topic Re: Dental Coverage in Wellness

Dental Coverage

ScrapHappy — Thu, 17 Mar 2022 23:45:22 GMT

We switched from Aetna to Cigna. Took my daughter (16) to the dentist today. First cavity. First time with Cigna and a cavity situation. Was surprised that we're not covered for cavities. If you have dental coverage, are you covered for cavities?

Re: Dental Coverage

Mary Bailey — Thu, 17 Mar 2022 23:50:14 GMT

I always recommend asking for exclusions or waiting periods before purchase. Including if coverage is different with providers that do not participate in the network.

Re: Dental Coverage

Kachina624 — Thu, 17 Mar 2022 23:55:51 GMT

Yes, I'm coveted for cavities but I don't know of any plan that's terribly generous or covers 100%. There's always an annual deductible too....are you sure that wasn't a consideration? You need to read your policy.

Re: Dental Coverage

Spacrazy — Fri, 18 Mar 2022 00:55:35 GMT

Did you confirm coverage prior to service? You have the same dentist but he/she might not be in your new insurance plan. It's on you to make sure. When I make an appointment anywhere I ask them if this visit/service is covered (even though I have not changed any of my doctors).

ALL of our fine caregivers are having to play hardball with the insurance industry on a daily basis and it's a money game for insurance.

Cover your bases and good luck.

Re: Dental Coverage

Snowpuppy — Fri, 18 Mar 2022 01:30:46 GMT

I had Aetna for a time but the only coverage was cleaning & xrays twice per year. Employer provided so not a separate policy that I purchased.

Oh, and they covered 0 out of network.

Re: Dental Coverage

ScrapHappy — Fri, 18 Mar 2022 01:22:37 GMT

@Spacrazy wrote:
Did you confirm coverage prior to service? You have the same dentist but he/she might not be in your new insurance plan. It's on you to make sure. When I make an appointment anywhere I ask them if this visit/service is covered (even though I have not changed any of my doctors).
ALL of our fine caregivers are having to play hardball with the insurance industry on a daily basis and it's a money game for insurance.
Cover your bases and good luck.

This was a 6 month check up visit. Cavity appointment is in April, end of April....didn't have anything sooner. Yes, in network. Benn going to same dentist for 6 years. I always make sure I'm in network, not by calling the provider but by calling insurance company. I know I have some phone calls and research to do. Plus, dentist said that after the cavity is filled, my daughter should go to a "regular" adult dentist. Trying to think things thru and maybe just find adult dentist for her now and have them do cavity. But, I do like the dentist she has now and they have always been nice to my daughter.

Re: Dental Coverage

spent2much — Fri, 18 Mar 2022 01:30:23 GMT

We have dental coverage, but it's not very good. They only considered $550 for a crown. Then they didn't even cover half of that. I admit I DO go to an out of network dentist because he has always done excellent work. And yes, cavities are covered but, again, they only cover about 50%. I'm considering changing to an in network dentist, but I'm kind of afraid to. You just don't know what kind of a job he/she does until it's over!

{*_*}

Re: Dental Coverage

Jaspersmom — Fri, 18 Mar 2022 11:48:47 GMT

There are many different levels of coverage. It all depends on what you, your company or bargaining unit has selected. My union recently switched from Cigna to Aetna and we maintained the same coverage at a lower cost. Cigna wanted to cover less for the same cost. You can access the company's website to determine what's covered and what's not. To answer your question, yes, I'm covered for cavities, but again, that may be because of the plan my union negotiated. We are a large bargaining unit with many people with children.

Re: Dental Coverage

Ainhisg — Fri, 18 Mar 2022 12:41:55 GMT

We are very fortunate to get dental coverage (Delta) through my husband's job at a crazy price. I think it costs us around $125 a year per person for coverage. This includes two dentist checkups, two cleanings, appropriate x-rays, oral cancer screening, etc. My husband goes in-network and never seems to have dental problems so never has any charges. I go out-of-network, because I was established with this dentist when my husband and I got married. My dentist does lots of restorative work, and I have needed (and continue to need) a lot. My OON dentist is covered at the same percentages as my husband's IN dentist.

