Dental Insurance question

[itsrobert]

Dental office quoted me $1500 for a procedure.

I asked does that include my insurance?

They call the insurance and they will pay 35 percent of up to $2100

The new dental office quote is 35 percent off $2100 and not 35 percent off $1500.

Is this the way dental insurance is suppose to work?

[2theleft]

1. sounds like your dental office is trying to rip you off.

Do you have a piece of paper with the original $1500 quote on it, if so, I would definitely ask why it jumped $600 if insurance is involved? I would seriously consider switching dentists.

[elleng]

2. No.

Depending on size of the practice, and kind of people you're dealing with, I'd say 'No, that's not right, you told me the procedure would cost $1500, so that's what you should bill me and send to insurance company.'

Could be that's their official way of doing business, or an error on part of the clerk.

[spanone]

3. dental insurance is a scam. it should be part of our health insurance. period.

we dropped our dental, it was worthless.

[Big Blue Marble]

5. As someone who has worked in dentistry for over 25 years,

I completely agree with you. It does not work like medical insurance.
It is a prepaid services plan usually with a annual limit of 1500 - 2000.

The quality of the plans depend on how much your employer pays for
the plan. The majority of plans claim to pay 50% of major services.
But due to their arbitrary "usual and customary fees" which tend to be
several years behind real fees usually reimburse at levels of 35%.

[frazzled]

7. They pay 50% until they tell you

"We don't pay for anything behind the first molar" (or something like that). That actually happened to me. I was dumbstruck.

[Big Blue Marble]

9. Insurance companies are so creative in the ways they can refuse to pay for treatment! N/T

[ChazInAz]

6. Beware Humana

They got me with a bait-and-switch scam that covers nothing. For example: they will replace a broken crown only if it was not broken through chewing or an accident.

[benld74]

4. N O. I'm getting a crown on Thursday,

molar broke in two last week. Wife has family on her work dental plan. Crown is $13xx, our portion is $388. YOur dental office is trying to get MORE money out of the insurance and forcing you to pay more as a result.

[davidn3600]

8. The $1500 is probably the cash price

Actual dental insurance usually has a contracted price, and then the insurance pays a percentage off of that. So the cash price might be $1500, the contracted price might be $1000. And then the insurance would pay say 50% of the $1000. You then pay the other 50%. (plus any any deductibles). And these numbers are just examples...

A dental discount plan is different...that is just a percentage off from the cash price.

So the answer to your question really depends on your plan. Your best advice would be to call the customer service number on your card and ask what kind of plan it is.