ok i went to the dentist and main things i need are scaling, root canal and a precious crown. total amount with insurance is $2325. why does my insurance only cover $490 of this money? i have cigna dhmo.
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Cigna dhmo is like an hmo medical plan. Your dentist has agreed to accept your insurance (your insurance is one of the weakest plans there is) but is not contracted with Cigna. This means that your dentist is willing to file a claim with your insurance and will accept their payment as partial payment for services rendered. Some insurance payment is better than nothing. I have a different Cigna plan, it is a pretty standard PPO, it pays 50% of major (precious METAL crowns, not precious crowns) which includes all prosthetics, 80% of routine (fillings, scaling) and 100% of routine (x-rays, cleanings). Yes, change plans. Met Life and Delta Dental have plans that are pretty standard/ Whatever you do, don't seek out less expensive dental work, the average fee for scaling is about $350 a quadrant (4 quads in your mouth), $900-$1200 per crown and $600-$1200 per root canal. Your dentist is right in range with good dentists. I really don't want to contradict anyone but insurance companies pay 50% for crowns because that is what they contract to pay for, some pay 100%, it depends upon the plan you have. Crowns are not cosmetic, they are vital and insurance companies will pay to replace them every 3-5 years, that is how necessary they are. Also, crowns are placed to preserve the integrity of your bite. If a space is allowed to remain, the surrounding teeth will eventually close inward, creating a terrible bite which leads to many other problems.
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