Wednesday, December 29, 2010

HELP!! Explain my Dental Insurance? w/ details?

Ok so I have an dentist appointment of Thursday for a regular check up, I havent been to the dentist in a couple of years (no more than 3) the dentist I use to go to closed or moved - so i'm going to a new dentist on Thurs. I have only asked for them to do a regular check up to see if I need my wisdom teeth extracted (which I will) and to see if I need any other work done (which I do) but right now the main thing is to remove my wisdom teeth.. so I spoke to the dental assistant and she said they will do X-Rays & etc. due to me being a new patient Anyway just on Thursday according to my employers insurance policy below how much will I be paying that day?? and how much will I pay when I do return to have my wisdom teeth extracted?? what is the $75 deductible fee for? and when do I pay? I am the only person on my dental insurance and like I said I have only asked for a check up on Thursday so that the dentist can tell me what I need to have done.. and hopefully set up an appointment for next week to have the wisdom teeth get removed...... thanks for your help Coverage Type: Type A: Preventive Cleanings, Oral Exams, Fluoride Applications, X-rays, Bitewing X-rays Type B: Basic Restorative Fillings, Extractions, Oral Surgery, Endodontics, Periodontics, Periodontal Maintenance, Sealants, Space Maintainers, Anesthesia, Emergency Palliative treatment, Injections of antibiotic drugs Type C: Major Restorative Consultation, Implantology, Relining and Rebasing, Bridges & dentures, Crowns/Inlays/Onlays, Repairs of dentures, crowns, inlays, and onlays, Prefabricated stainless teel crown. Type D: Orthodonthia So the company pays: In Network: Type A: 100% of Fee Type B: 80% of Fee Type C: 50% of Fee Type D: 50% of fee Deductible applies to type B and C services only. Individual - $75 Family - $225 Annual Maximum Benefit Per Person - $1,000
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According to your description you should not have to pay for the first dentist visit, it would be covered under the type A . Then when you go to the Oral Surgeon (if that is where you go for your wisdom teeth) your deductible will apply there. When you go in for your consultation they will know exactly how much you will have to pay and it should be 20% of the fees plus your $75.00 deductible. That means the insurance will pay the Oral Surgeon $75.00 less than the full 80%. You should not have to pay anything until you go in to actually have your teeth pulled, unless your dentist does anything that is in the type B category (like fillings). But they will tell you before they do anything that will cost you. Hope that helped. And make sure that any dentist that you see is in your network. It is a lot cheaper. I am sure they asked you about your insurance when you made the appointment. Also remember the $1000,00 limit per year. Get the most important things done first and keep tract of how much you still have available, you can call your insurance company to find that out.
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