How the heck does dental insurance work?
I called my insurance company buy the lady I talk to sounded really confused. If she's confused, how is that supposed to help me?
I know it varies from plan to plan. Here is what I know so far:
I hold a $2500 maximum per calendar year.
I have an "80%/20%" plan (?)
My deductable is $300 (?)
Here is what I don't get:
I go to the dentist, my bill was $306, my insurance paid for adjectives but $28 of it... if my deductable is $300, shouldn't I have to pay $300?
I do not apprehend the 80/20 thing, if I have a deductable too.
Anyone insurange brokers out near?
Answers:
You should pay the first $300, and 20% of the remainder.
But with dental, near are some things that are covered, and some that aren't. Say you got a flouride treatment - that's usually not covere - you'd pay 100% of that.
But usually the cleaning and exam is covered contained by full, not subject to the deductible. Source(s): agent, 21+ years
The way it's supposed to work using your figures - you settle the $300 deductible then 20% of the remaining $6 ($1.20) for a total of $301.20.
Possible explainations (since we don't have the bill to look at or know your history next to this plan)
-your deductible is per lifetime and you've already paid in a different year.
-you've already rewarded part of the deductible previously if the deductible is annual.
-the deductible may be per family instead of per entity.
-the insurance company may not have paid the amount to the dentist nonetheless. Your bill is just an estimate of the charges and may change after the insurance company processes it.
-you may be on a DPO or DMO plan and the billed amount is smaller amount than the actual charges because the insurance company will only allow reasonable and customary fees. Source(s): Independent Agent
Related Questions:
I know it varies from plan to plan. Here is what I know so far:
I hold a $2500 maximum per calendar year.
I have an "80%/20%" plan (?)
My deductable is $300 (?)
Here is what I don't get:
I go to the dentist, my bill was $306, my insurance paid for adjectives but $28 of it... if my deductable is $300, shouldn't I have to pay $300?
I do not apprehend the 80/20 thing, if I have a deductable too.
Anyone insurange brokers out near?
Answers:
You should pay the first $300, and 20% of the remainder.
But with dental, near are some things that are covered, and some that aren't. Say you got a flouride treatment - that's usually not covere - you'd pay 100% of that.
But usually the cleaning and exam is covered contained by full, not subject to the deductible. Source(s): agent, 21+ years
The way it's supposed to work using your figures - you settle the $300 deductible then 20% of the remaining $6 ($1.20) for a total of $301.20.
Possible explainations (since we don't have the bill to look at or know your history next to this plan)
-your deductible is per lifetime and you've already paid in a different year.
-you've already rewarded part of the deductible previously if the deductible is annual.
-the deductible may be per family instead of per entity.
-the insurance company may not have paid the amount to the dentist nonetheless. Your bill is just an estimate of the charges and may change after the insurance company processes it.
-you may be on a DPO or DMO plan and the billed amount is smaller amount than the actual charges because the insurance company will only allow reasonable and customary fees. Source(s): Independent Agent
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