What To Do When Dental Insurance Won’T Pay

Dental bills can quickly become expensive if your insurance doesn’t fully cover a procedure. If you’ve received a larger than expected bill, don’t panic. There are steps you can take to reduce costs and get the help you need.

Here’s a quick answer: First, review your policy details to understand your coverage. Next, negotiate with your dentist and insurance company. Finally, look into payment plans or dental financing options.

Review Your Dental Insurance Policy

When faced with the situation where dental insurance won’t pay, the first step you should take is to review your dental insurance policy. This will help you understand what is covered, the limitations, and any exclusions that may apply.

By familiarizing yourself with the details of your policy, you can better navigate the claims process and know what to expect.

Check What’s Covered

One of the most important aspects to review in your dental insurance policy is what procedures are covered. Dental insurance typically covers preventive care such as cleanings and exams, as well as basic procedures like fillings and extractions.

However, coverage for more extensive procedures such as crowns, bridges, or orthodontics may be limited or require pre-authorization. Make sure you have a clear understanding of what your policy covers so you can plan your dental treatments accordingly.

Understand Annual Maximums

Another crucial factor to consider is the annual maximums set by your dental insurance policy. The annual maximum is the maximum amount of money that your insurance will pay for dental care within a year. If your treatment costs exceed this amount, you will be responsible for covering the difference.

Understanding your annual maximum will help you budget for your dental expenses and make informed decisions about your treatment options.

Review Pre-Estimates

Before undergoing any major dental procedure, it is essential to obtain a pre-estimate from your dental insurance company. A pre-estimate is an estimate of the costs that your insurance will cover for a specific treatment. It gives you an idea of how much you will need to pay out-of-pocket.

Reviewing pre-estimates can help you anticipate any potential issues with coverage and make necessary adjustments to your treatment plan.

Remember, each dental insurance policy is unique, so it’s crucial to carefully review the specific terms and conditions of your own policy. If you have any doubts or questions, don’t hesitate to contact your insurance provider directly for clarification.

Negotiate the Dental Bill

Dealing with dental insurance can sometimes be a frustrating process. If your dental insurance won’t pay for a particular treatment or procedure, there are steps you can take to negotiate your dental bill and potentially reduce your out-of-pocket expenses. Here are some strategies to consider:

Talk to Your Dentist

The first step in negotiating your dental bill is to have an open and honest conversation with your dentist. Discuss your concerns about the cost of the treatment or procedure and ask if there are any alternative options available that may be more affordable.

Dentists understand the financial strain that dental care can place on patients, and they may be willing to work with you to find a solution.

Contact Your Insurance Provider

If you believe that your dental insurance should cover the treatment or procedure in question, it’s important to contact your insurance provider directly. Ask for a detailed explanation of why the claim was denied and gather any necessary documentation to support your case.

Be persistent and don’t be afraid to escalate your concerns to a supervisor if needed. Remember, insurance companies are in the business of making money, so they may be more willing to reconsider their decision if you present a strong argument.

Look for Errors or Miscommunications

Mistakes happen, and it’s possible that errors or miscommunications may have occurred between your dentist’s office and your insurance provider. Carefully review your dental bill and the Explanation of Benefits (EOB) provided by your insurance company to ensure that everything is accurate.

If you notice any discrepancies or inconsistencies, bring them to the attention of both your dentist’s office and your insurance provider. Resolving these issues could potentially lead to your dental insurance covering the treatment or procedure.

Remember, negotiating your dental bill requires patience and persistence. It’s important to stay proactive and advocate for yourself. By taking these steps, you may be able to find a solution that works for both you and your dental insurance provider.

Explore Payment Options

Dealing with dental insurance can be frustrating, especially when they refuse to cover certain procedures or treatments. However, there are several payment options available that can help you manage the cost of dental care.

By exploring these options, you can still receive the treatment you need without breaking the bank.

Payment Plans

One option to consider is setting up a payment plan with your dentist. Many dental offices offer this service to help patients spread out the cost of treatment over a period of time. With a payment plan, you can make monthly installments instead of paying the full amount upfront.

This can make dental care more affordable and manageable for individuals who may not have the funds readily available.


If a payment plan is not feasible for you, another option is dental financing. Dental financing allows you to borrow money specifically for dental procedures and pay it back over time. There are various financing options available, such as dental credit cards or loans.

It’s important to research and compare different financing options to find the one that best suits your needs and budget.

Dental Discounts and Savings Plans

In addition to payment plans and financing, dental discounts and savings plans can also help reduce the cost of dental care. These plans are not insurance, but rather membership programs that offer discounted rates on dental services.

By becoming a member, you can enjoy reduced fees for treatments and procedures at participating dental providers. Some dental discount plans even cover pre-existing conditions, making them a viable option for individuals who have been denied coverage by their insurance.

When dental insurance won’t pay, it’s important to explore these payment options to ensure you can still receive the necessary dental care. Remember to discuss your situation with your dentist and explore all available resources to find the best solution for your specific needs.

Avoid Future Surprise Bills

Dealing with dental insurance can sometimes be a frustrating experience, especially when they refuse to pay for certain treatments or procedures. To avoid future surprise bills, there are a few steps you can take to better understand your coverage and make informed decisions about your dental care.

Get Pre-Treatment Estimates

One way to avoid surprise bills is to get pre-treatment estimates from your dental provider. Before undergoing any major dental procedure, ask your dentist to provide you with a detailed breakdown of the costs involved.

This will give you a clearer picture of what to expect and allow you to plan for any out-of-pocket expenses. It’s important to note that while pre-treatment estimates can be helpful, they are not a guarantee of what your insurance will ultimately cover.

However, they can still provide you with a rough estimate and help you make more informed decisions about your dental care.

Understand Covered Procedures

Another important step in avoiding surprise bills is to thoroughly understand what procedures are covered by your dental insurance. Take the time to review your policy and familiarize yourself with the specific procedures that are covered, as well as any limitations or exclusions.

This will help you avoid unexpected bills for treatments that may not be covered by your insurance. If you have any questions or need clarification, don’t hesitate to reach out to your insurance provider for more information.

Consider Supplemental Insurance

If you consistently find yourself facing unexpected bills from your dental insurance, it may be worth considering supplemental insurance. Supplemental dental insurance can help cover the gaps left by your primary insurance, providing you with additional coverage for certain treatments or procedures.

Before purchasing supplemental insurance, carefully review the coverage options and compare them to your current policy. Some websites, such as www.dentalplans.com, offer comparison tools that allow you to easily compare different dental insurance plans and find the one that best suits your needs.

By taking these proactive steps, you can avoid future surprise bills and have a better understanding of your dental insurance coverage. Remember to always consult with your dental provider and insurance company to ensure you have the most accurate and up-to-date information regarding your coverage.


Getting slapped with a huge dental bill when you expect insurance to cover it is stressful. But you have options to dispute charges and make payments over time. Understanding your dental insurance fully is crucial to avoid surprise bills.

With patience and persistence, you can reduce the costs and get the dental care you need.

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