Insurance Considerations

Dental Insurance Facts

Dental insurance plans are designed to share in dental care costs rather than completely covering them. All plans have certain coverage limitations including yearly maximums and annual deductibles. These amounts vary between plans and insurers.

The amount of payments made by insurance companies, allowable fees and other specifics are governed by each policy and the premiums you pay. Each insurance company and coverage plan imposes maximum reimbursable amounts for eligible services, known as “Usual, Customary and Reasonable” (UCR) charges. The insurer pays either that plan’s UCR limit or an established percentage of the dentist's fee, whichever is less. Although such limits are called "customary," they often do not reflect what dentists in the area are charging.

The fact that a dentist’s charges exceeded an insurance company’s limit does not mean that you were overcharged. This is because there are no regulations as to how insurance companies determine reimbursement levels, which results in wide fluctuations. In addition, insurance companies are not required to explain how their "usual," customary and reasonable" amounts are determined.

Our Insurance Practices

At W. Todd Rogers Dental, our fees are based upon a combination of direct costs, time expended, and a constant dedication to providing our patients with the highest quality dental care available. Our treatment recommendations are never based on what your insurance will pay, because we believe that your dental well-being should not be governed by an insurance company. We strive to remain informed regarding the coverage provided by various plans, but constant changes make this very difficult.

We accept most of the dental insurance plans provided by the employers in the Colorado Springs area. We are an in-network provider for the following insurance companies:

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As a courtesy to you and your family, we do everything reasonably possible to process your insurance claims and maximize benefits. However, there are times when problems arise that only you be resolved between you and your insurance company. On those occasions, we ask that you promptly respond to any requests so that your claim can be processed in a timely manner. Please remember that dental insurance is a contractual agreement between the patient and an insurance company, and the policy holder (patient) is ultimately responsible for all charges.

Please take the time to carefully review our services contract and do not hesitate to ask for additional information about our services, billing and payment policies or dental benefits.

The Research Parkway Dental Plan

We are aware that many patients do not have access to dental benefits. To those individuals and their dependents, we are pleased to offer the Research Parkway Dental Plan ("The Plan").

The Plan was designed by Dr. Rogers to provide quality care for patients who do not have conventional dental insurance. The Plan represents a unique dental value. While many conventional insurance plans offer only partial benefits for the most frequently needed services, all dental services offered in our office are a covered benefit of The Plan.

  • NO MAXIMUM: Unlike dental insurance, there is no cap on the amount of discounted dental work you can have done in a year.
  • NO DEDUCTIBLE: Most conventional insurance plans require that you meet a deductible each year. The Plan lets you begin using your benefits immediately without first meeting a deductible.
  • NO PRE-EXISTING CONDITIONS: No conditions are excluded from treatment under The Plan simply because they existed before coverage started. For example, we will extend the discount for replacement of teeth which were removed before you joined The Plan.
  • NO WAITING PERIOD: Coverage will begin on the day you sign up and make the first year's payment, and will be effective for one year from the date you sign up. You may renew The Plan each year.

What Is My Annual Fee?

  • The annual fee is $250.
  • One dependent +$150;
  • Two or more dependents +$175.

How Does The Plan Work?

  • When you enroll, you're eligible for one full year from the date you sign up. The benefits, which range from 15% – 100% off of all dental services in our office, begin immediately.
  • 100% off of your first New Patient visit, which includes a complete oral examination, full set of X-rays, cleaning and fluoride (estimated savings of $319 ). If you are an exisiting patient, there is no charge for your your first regular recall of that year.
  • 50% off your next regular six month's cleaning, exam and fluoride (estimated savings of $77 ).
  • 15% off any and all other services we provide in our office.

Example: A crown with build-up is currently $1250.00. With enrollment in The Plan, you pay only $1062.50, a savings of $187.50! An implant and abutment with an all porcelain crown is currently $3,600.00. 15% off as a member of The Plan = $540, for a final
cost of $3,060.00.

Again, you can have as much dental work as you want with a 15% discount. There is no maximum benefit as with conventional dental insurance plans.

Who Is Eligible For The Plan?

You and your spouse (if applicable) are eligible. Your children under the age of 19 or full-time students under the age of 25 are also eligible as your dependents under The Plan .

How Do I Join?

Simply fill out the enrollment form available from our office and pay the first year's fee. Then, schedule your first appointment and enjoy your new reduced-fee dental benefits immediately!