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Navigating the World of Dental Insurance Terminology

May 19th, 2014

Unless you work for an insurance company, you probably do not spend a lot of your time studying all the terminology that dental insurance companies use to describe the treatments and services they cover. If it seems pretty confusing, here are some of the most commonly used dental insurance terms and what they mean.

A Basic Glossary

Annual Maximum–The maximum amount your policy will pay per year for care at Weaver Dentistry. It is often divided into costs per individual, and (if you are on a family plan) per family

Co-payment– An amount the patient pays at the time of service before receiving care, and before the insurance pays for any portion of the care

Covered Services– A list of all the treatments, services, and procedures the insurance policy will cover under your contract

Deductible– A dollar amount that you must pay out of pocket each year before the insurance company will pay for any treatments or procedures

Diagnostic/Preventive Services– A category of treatments or procedures that most insurance will cover before the deductible which may include services like preventive appointments with Dr. Gregory Weaver, X-rays, and evaluations

In-Network and Out-of-Network– A list of providers that are part of an insurance company’s “network”

  • If you visit in-network providers, the insurance company will typically cover a larger portion of the cost of the care you receive. If you visit someone who is not part of the network, known as an out-of-network provider, the insurance company may pay for a portion of the care, but you will pay a significantly larger share from your own pocket.

Lifetime Maximum– The maximum amount that an insurance plan will pay toward care for an individual or family (if you have an applicable family plan)

  • This is not a per-year maximum, but rather a maximum that can be paid over the entire life of the patient.

Limitations/Exclusions– A list of all the procedures an insurance policy does not cover

  • Coverage may limit the timing or frequency of a specific treatment or procedure (only covering a certain number within a calendar year), or may exclude some treatments entirely. Knowing the limitations and exclusions of a policy is very important.

Member/Insured/Covered Person/Beneficiary/Enrollee– Someone who is eligible to receive benefits under an insurance plan

Provider– Dr. Gregory Weaver or other oral health specialist who provides treatment

Waiting Period– A specified amount of time that the patient must be enrolled with an insurance plan before it will pay for certain treatments; waiting periods may be waived if you were previously enrolled in another dental insurance plan with a different carrier

There are many different insurance options available, so you need to find out exactly what your insurance covers. It’s important to review your plan with a qualified insurance specialist. Don’t be afraid to ask questions about the policy so you can understand it fully and be confident that you know everything your policy covers the next time you come in for treatment at our Raleigh, NC office.

Sealants: What are they and how do they help?

May 12th, 2014

Molars are made up of canyons, caves, pits, and seemingly endless caverns that are a breeding ground for decay. The protective solution is a sealant. When done correctly, a sealant from Dr. Gregory Weaver of Weaver Dentistry can be most effective in preventing cavities.

A sealant is made up of composite (a plastic-like) material that contains bonding agents to seal to the edge of the tooth. Sealants placed on the chewing surfaces of back teeth block food from being trapped. The process in which a sealant is placed is quite precise and painless.

First the tooth is cleaned with a sodium bicarbonate (baking soda) spray. Then an acid etch is applied to “roughen up” the surface. No saliva is to touch the tooth. This will re-mineralize the area, then a repeat etching is needed. An alcohol-based liquid then dries out the area and it must remain completely dry. The sealant is placed and guided through all the caverns, pits, fissures, and grooves. It is then cured with a special light, which makes it a hard, plastic-like material.

Sealants can last for several years. It is wise to have them examined on a semi-annual basis. If there is a break in the sealant, a high risk for decay is common. If a sealant is damaged, repair is simple, painless, and quick to complete.

Who can benefit from sealants? Anyone! Children often receive sealants as routine preventive care. Adults with deep canyons with stained grooves on their teeth can also benefit from a sealant. The process is quick, painless, and does not require any anesthesia. It is an effective way to lower dental restorative costs.

An investment in dental sealants can reap great benefits as properly cared for teeth will remain cavity free. Our Raleigh, NC location is available to answer your questions so give us a call today!

Wishing all our moms a happy Mother’s Day!

May 5th, 2014

"Motherhood: All love begins and ends there." - Robert Browning

We would like to take this moment to thank all the great moms out there for being so great during their child’s visits to Weaver Dentistry. Whether it’s driving their kids to regularly scheduled appointments or for “being there” while their child is treatment, the moms who come to our office are all stellar individuals, so Dr. Gregory Weaver and our entire staff would like you to know that we appreciate you all!

Happy Mother’s Day and enjoy your special day!

Five Common Reasons for Emergency Care Visits

April 28th, 2014

A dental emergency can strike anywhere, anytime, and without warning. Perhaps you’re playing a game of touch football on Thanksgiving and your brother-in-law decides to up the ante and tackles you, accidentally knocking out your two front teeth. Or maybe you’re on vacation somewhere in the tropics and decide to go deep-sea fishing, but when you’re climbing onto the boat you slip on the dock, fall, and chip three of your teeth. From misplaced fly balls to bagel seeds causing a painful bout of inflammation, there are all kinds of dental emergencies.

Here are the five most common reasons for emergency care visits.

  1. Somehow you've managed to knock out a tooth. Whether it's the result of a sports injury or because of decay, when you lose a tooth, you need emergency dental care. If the tooth is salvageable, then it can be reattached to the socket, but this needs to be done within a one- or two-hour window.
  2. A chipped tooth is the most common dental emergency. Small chips can be caused by food (chicken bones and nuts have sent many people to the dentist); however, it's usually some sort of accident or injury that more often causes a chip. While you might be embarrassed to walk around with a gaping chip in your front tooth, it is easily fixed with a bond, crown, or veneer.
  3. A broken tooth is more severe than a chipped tooth. When a tooth breaks, it might be due to a small or hidden chip. However, chances are the pain and discomfort will be more severe.
  4. It might seem comical, but getting a piece of food lodged in the wrong place can result in a dental emergency. If something gets stuck deep in a crevice, it can cause pain and inflammation.
  5. The loss of a filling happens more often than you think. When you lose a filling, you need to receive emergency care immediately. If you don’t, you risk further damage to your tooth.

When you injure your teeth or mouth, you need to seek emergency care as soon as possible. In the event of a suspected emergency, don't wait. Contact Dr. Gregory Weaver immediately.

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