dental cleanings per year. Fluoride treatments may be limited to patients under 14 years of age. Certain x-rays may only be covered once per year. Other services may be excluded such as bone grafts, sinus lifts, implants, night guards, and braces.
How do you find out what the rules are for your particular dental insurance policy? The staff of Sunnyvale Dentist Dr. Antonious would be happy to contact Health Net Dental PPO insurance for you to request a detailed report on your chosen insurance plan that would include information on any exclusions, limitations, frequency rules or a missing tooth clause. They will need the identification number and date of birth of the insurance subscriber, and if the subscriber is not the patient, the patients date of birth to access this information.