Dental Insurance – Mercerville, NJ
Helping Make Dentistry Financially Feasible
At Dr. Brian Lavery Family & Cosmetic Dentistry, we understand that your budget is limited when it comes to paying for dental work. One of the ways our practice ensures you can afford the care you need is by being in-network with many insurance providers so that you’re not responsible for 100 percent of costs. We’ll maximize your insurance benefits and make sure that your hard-earned money that goes towards your monthly premium doesn’t go to waste. Trust our team to make your insurance work for you in Mercerville. Just let us know which plan you have when you schedule your appointment and we’ll start working to make your insurance work for you. Contact us today!
How Dental Insurance Works
Dental insurance works by helping cover the cost of preventive, basic, and major dental care. Most plans operate on a 100-80-50 structure, meaning preventive care like checkups and cleanings are often covered 100 percent, basic services like fillings are covered at 70 to 80 percent, and major treatments such as crowns or dentures are covered at around 50 percent. Patients typically pay a monthly premium, plus out-of-pocket costs like deductibles and co-pays. Many plans also have an annual maximum, the highest amount the insurer will pay in a year. Dental insurance encourages routine care while reducing financial stress for unexpected treatments.
What is the Difference Between Dental and Medical Insurance?
Dental and health insurance differ in coverage, structure, and focus. Health insurance is designed to cover major, often unpredictable medical expenses such as hospital stays, surgeries, and ongoing treatments. It usually has higher premiums, broader networks, and higher annual maximums or no cap at all. Dental insurance, on the other hand, emphasizes preventive care like cleanings, exams, and X-rays while offering partial coverage for restorative and major treatments. It also typically has lower annual maximums. While health insurance addresses serious, costly health needs, dental insurance primarily encourages routine maintenance to prevent bigger oral health problems.
In-Network vs. Out-of-Network
In-network vs. out-of-network refers to whether your provider has an agreement with your insurance company. Depending on if your provider is in- or out-of-network with the dentist will determine what portion of the treatment you will be responsible for paying.
In-Network Coverage
In-network providers have negotiated rates with your insurer, meaning you’ll usually pay less out of pocket for services. Your insurance covers a higher percentage of the cost, and billing is often handled directly between the provider and insurer.
These are the insurers our practice is specifically in-network with:
Always Care
Unum
AmeritS
Cigna (DPPO)
Delta Premier
Geha
Guardian
Lincoln Financial
MetLife (PDP PLUS)
Principal
United Healthcare
Out-of-Network
Out-of-network providers don’t have a contract with your insurance company, so care is often more expensive. You may face higher deductibles, lower reimbursement, or have to pay the full amount upfront. Choosing in-network providers helps maximize benefits and minimize unexpected healthcare expenses.
Our practice accepts most PPO plans and can still maximize out-of-network benefits and save you money over paying completely out-of-pocket.