Insurance Glossary

To keep premiums affordable, dental plan administrators limit what the dental plan will consider as an "allowable amount" for dental care provided by out-of-network dentists. Dental plan administrators often use a method called Reasonable and Customary (R&C), also known as "Usual, Customary and Reasonable (UCR)," or "Usual and Customary". With this method, the dental plan's out-of-network allowable amount will be the dentist's charge unless that charge exceeds a designated percentile of dental charges in a given community. The designated percentile is often established at the higher end of charges in each area. Because of this, only the more costly dentist's services are cut back by the dental plan administrator.