I have two dental insurances: Primary is Delta insurance which will cover 80% of total. Secondary isPrem eraa Blue Cross which will cover 85% of total. While their allowable amount for each service is different.\ Say I have two services done and the doctor charge 600 of each.Total charges billed by my dentist=1200 For Delta(Primary): the allowed amount is 500 each, then it will pay 500*80%+500*80%= 800. The remaining is 1000-800=200. For Premera: the allowed amount is 550 for the first service and 450 for the second service. It will pay 550-400=140? 480-400=80? Total paid to my dentist =220 > the remaining amount asked by my first insurance??? Is that the correct way? If this is correct, what if my secondary insurace's allowable amount is only 400 each. Then it won't pay my dentist any more. Who will responsible for the remaining 200??? Will the dentist bill me? Please help me !! I think it's ridiculous for Premera, because they use their allowable amount (which could be higher or lower than Delta) as a total. So it end up overpay the doctor or pay less. It won't pay exact the remaining amount unless its allowed amount is same as the primary one.
--------------------
Assuming you have no deductible with either plan, for the first service, your primary coverage will pay 80% of $500, or $400, leaving you to pay $100. Your secondary carrier would pay up to 85% of $550, or $467, minus what your primary paid - so they pay $67. You will have to pay $83 - the difference between the allowable and what was covered. For the second service, same thing - Primary pays $400, leaving a balance for you to pay of $100. Secondary won't pay anything, because their payable amount is under your primary payment. Although your goal was probably to not pay anything out of pocket, it doesn't work that way in the real world - you still have to pay. In this case, your dentist is going to bill you for $183 - which is how much you will owe.
Source
No comments:
Post a Comment