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Using Your Dental Insurance

We work with your benefits and make your share clear before treatment

McElroy Smiles in Encinitas is in-network with most major PPO dental plans and files your claims for you, so you use your benefits and pay only your share. A covered exam and cleaning is often little or nothing out of pocket. Same-day emergency exams are $100 for patients without insurance, and if you are insured we bill your plan and you pay only your copay. Share your plan and we confirm your benefits before treatment.

How does dental insurance work?

How does dental insurance work? Your plan helps cover the cost of care, and what to expect generally looks like this: preventive care such as cleanings, exams, and X-rays is usually covered at or near 100 percent; basic restorative work such as fillings is usually around 80 percent; and major restorative work such as crowns and dentures is usually around 50 percent. Cosmetic treatment is usually not covered, since it is considered elective. A few things worth remembering: most plans reset at the start of the calendar year and benefits do not roll over, you usually meet a deductible first, and each plan has an annual maximum it will pay. We help you use your benefits before they expire.

What does in-network mean, and are you in-network with my plan?

What does in-network mean, and are you in-network with my plan? Choosing an in-network dentist is the best way to stretch your benefits, because the practice and the insurer have agreed on set fees. We are in-network with most major PPO plans, including Delta Dental, MetLife, Aetna, and Cigna. If your plan is not listed, we very likely still accept it and will file your claims, so you still get great care at a fair rate. Plans we accept and are in-network with include: Guardian, Aetna, Anthem Blue Cross, DenteMax, Delta Dental, Sun Life Financial, DentaQuest, UnitedHealthcare, Connection Dental, Cigna, MetLife, Humana, Blue Shield of California, GEHA, Ameritas, Blue Cross Blue Shield Federal Employee Program, Blue Cross Blue Shield of Massachusetts, Advantica, and Best Life and Health. If you do not see yours, call (760) 621-8700 and we will let you know. Delta Dental patients, see our Delta Dental page.

Is the $200 new patient price on top of my insurance?

Is the $200 new patient price on top of my insurance? No. The $200 is the price for new patients without insurance. With a PPO plan, we bill your insurance and you pay only your share, which is often little or nothing for a covered exam and cleaning.

No insurance? You still have good options

No insurance? You still have good options. Without coverage, you still have clear options at McElroy Smiles. Pay our flat cash prices with no surprises, join the McElroy Smile Membership built for patients without insurance, or split treatment into low or no-interest monthly payments through financing with CareCredit, Proceed, and Sunbit. We help you find the right fit before treatment begins.

We are in-network with most major PPO dental plans in Encinitas, including Delta Dental, MetLife, Aetna, and Cigna. Call (760) 621-8700 with your plan name and we will confirm before your visit. If we are not in-network with yours, we still file your claims so you get the most from your benefits.

Yes. We file your claims directly, so you do not handle the paperwork. You pay only your share of the plan, with the price agreed upfront before any treatment.

No. The $200 is the price for new patients without insurance. With a PPO plan, we bill your insurance and you pay only your share, which is often little or nothing for a covered exam and cleaning.

If you have insurance, we bill your plan for the emergency exam and any X-rays, and you pay only your copay, if any. The $100 price is for patients without insurance, new or existing. Call by noon and we will see you the same day.

You can use our flat cash prices, join the McElroy Smile Membership built for patients without coverage, or finance treatment through CareCredit, Proceed, or Sunbit.

Frequently Asked Questions

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