Understanding Dentist Fees After Insurance Max Out - What Are Your Rights?

In most cases, dentists are required by law to charge patients based on the contracted rate with their insurance company. This means that even if a patient has maxed out their annual benefits, the dentist can only charge the contracted amount for any additional services provided. However, there are a few exceptions to this rule.

1) If the patient is not covered by insurance, the dentist can charge whatever fee they wish for their services.

2) If the patient has a coinsurance or copay, the dentist can charge the contracted amount plus the coinsurance or copay.

3) If the patient has reached their annual maximum for certain services, the dentist may be able to charge a higher fee for those services.

It is important to check with your dentist and your insurance company before receiving any dental treatment to ensure that you are aware of the charges you will be responsible for.