Tuesday, December 21, 2010

Question about dental insurance.?

I'm 19 years old, and I'm enrolled at a technical college, so, I'm still on my parents insurance, I have my parents as my secondary insurance. Anyways, I need to get braces. They cost about $4,800(quoted). My parents have Aetna dental, and I do to through UPS. I was reading about how much it would cover and both of our insurances covers up to $2,300. So, my question. Can both of our insurances cover the cost of the braces? Thank you.
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No, they will not pick up the entire balance of your braces. Dual insurance will coordinate the benefits and how they do this is they will bill your primary insurance first and when a payment is received from the primary the orthodontic office will submit to the secondary insurance. If the secondary sees what payment are made per procedure they will only cover a small portions of what is left of each treatment submitted. For example: If the office submits for xrays, molds and consultation at $250.00 and then submits for the initial placement of the braces at $1000 the primary insurance will probably pay for the entire amount of the xrays but when it comes to the initial placement of the braces, they may only allow $500.00. Once this is paid then the secondary insurance is submitted and they will see payment in full for the xrays and may only allow $200 on the placement of the of the braces. So regardless you will have an out-of-pocket expense and the Orthodontic office may require that your insurance reimburses you. Anotherwords, you pay up front with your down payment and monthly payments and the insurance will be submitted as you go. But no, the insurances will absolutely not pay the remaining balance of your braces, you will have some out-of-pocket expense regardless of the 2 insurances. Sorry
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