What is a pre-treatment estimate, and when should you get one?

What is a pre-treatment estimate and when should you get one?.png

Surprises can be fun — but not on your dental bill. If your plan includes dental coverage, or if you added the Tufts Health Plan Medicare Preferred Dental Option, a pre-treatment estimate can help you avoid unexpected costs at the dentist’s office. 

What is a pre-treatment estimate?
A pre-treatment estimate is a breakdown of your prescribed dental services or procedures, including the out-of-pocket costs you’d be responsible for paying.

You can obtain a pre-treatment estimate prior to receiving services — so you know what to expect ahead of time. 

How does it work?
If your dentist is recommending dental work, you can ask the dental office to submit a breakdown of the services or procedures to Dominion National — the administrator of dental benefits under your embedded dental coverage and/or Tufts Health Plan Medicare Preferred Dental Option.

Dominion National will review the treatment plan and issue you or your dentist a confirmation of whether the services or procedures are covered and how much you’d be responsible for paying.*

In what scenarios do you need a pre-treatment estimate?
Though a pre-treatment estimate is not a requirement to receive care, it can provide you with peace of mind by helping you anticipate your dental care costs.

It’s recommended that you obtain a pre-treatment estimate for all major services, or when the charge for your services or procedures will be more than three hundred dollars ($300).

*The pre-treatment estimate is based on eligibility and benefits available at time it is processed. A pre-treatment estimate is not a guarantee of payment, and the claim for services performed will be based on eligibility and available benefits at the time it is submitted for payment. Other procedure performed, especially in the same area/quadrant/tooth, could affect the actual claim determination/payment.

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