http://findthebestplan.com/dental-plan-questions/is-it-typical-to-have-to-pay-high-out-of-pocket-expenses-for-dental-work-even-with-a-good-ins-plan/ Thu, 01 Oct 2009 13:17:10 +0000 hourly 1 http://wordpress.org/?v=3.1 http://findthebestplan.com/dental-plan-questions/is-it-typical-to-have-to-pay-high-out-of-pocket-expenses-for-dental-work-even-with-a-good-ins-plan/comment-page-1/#comment-138 spongebobrogers Mon, 01 Jun 2009 23:42:13 +0000 http://findthebestplan.com/?p=31#comment-138 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. 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.

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