My deductible is $100.00, I had a filling done and was charged $116.00, my dentist told me I had to pay the deductible plus 20%. I recieved my claim from the insurance company the filling cost 81.00 and 81.00 was applied to the deductible, it said my responsibility was 81.00, so I think I should have paid 81.00. It's my understanding that you pay the full amount of services until the deductible is reached and then your insurance covers a percentage of it, not the other way around. Am I wrong?
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Generally you are right. However, if your insurance doesn't have networks or if you went outside the network the dentist can charge whatever they want. The insurance company will only pay "reasonable and customary" charges. This means the normal rate for the proceedure in your area is $81. The insurance company applied this to the deductible and you are responsible for the rest. Next time you get work done you'll only have $19 left on the deductible.
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