What is a pre-treatment estimate, or predetermination?
Think of a pre-treatment estimate as a fortune-teller and crystal ball – it predicts the future of a dental procedure. The difference is, pre-treatment estimates are accurate. A pre-treatment estimate, or predetermination, is when your dentist submits a pre-treatment plan to your insurance company before treatment begins to determine one or more of the following: your eligibility, covered services, amounts payable, co-payment and deductibles, and plan maximums. This helps you plan for exactly how much a dental procedure will cost you according to your dental plan.
Why would you want to get a pre-treatment estimate?
- You’re planning to have extensive dental work, such as crowns, wisdom teeth extractions, bridges, dentures or periodontal surgery.
- To see if a procedure is covered under your dental plan.
- To see if you’re going to exceed your maximum.
Before you schedule an extensive dental treatment, ask your dentist for a detailed cost estimate. Next, your dentist will submit the procedure cost to your benefit provider (i.e. Delta Dental of Virginia) for an estimate. Your dentist may have to submit X-rays or supporting documents. Finally, your benefit provider will send you and your dentist the final estimate.
After you receive the estimate you’ll know:
- How much your plan will pay toward treatment
- Your out-of-pocket financial responsibility
- The amount remaining toward your deductible (if applicable)
- How close you are to your benefit maximum
While many aspects of your future remain unknown, pre-treatment estimates act as the tarot cards of the dental world. Get an accurate picture of what your next dental procedure has in store for you.
Remember, coverage details will differ depending on your benefit provider, as well as your specific plan. If you’re a Delta Dental of Virginia subscriber, log in to the Subscribers area to get more details on your plan.
Not a Delta Dental of Virginia subscriber? Get more information on our plans and enroll today!