Insurance and payment

How you can pay

• Insurance. We accept Blue Cross Blue Shield, Delta Dental, UnitedHealthcare, Cigna, Aetna, MetLife, Guardian, Principal, GEHA, MassHealth and Commonwealth Care Alliance (CCA), among others. Please have your insurance card ready so we can verify your coverage.
• We do not accept DentaQuest.
• Trubright membership plan. No insurance? Our yearly dental savings plan covers routine care and gives you 10% to 15% off most treatment.
• Financing for larger treatment. We work with Cherry, CareCredit and HFD, so you can spread the cost over time.
• In-house payment plan. Ask our team whether a payment plan with the office works for your treatment.
• Cash, check and credit cards.
• FSAs and HSAs. We accept flexible spending accounts and health savings accounts.

If your insurance does not cover all of your treatment, tell us. We are health care professionals first, and we will work with you to find a payment solution so you can get the care you need.

How dental insurance works

You pay a monthly premium for the plan. Many plans also have a deductible, the amount you pay each year before the plan starts paying its share, and a copay, a set amount you pay for a visit or treatment. Most plans also have an annual maximum, a cap on what they pay per person each year. Anything above it is your responsibility.

Coverage usually comes in tiers. A common pattern is that preventive care such as checkups and cleanings is covered at or near 100%, basic work such as fillings and extractions at around 70% to 80%, and major work such as crowns, bridges and root canals at around 50%. Plans differ, and a carrier may call a procedure basic while another calls it major, so check with your insurer before treatment.

Types of plans

• PPO: you can see providers outside the network, but you pay more out of pocket.
• HMO: you pay premiums but can only see providers in the network.
• Indemnity (fee-for-service): less common. The plan caps what it pays for each procedure, and you pay the difference if the fee is higher.
• Discount dental plan: not insurance. You pay a membership fee and get set discounted rates from providers in the plan's network, with no claim forms.

If you have two plans, one is treated as primary and pays first, and the other may cover part of what is left. Together they cannot pay more than 100% of the cost. Under the Affordable Care Act, dental coverage for children is part of the options available to families, but adults are not required to buy dental coverage. Many people get dental coverage through an employer, and it can be a stand-alone plan or part of a medical plan.

We cannot predict what your plan will cover. For questions about benefits or a claim, call your insurance company or your employer's benefits department.

Questions to ask when choosing a plan

• Is my dentist in the network, and can I change dentists later?
• What are the premium, the deductible, the copays and the annual maximum?
• Which procedures are covered, including any I expect to need?
• How many people does the plan cover?

Using an FSA

A flexible spending account (FSA) is set up through your employer. You put aside part of your pay before taxes and use it for qualified health costs, including deductibles, copays and many dental services such as cleanings, fillings, crowns, dentures, gum disease treatment and oral surgery. Cosmetic work is usually not covered, though orthodontics needed for medical reasons may be.

The yearly limit is set by law, and the account belongs to your employer, so you generally cannot take it with you if you change jobs. FSAs are also "use it or lose it": money left at the end of the plan year may be forfeited, although some employers allow a short grace period or let you carry over a limited amount. Check your plan's rules and plan your contribution with care.

Using an HSA

A health savings account (HSA) works with a high-deductible health plan. Money goes in before taxes, can grow tax-free and can be taken out tax-free for qualified medical costs, which include many dental treatments: checkups and cleanings, fillings, root canals, extractions, crowns, dentures and bonding. Cosmetic treatments such as whitening, and everyday items like toothpaste or floss, are generally not eligible.

Unlike an FSA, the money in an HSA is yours. It rolls over every year and stays with you if you change jobs or insurance. Using HSA money for non-qualified expenses means paying income tax on it, plus a 20% penalty if you are under 65. Keep your receipts in case you need to show what the money was spent on.

When to spend your HSA

There are two good ways to use it. You can spend it on current out-of-pocket dental and medical costs, which is especially helpful for care your insurance does not cover. Or you can pay those costs another way and let the balance keep growing, even investing part of it, as a long-term reserve that can help in retirement. Many people do a mix of both: spend a little on routine costs and keep building the account. Opening an HSA earlier gives the money more time to grow. Talk with your employer or a financial professional about what suits your situation.

Common questions