The Role of Dental & Medical Insurance in Our Practice

Our practice focuses on providing high quality holistic, biocompatible dental care to each patient we see. We take the time needed to do procedures correctly the first time. Rushing through appointments to see more patients can cause problems later.

Providing biological dentistry requires great care, skill, and judgment from each member of our dental team. We stay up-to-date through continuing education and use the best systems. This helps us give predictable, beautiful results.

Unfortunately, the way we do dentistry at the Laguna Hills Center for Sleep Apnea & CPAP Intolerance is in many ways at odds with how dental insurance works, especially when treating obstructive sleep apnea (OSA) and temporomandibular (TMJ) disorders (TMDs).

insurance formsDental insurance can help cover some of the cost of quality dental work, but it is not the same as medical insurance. Dental plans have fee schedules and annual maximums based on averages. Coverage depends on what an employer negotiates.

Dental insurance mainly lowers costs. Many routine services are not covered. Companies say plans cover 80-100%, but reality is more like 25-60% because of limitations.

Medical insurance will sometimes cover some of the cost of treating OSA and TMDs, but not always and not all of it. This is especially the case with a practice like ours, where we offer BPA-free, biocompatible appliances and longer lasting, drug-free holistic therapies for TMD, and where you get more one-on-one attention than you would at your typical dental office.

We believe that our comprehensive approach offers a much greater value to our patients than the minimal treatments covered by insurance. We believe that we would be doing a disservice to our patients by letting insurance coverage dictate the care that they receive.

Insurance interferes with the doctor-patient relationship. We believe this relationship is sacred and makes our practice special. Insurance takes on risk, which is why “dental insurance” is a misnomer. Companies want to profit, not care for your health. They limit the range of treatments available to you based not on your needs but their bottom line.

Insurance companies should NOT be in charge of your health. You and your doctor should. Your insurance company doesn’t know you or your needs. You and your doctor do.

We provide excellent care regardless of insurance limits. Many patients choose us though insurance directs them elsewhere.

Whether we are in network or out of your particular benefits plan, we’re happy to submit claims and paperwork to your insurer. We just cannot guarantee coverage. We will estimate what insurance may cover, but you are responsible for any uncovered services.

Please discuss any concerns openly with us. We will recommend treatment based on your needs, not what insurance dictates. Insurance can help with costs, but in our office, it does not drive treatment decisions.

Your well-being is our priority.