I chose to upgrade to a "Special" dental plan of Delta from the "Standard" dental plan, both of which I have through my employer. Before upgrading, I researched how much of a crown the Special plan would cover. According to the info sheet my HR department gave me, 90% was to be covered for a crown provided by a PPO Network Dentist, and if it was a Non-PPO Network Dentist, Delta would cover only 60%. I asked the dentist if they were a member of Delta, and they said yes. (Since they had not been able to give me an idea of how much the crown would cost me, I made the effort to do this research) I then told the dental office it was 90%. But it turns out Delta only covered 60%. I only learned after that there are different kinds of Delta members (my dentist was member, but not a member of "Delta Premiere"). If a provider is a member of Delta, don't most people understand it to mean they are therefore part of the PPO network? Very misleading. Who can I show is responsible for these fees?
2007-07-20
13:28:48
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4 answers
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asked by
picty
1
in
Dental