ok, here I go again, my insurance says : Type I dental expenses 100% no deductible Type II 90% after deductible *only one deductible applies if Type II and Type II expenses are incurred, Type III 60 % after deductible. It says I have 1500 dlls max. Now 10 points to whoever answers these questions: What the hell does this mean? I am new at this so please be gentle, what happens when the 1500 dlls are spent, what if I need more dental work and I don't have more insurance money?. Thanks.
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Well, this is worth more than 10 points because it is more complicated than Chinese arithmetic. Type 1 expenses usually include: cleanings, exams, x-rays, and other diagnostic and preventative services. Type 2 usually includes: fillings, root canals, extractions, periodontal treatments.. Type 3 usually includes: crowns, bridges, dentures. So, you visit the dentist twice per year and have cleaning, exam, and x-rays each time. If your dentist's fees fall within the insurance company's "usual and customary (UCR)" rates, you have no out of pocket. The deductible is waived. Also, in the same year, you need some fillings, a root canal and a crown. Your insurance will pay 90% of their UCR on the fillings and root canal and 60% of the crown AFTER the deductible. But once your insurace pays $1500 for the year, no more will be paid out for ANY service, including cleanings. If you need more work done, you are paying for it out-of-pocket. Your maximum is individual - that is, if you have others in your family covered, they each have their own $1500 and deductible to pay. That's a basic explanation, but there are all kinds of clauses and limits in your plan which I don't know about. Dental insurance is complicated stuff and after years of working with it, I still get surprised every now and then.
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