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First Dental Health Exclusions

First Dental Health Exclusions

Like most dental insurance companies, First Dental Health PPO will pay for a portion of their members’ dental treatment. The exact percentages and amounts will depend upon the individual policy. Besides the basic coverage information that you’re probably familiar with, there are a few items that Sunnyvale Dentist Dr. Gupta would like to help you understand about dental insurance.

Exclusions: Your First Dental Health PPO insurance plan may have procedures that are excluded or not covered. There can be many reasons why this is the case, but usually it is because there are cheaper options available that they would prefer to pay for. These options may not be better for you as a patient, so Sunnyvale Dentist Dr. Gupta will explain to you the pros and cons of each option so you can make an informed dental treatment decision.

Limitations and Frequency Rules: It would be nice if you could have your teeth cleaned as often as you like, but unfortunately frequency rules determine how many and how often you can receive certain dental services. For cleanings it is usually twice a year or every six months. Exams and x-rays are also subject to frequency rules. Coverage for certain procedures like sealants or fluoride treatments may be limited by your First Dental Health PPO insurance policy to children below a certain age. The Sunnyvale Dental Care insurance coordinator can verify if there are age limits for any procedures on your policy.

Missing Tooth Clause: Sunnyvale Dental Care offers several solutions to replace missing teeth. Bridges, Partial Dentures, Full Dentures and Implants are the most common options. When we request coverage information for you from First Dental Health PPO insurance we will ask if your policy has a missing tooth clause. If so, any tooth or teeth lost prior to you purchasing dental insurance through them would not be a covered expense. Unfortunately you would be responsible for the entire cost.

We welcome you to our office and are committed to helping you understand your insurance policy and utilize it to your full benefit. Please call or stop by to schedule an appointment.

Learn more when you visit Sunnyvale Dental Care. Call Sunnyvale Dentist Dr. Gupta at 408-720-0900 to schedule a consultation today!

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