Friday, December 31, 2010

Can someone take a look at my dental insurance, I have a question about it?

Please review your plan documents for full details, including exclusions, limitations and state mandates that might affect your benefits. Please be aware Deductibles and Maximums apply to both the In-Network and Out-of-Network Benefits. Deductibles In-Network Out-of-Network Individual Calendar Year Deductible Basic & Major Restorative, Orthodontic $50.00 $50.00 Family Calendar Year Deductible Basic & Major Restorative, Orthodontic $150.00 $150.00 Maximums In-Network Out-of-Network Individual Calendar Year Maximum Diagnostic & Preventive, Basic & Major Restorative $1,000.00 $1,000.00 Individual Lifetime Maximum Orthodontic $1,000.00 $1,000.00 Member's Coinsurance Percents In-Network Out-of-Network Reimbursement: Fee Schedule Reasonable and Customary Basic Restorative 20 % 20 % Diagnostic & Preventive 0 % * 0 % * Major Restorative 50 % 50 % Orthodontic 50 % 50 % * Fields that display zero as the Member's Coinsurance Percent indicate that CIGNA covers this service at 100%. Frequency and Age Limitations Specific Coverage Information In-Network Out-Of-Network Dependent Age Limitation 19 19 Student Age Limitation 25 25 Date Coverage Ends Birth Month Birth Month Procedure In-Network Frequency/ Age Limit Out-of-Network Frequency/ Age Limit Oral Exam Twice per Calendar Year Twice per Calendar Year Full Mouth X-Rays Once per 36 Consecutive Months Once per 36 Consecutive Months Adult Cleaning Twice per Calendar Year Twice per Calendar Year Child Fluoride Once per Calendar Year / Under Age 19 Once per Calendar Year / Under Age 19 Topical Sealant Application Once per 36 Consecutive Months / Under Age 14 Once per 36 Consecutive Months / Under Age 14 Crown Once per 60 Consecutive Months Once per 60 Consecutive Months Bridge Work Once per 60 Consecutive Months Once per 60 Consecutive Months Orthodontics Coverage for Dependent Children Coverage for Dependent Children Now my question is....see where it says "frequency and age limitations"? where it says something about being 25? I turned 25 on september 2nd, can I not use this insurance anymore for myself, its dental insurance through my employer so it wasnt explained very well, or can I use it maybe until right before I turn 26, meaning can I use it while I'm 25 or did it end as soon as I turned 25?
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Student limitation is most likely towards any dependants that you have on your coverage - not you as the policy holder.
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