I have a decent dental plan (Principal Dental plan) through my job but every time I go to the dentist, they bill me about as much as they get from the insurance claim. Some people have told me they are being dishonest and others have said this is typical. My new dentist does the same procedures but I only pay a small amount (20 or so) on a $200.00 bill. I know with MD bills, we don't have to pay the difference between the doctors billing amount and what the insurance company pays. Does the same apply to dental work?
Is it typical to have to pay high out of pocket expenses for dental work even with a good ins. plan?
Depends, most dental insurance will pay 100% of cleaning/x-rays/dr. exam and checkup fees as long as that dentist is a provider of your insurance. If he simply files the insurance and is not a provider he can charge you the difference between his fees and the insurance fees. Example cleaning at dentist $60 but insurance agreement price for a PPO is $45 so he can only charge that but if he only files you insurance he can charge the difference. Otherwise it is illegal if he has been charging extra for things covered !00% and he is PPO for your insurance. Also, many insurances cover only 50% of major things like crowns and root canals leaving a heafty split for you to pay and 80% for basic things like fillings and then you have the copay. Bottom line is dental insurance doesn't actually pay that well for what you pay but it is also possible you are getting screwed. You get a copy of the insurance statement in the mail that tells what they paid them, what the services costed, and what your part should be if he is a PPO for your insurance things should not differ from this statement.
Reply:Its around 60 to 80% coverage for normal premiums...
Reply:There are a lot of factors in determining dental insurance premiums...Also depends on the procedure being done becuase each one is cover at a different Percentage and some insurance companies have what are called allowences on what they will pay the dentist and the office can chose to except it or not...And some offices may make the patient pay their share of cost and the difference of what the insurance company will pay and what the office charges for that certin procedure....Hope this was helpfull...Good Luck
Reply:If the dentist you are going to is "out of network" with your insurance company they will not write off the difference your insurance doesn't pay. So you need to make sure the dentist you are seeing is "in network" with your insurance company. If they are you may have a small co-pay but you shouldn't have outrageous amounts, unless they are "out of network". You can either call you dentist and ask them if they are "in network" with you insurance company or call the insurance company and ask them if your dentist is cover by them.
Reply:Did you know they haven't updated the annual maximum on dental insurance since the 1950s? Dental prices have gone up since then, but insurance companies refuse to raise their maximum. It's not the dentists fault, it's insurance.
Subscribe to:
Post Comments (Atom)
No comments:
Post a Comment
Note: Only a member of this blog may post a comment.