UCR (Usual, Customary And Reasonable)

Under a UCR plan, patients are usually allowed to see the dentist of their choice. These plans pay an established percentage of the dentist's fee or pay the plan sponsor's "customary" or "reasonable" fee limit, whichever is less. Although these limits are called "customary," they may or may not reflect the fees that area dentists charge.

ANNUAL MAXIMUMS

Your plan purchaser makes the final decision on "maximum levels" of reimbursement through the contract with the insurance company.

PREFERRED PROVIDERS

Your plan may want to choose your dental care from a list of their preferred providers. Whether or not you chossed your dental care from this defined group can affect your levels of reimbursement.

LEAST EXPENSIVE ALTERNATIVE TREATMENT

Your dental plan may only allow benefits for the least expensive treatment for a condition. For example, your dentist may recommend a crown, But your insurance may only offer reimbursement for a large filling. As with other choices in life- such as purchasing medical or automobile insurance, or buying a home- the least expensive alternative is not always the best option.

PREEXISTING CONDITIONS

Just like your medical insurance, your dental plan may not cover conditions that existed before you enrolled in the plan. Even though your plan may not cover certain conditions, treatment may still be necessary.

TREATMENT EXCLUSIONS

Your dental plan may not cover certain procedures, or preventative treatments such as sealants that can save you money later. This does not mean these tratments are unnecessary. Your dentist can help you decide what type of treatment is best for you.