Questions To Ask Your Insurance Provider As a courtesy to you, our staff may offer to process insurance claims on your behalf for your treatment with your consent, however each insurance plan is unique. Due to current privacy laws, many insurance companies will not provide us with any information regarding your plan. To assist you best, we encourage you to take the time to contact your insurance provider and request a breakdown. Once we have this information, we will have a better understanding of your coverage and will be happy to clarify any questions you may have. Please note the treatment options presented to you from our team are based upon our professional judgment and not based on your coverage by a dental benefit plan.Your Name* First Last PhoneEmail Insurance Company NamePolicy or Plan #ID #Subscriber Name / Date Of BirthWhat is my yearly maximum on my plan?and at what percentage?Please enter a number from 0 to 100.Is it a combined maximum? Yes NoWhat is my Basic coverage maximum?and at what percentage?Please enter a number from 0 to 100.What is my Major coverage maximum?and at what percentage?Please enter a number from 0 to 100.Do I have orthodontic coverage? Yes NoWhat is my orthodontic coverage maximum?and at what percentage?Please enter a number from 0 to 100.When does my plan renew? Month Day YearWhat years fee guide?Do I have a deductible? Yes NoIf Yes, How Much Is My Deductible?How often am I covered for a complete exam? ( Codes 01103 / 01102 or 01101)How often am I covered for a recall exam (Code 01202)?How often am I covered for Bitewing x-rays?How often am I covered for a panoramic X-ray?How many scaling units are covered per year?Can I get coverage for more scaling units if necessary with a pre-determination? Yes NoIf yes, how many?How often am I covered for a polish?How often am I covered for fluoride?Is there an age restriction for fluoride?Do I have any sedation coverage?