we just got dental health insurance and on it it says it covers for amalgam and resin restorations: limited to one filling per 24 months per tooth surface. Multiple restorations on a single surface will be paid as a single filling. Does this mean that we can only get on ONE filling every 2 years...or does it mean we can get all our teeth filled..but only once every 2 years?? I'm really confused i don't think it makes any sense to have just ONE filling every 2 years...
2006-09-29 07:49:09 · 6 answers · asked by samborambo86 1 in Health ➔ Dental
I think for the the most part, dental insurance is a scam. The cost often matches what is paid out, so having it does not seem to make sense. What that means is that each tooth can only be filled once every two years. You can get each of your teeth filled.
2006-09-29 07:52:28 · answer #1 · answered by united9198 7 · 1⤊ 1⤋
Dentists divide up a single tooth into surfaces: occlusal (biting surface) or incisal (the sharp edge if it's a front tooth), buccal (side next to the cheek), lingual (side next to tongue), mesial (towards the middle), and distal (away from the middle).
So, when insurance says, "one filling every two years per tooth surface, what it means is - if you have an occlusal filling on tooth #30, we won't pay for ANOTHER filling on the occlusal side of tooth #30 for 2 years...
Fillings should last more than 2 years under most circumstances.
Apart from the frequency of same-tooth fillings, you also have a yearly cap - anywhere from $750 to $2000.
As for the "multiple restorations on a single tooth paid as a single filling" that's a bit more complicated. I'll explain it if you really want to know.
Edited to add: Please be cautious of Ameriplan and other so-called "dental discount plans" because they often do not live up to promises, and are completely unregulated. Consumer guides report many cases of dissatisfied users who got ripped off.
2006-09-29 14:58:33 · answer #2 · answered by emmalue 5 · 2⤊ 0⤋
One filling per SURFACE every two years. Not one filling per MOUTH every two years. Each tooth has FIVE surfaces.
If you had every surface of every tooth filled this week, your insurance would not pay for any more fillings for two years.
2006-09-30 00:54:05 · answer #3 · answered by Picture Taker 7 · 0⤊ 0⤋
one filling per tooth every 2 years - multiple restorations (fillings) on any one tooth will only be paid once within a two-year period.
2006-09-29 15:01:54 · answer #4 · answered by tirebiter 6 · 0⤊ 0⤋
Call your Dentist and talk to the person who handles the insurance,
they will tell you exactly what you are able to have done according to your insurance plan.
I have Aetna PPO with Dental, they pay $1200.00 per year, the deductible I have to pay and I have a 20% co-pay on anything that I have done, except cleanings.
and any Balance left at the end of the year is not carried over.
2006-09-29 14:56:32 · answer #5 · answered by kar_summers 3 · 0⤊ 0⤋
one filling per tooth every 2 years. you got to keep off chocolates and wash your mouth after every meal however wee it may be
2006-09-29 14:55:10 · answer #6 · answered by Anonymous · 0⤊ 0⤋