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Dental Insurance in Wauwatosa, WI

Helping You Maximize Your Benefits at Firefly Family Dentistry

At Firefly Family Dentistry, we believe dental insurance should help you, not confuse you. Our team is experienced in working with all dental insurance plans that allow you to select your own dentist, and we’re here to help you maximize your benefits.

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How We Handle Dental Insurance

  • =We submit dental claims on your behalf to any insurance plan that permits you to choose your own provider.
  • =Our team does its best to estimate your out-of-pocket costs before your appointment.
  • =Treatment recommendations by Dr. Matthew Sandberg and Dr. Katelyn Stine are based on your individual dental needs, not on insurance limitations.

Because every dental insurance plan is different, we encourage you to contact us ahead of time so we can review your plan together.

How Does Dental Insurance Work?

Dental insurance operates differently from medical insurance, and it’s important to understand the distinction:

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Medical insurance typically requires you to meet a deductible first, after which the insurance pays a percentage of medically necessary treatments.

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Dental insurance functions more like a “coupon book”, helping to offset the cost of pre-determined procedures — which may not always align with the treatments you actually need for optimal oral health.

Plans differ significantly based on what you or your employer have purchased. Lower-cost plans often require higher patient contributions at the time of service.

Key Things to Know About Dental Insurance

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Annual Maximums

Most plans cover a maximum benefit between $500–$2,000 per year after you pay a deductible (typically $25–$150 per year).
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Waiting Periods

Many plans require you to wait six months to a year before they cover procedures like fillings, crowns, or dentures.

Missing Tooth Clauses

Some plans won’t cover the replacement of teeth lost before the policy was active.

Fee Schedules

Even if your plan says it covers 100% of a procedure, it may cover only 100% of a reduced fee based on the insurance company’s schedule—not the actual cost of the procedure.

Example: A filling may cost $400, but your plan might reimburse based on a $300 fee schedule, leaving you responsible for the $100 difference.

Why It’s Important to Review Your Plan

Our team works hard to understand and navigate your insurance coverage, but ultimately:

  • =You are responsible for any costs not covered by your dental plan.
  • =Full payment of uncovered amounts is required at the time of your appointment unless you arrange a payment plan in advance.

If you’re considering purchasing dental insurance, we strongly recommend contacting our office first. We are happy to review your options and help you choose a plan that best supports your dental health.

Related Dental Insurance Resources

Let Us Help You Understand Your Benefits

Navigating dental insurance can be confusing, but you don’t have to do it alone. At Firefly Family Dentistry, we’re committed to transparency and patient education.

Call 414-258-8190 today with any questions about how we work with insurance plans or to schedule your next appointment.

Call (414) 258-8190Request an Appointment