This Article Will Address:
- What “in-network” means for dental insurance
- How accepting insurance differs from being in-network
- The difference in cost between in-network and out-of-network pediatric dentists
- Why some pediatric dentists choose to be out-of-network
- Whether switching to an in-network dentist is the right choice
- How Pediatric Dentistry on Kimball supports families navigating dental insurance
As a parent, you want to make the best decisions for your child’s health—and that includes dental care. But when it comes to insurance, many families find themselves wondering: What’s the real difference between in-network and out-of-network pediatric dentists? And more importantly, does it really matter?
At Pediatric Dentistry on Kimball, we work with families across Brooklyn to make sure their children receive the care they need, whether their plan is in-network, out-of-network, or somewhere in between. Let’s break down what these terms mean—and how they affect your child’s care and your peace of mind.
What Does “In-Network” Mean for Dental Insurance?
When a dentist is in-network, it means they’ve agreed to a contract with your dental insurance provider. That contract sets specific rates for services, helping control costs and streamline billing.
For example:
- You’ll likely pay lower out-of-pocket fees
- Your plan may cover a larger portion of treatment
- Billing is often handled directly between the dentist and your insurance
Is In-Network the Same as Accepting Insurance?
A dental office that accepts insurance may still be out-of-network. This means:
- The dentist does not have a contract with your insurance provider
- You may pay upfront and be reimbursed by your insurance
- Your plan may still partially cover treatment, just at a different rate
At Pediatric Dentistry on Kimball, we accept most major plans and offer support for submitting claims—even if your plan considers us out-of-network. We’re here to make the process easier, not more confusing.
Visit our Financing Page to view the insurance plans we accept.
What Is the Difference Between In-Network and Out-of-Network Dental Costs?
Typical Cost Differences
In-Network Pediatric Dentist:
- Lower, pre-negotiated rates
- More predictable co-pays
- Streamlined billing process
Out-of-Network Pediatric Dentist:
- The dentist sets their own fees
- Insurance reimburses based on UCR (Usual, Customary, and Reasonable) rates
- You may pay more up front, though reimbursement is often possible
Are Pre-Authorizations Required?
Yes—for both in-network and out-of-network care, major procedures (like crowns or certain types of sedation) may require insurance pre-authorization.
We help with this too. At Pediatric Dentistry on Kimball, our team will walk you through the steps so you’re never left guessing about what’s covered.
Why Do Some Pediatric Dentists Choose to Be Out-of-Network?
Being out-of-network gives dentists the flexibility to:
- Spend more one-on-one time with each patient
- Choose the best materials and treatment methods—not just what’s covered
- Focus on individualized, anxiety-free care
Dr. Lionel Vera believes in putting your child’s experience first. That’s why we offer kid-friendly techniques like Nitrous Oxide (laughing gas) and flexible scheduling to reduce stress and make every visit positive.
Should I Switch to an In-Network Dentist?
Factors to Consider:
- Your child’s dental needs (preventive care, sealants, fillings, etc.)
- Your plan’s reimbursement rate for out-of-network providers
- The trust and comfort you and your child feel with your current dentist
- Availability of pediatric-specific tools like laughing gas
- Office hours that work for your family’s busy Brooklyn schedule
Yes, insurance matters—but so does the quality of care your child receives. Many parents choose Pediatric Dentistry on Kimball because we provide more than checkups—we provide comfort, education, and trust.
Pediatric Dentistry on Kimball Helps Families Navigate Insurance in Brooklyn, NY
Whether you’re using Medicaid, PPO coverage, or a private plan, we’re here to help you:
- Understand your benefits
- Get clear cost estimates
- File claims with ease
And if you’re not sure what your plan covers, just ask. Our team is happy to help—no pressure, no judgment.
Dr. Vera and our entire staff believe that parents deserve transparency and children deserve great care—regardless of insurance networks.
Still Not Sure What’s Best for Your Family?
At Pediatric Dentistry on Kimball in Brooklyn, NY, we believe every child deserves dental care that’s effective, affordable, and full of compassion. Whether your insurance is in-network or not, we’ll make sure your child gets the attention they need in a positive, judgment-free space.
Book an appointment online, call us, or stop by. We offer after-school and weekend hours—because your child’s smile shouldn’t wait.
Sources:
- American Dental Association (ADA)
- American Academy of Pediatric Dentistry (AAPD)
- New York State Child Health Plus
Dr. Lionel Vera
Dr. Lionel Vera brings warmth, expertise, and advocacy to Pediatric Dentistry on Kimball as a board-certified pediatric dentist. He earned his dental degree from the University of Puerto Rico, Medical Science Campus, followed by a residency at Kingsbrook Jewish Medical Center, where he honed his skills with children and special needs patients. A Brooklyn-based pediatric dentist since 2018, Dr. Vera blends compassionate care with a strong focus on educating both children and parents about oral health. Dr. Vera’s mission: to inspire a lifetime of healthy smiles through trust, education, and proactive care.