Finding Dental Coverage Peace in December

Reflecting, Resetting, and Rethinking Your Dental Coverage

By Dr. Lance P. Martin, DMD
Spring Valley Dental Group – O’Fallon, IL

December brings a mix of reflection and renewal — family gatherings, festive lights, and for many, the realization that their dental insurance is about to reset in January.

Every year, our patients at Spring Valley Dental Group call with questions about coverage changes, new plan options, and how to make the most of their benefits before the year ends. Below, I’ve shared some of the most common questions we hear — and my honest take as a dentist who’s been navigating this system with patients for over 25 years.

Which Plans Are In-Network with Spring Valley Dental Group?

Our office is currently in-network with several major carriers, including Delta Dental, United Concordia, MetLife, and Blue Cross Blue Shield of Illinois.

We also work with many other insurance plans out of network, and we’re happy to file claims on your behalf to help you maximize your benefits. In many cases, out-of-network coverage still applies — we’ll review your plan details with you to help estimate any out-of-pocket costs before your appointment.

(Need coverage verification? Our team can help — just call us at 618.632.8471.)

What If You’re Out of Network?

When a provider isn’t in-network, you may see a slightly higher deductible or copay percentage. However, many patients choose to stay with Spring Valley Dental Group because they value continuity of care, the quality of service, and a relationship with a trusted dentist who knows their history.

Our goal is to be transparent and help you understand exactly what to expect before treatment — no surprises.

Choosing the Right Dental Plan Tier

If you have options when selecting a dental plan through your employer, choose the highest tier you can reasonably afford.

While the premiums may be higher, the coverage difference is significant. For instance, top-tier plans often cover:

  • 100% of preventive services (cleanings, exams, x-rays)
  • 70% of basic care (fillings, root canals, periodontal treatment)
  • 50% of major work (crowns, dentures, implants)

Compare that to standard or basic plans, which might drop those numbers to 100%, 55%, and 35%, respectively. Over the course of a year, the higher-tier coverage typically saves patients money if any treatment is needed.

My Honest Take on Dental Insurance

Dental insurance has changed dramatically since it was introduced in 1969. At that time, the average annual benefit cap was $1,500, and a dental crown cost around $200.

Today, even though premiums have increased nearly tenfold, the average annual benefit cap is still $1,500 — while a crown now averages $1,200. The math doesn’t lie: your coverage hasn’t kept up with the cost of care.

In addition, insurance companies regularly reduce reimbursement rates to in-network dentists, asking them to do the same work for less pay. Many providers respond by shortening appointments or reducing service time to keep up — something we refuse to do at Spring Valley Dental Group.

Here, your cleaning is a full hour-long preventive and educational visit, not a rushed session. We’ll never compromise on the quality of care our patients receive.

Why We Still Handle Insurance (and Always Will)

Some dental offices have stopped working directly with insurance altogether. We understand why — it’s complex, time-consuming, and often thankless. But that’s not how we operate.

At Spring Valley Dental Group, we:

  • File and refile insurance claims for you
  • Send supporting documentation and appeals when needed
  • Only charge your estimated patient portion at the time of service
  • Wait for insurance reimbursement (sometimes months!) before finalizing your account

We believe this is part of providing true patient-centered care.

Exploring Alternatives to Dental Insurance

If you don’t have dental insurance — or if you’re tired of its limitations — consider our SVDG Membership Plan.

For just $200 per year, you’ll receive:

It’s affordable, immediate, and simple — no claims, no waiting periods, no surprises.

Final Thoughts — Dental Peace Is Possible

The end of the year can bring enough stress on its own. Your dental care shouldn’t be one of them.

If you have questions about your coverage, plan changes, or membership options, we’re happy to help you find clarity and peace of mind — so you can enter the new year smiling.

Sincere wishes for a healthy, happy dental insurance new year,
– Lance P. Martin, DMD

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