Let me preface this question by saying I just want an answer for what happens in most circumstances. I know all insurance companies vary greatly. Anyway, let's just assume I have the usual 100% UCR with no deductible for regular cleanings and I have an annual maximum of $1500. If I get my regular dental cleaning, x-ray, etc. and it costs $100, I won't pay for any of it (because it's covered 100%), but should it drop my allowed charges for the year down to $1400? I was under the impression that in most circumstances, cleanings are completely separate from your annual maximum. Can someone that works or used to work in a dental office or someone that's had an issue with this before tell me what you think? Thanks.
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No, cleanings are NOT separate from your annual maximum. Yes, your annual maximum WILL drop to $1400 after the cost of exam, x-rays and cleaning gets deducted. Unfortunately, that is the way it is done because you ARE utilizing the dental benefit. Otherwise, the insurance company will go broke leaving you with no insurance !!
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