HeLP!! Dental insurance question???

Question

I was told in the consultation that my insurance can only cover 80% of my removal of my 4 wisdoms teeth. It will be $1,500 to remove my wisdoms and the insurance can only cover $1,200 according to them, the surgeon. And the rest $300 i have to pay.
I wanted to know if this is true with other surgeons if i was to go to other places.
Insurance doesnt cover the whole %100??
Is this true??

Answer 1

Although I agree with many of the answers, that your scenario doesn't sound unusual, there is only one way to be sure. Get a copy of the policy or plan document. All limiations and coverage levels will be spelled out in there. My son's wisdom teeth were covered, but the plan limit was $1500 per year per person. His cost $2200 (3 years ago), so I could have said only take 2 out this year and 2 out the next year and had it fully covered, but I knew there was a good chance he'd never go back.

If it's not too late, see if you can put the additiona $$ required in an FSA. It will allow you to spead the $300 cost over the full year through pretax payroll deductions.

I think there is no 'bargain' in dental insurance as a whole, but if you collect $1500 in a year, you are a definite winner as far as insurance works. It's normally break even if you get your 2 annual cleanings...anything more is gravy.

Answer 2

It's not the surgeon, it's the insurance coverage. If you went to another surgeon, your insurance would still only cover 80% of the cost. The amount that insurance covers depends on the plan....which, in simple terms, mostly depends on how much you (or your employer) pay into it each month. Usually, the more expensive the insurance, the better the coverage, and vice versa......80% for a surgical procedure is usually normal.......one other thing, if you are on an HMO, make sure that surgeon is in your network, and you were referred by your dentist.

Answer 3

That is true in most cases. My dental insurance pays for 100% for everything except for braces. I had to pay 10% so for my $5,000 braces I still had to pay $500. Most insurances aren't so generous. My wisdom teeth removal was paid 100%, even though I had to go to an oral surgeon and was fully anesthesized.

Be glad you have insurance. there are MANY people in this country that don't have any at all. Your dental coverage sounds fair to me.

Answer 4

You are lucky if it will cover that much! Most dental insurances have a $1,500 per year anyway. The 80% for wisdom teeth is probably pretty standard. Dental insurance has always been a ripoff.

Answer 5

It's not the surgeons - they'd be happy if insurance paid everything.

It's whatever your insurance policy is. Sounds like you have a deductible, which is common. I don't think that's out of line.

Ask your dentist if they'll accept a payment plan for the $300. Many will.

Answer 6

For those of us like you who have dental coverage, your coverage sounds in line with what is out there. It sounds close to what I have and I feel I'm blessed to have it. I do think that you can get 100% coverage from some companies. You have to corner them on it because they usually don't advertise it...and of course it will cost you more...probably the $300 dollars more your already out. No matter what happens with insurance we all seem to get drilled!

Answer 7

Yes it's very true insurance company's only cover 80%

Answer 8

I even have scientific for existence from my previous job...Eye and dental I lost as quickly as I left my final job yet i could have those 2 back in 2 months.....can no longer arise with the money for to no longer have coverage.

Answer 9

80% is pretty standard. Take it and run. I know the $300 out of pocket hurts but which hurts more, your mouth or your wallet?

Answer 10

Sounds about right.