Benefit Plan Document

The benefit plan document refers to the legal document that details the coverage you receive from your insurance plan, whether it be an individual or a group plan. Sometimes the Benefit Plan Document is called a Certificate of Coverage, Summary Plan Description, or Certificate of Insurance.

Insurance companies will supply their members with a copy of the Benefit Plan Document. The member should keep the Benefit Plan Document on hand to refer to when there are questions about what is or is not covered in the plan. This document is very helpful when there are questions about coverage. A good Benefit Plan Document will clearly state what dental services are covered in the plan.

It is the responsibility of the patient, not the dentist, to know what is or is not covered by their insurance provider. The dentist is going to recommend treatment as he or she sees need. The patient then can refer to the Benefit Plan Document to decide if they want to have the procedure done or not.

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