We have filling coverage for cavities at 80%. We each have a $75 copay every year for anything other than basic cleanings/x-rays. Crown coverage is 50%, which in my area, is a $650 allowance per crown. My dentist is much higher on crowns than an IN dentist, and I really felt the pinch of that when I needed two crowns late last year! I have considered switching to an IN dentist just to save a bit of money, but I am hesitant to do so. I'm going to need three crowns replaced right in the front of my mouth soon, and I know the dentist I go to know will make sure the color match is great, the teeth look real, etc. If I have an issue with a crown not fitting, chip a tooth, "something else go wrong," they get me in the day I call 99% of the time. So when I think about all that, it puts switching dentists right out of my mind, because as someone else said, you never know what you're going to get, and when you've had literally the best dentist (imo), I'm sure most others will pale in comparison. One person's idea of a good dentist is not another's--especially if they've not needed major restorative work.

Re: Dental Coverage

jlkz — Fri, 18 Mar 2022 13:25:24 GMT

@ScrapHappy

We switched to Cigna about 3 years ago ( not an employee plan ) and we're covered for all dental needs immediately because we both had been covered previously by another dental plan.

If we hadn't been in another plan, then there would have been a year ( I think ) wait for coverage. Could this have been the case with your young daughter ? May be worth a call to their Customer Service #.

Re: Dental Coverage

AuntG — Fri, 18 Mar 2022 13:31:34 GMT

My Delta Dental coverage is 80% on cavities and 50% on crowns. 2 cleanings and one X-Ray a year are 100% covered. However, I pay $450 a year in premiums, so in essence, I'm still paying for those cleanings and X-Ray!

Re: Dental Coverage

Effie54 — Fri, 18 Mar 2022 13:32:30 GMT

@ScrapHappy wrote:
We switched from Aetna to Cigna. Took my daughter (16) to the dentist today. First cavity. First time with Cigna and a cavity situation. Was surprised that we're not covered for cavities. If you have dental coverage, are you covered for cavities?

If your dentist takes CIIGNA dental, then there's usually a $50 deductible, and fillings are usually covered between 50–80% of the usual and customary fee. Then you're responsible for what is above that. I heard from a few dental offices that CIGNA is not a very good dental company, though that's what we have as well. There are only a few offices in my area that except it. I found that upsetting, as I would have thought it was a good choice.

Re: Dental Coverage

meem120 — Fri, 18 Mar 2022 19:30:49 GMT

As my dentist told me years ago, its not really insurance like your medical insurance. Its more or less a pre payment savings plan. Coverage even on great plans are not nearly enough if you need major work. It covers mostly preventive work. and small amounts towards caps, root canals etc. ANd if you want implants you can kiss $10000. goodbye.

Re: Dental Coverage

icezeus — Fri, 18 Mar 2022 20:01:57 GMT

I have Delta Dental PPO Coverage that is offered through my employer. I pay a little extra for the PPO vs the HMO that is offered, but I like my particular dentist and have no intention of giving him up.

I also have an FSA Card that I add funds to each year during open enrollment. I only use this to supplement any charges that arise from my dental visits.

I have not had a cavity in a very long time so I am not sure if they are covered or not.

I have had three crowns and my portion was in the $ 600 range for each.

Re: Dental Coverage

judianne — Fri, 18 Mar 2022 22:58:25 GMT

I have a private dental plan , costing $33 a month . It pays out $1500 a year for cleaning,implants,crowns,cavities ,since my teeth are so bad l use up all the $$ every year , so for $400 a year premium l get $1500 paid for plus my dentist is in network so I get a big discount as well ! I was pleasantly surprised to find out that my BCBS Advantage plan is now covering $2000 in dental stuff a year . I just had a crown replacement and my Advantage paid $750 of the bill and my private dental paid the rest ! I am so impressed with the Advantage plan , it's only $86 a month , l get $40 OTC stuff free , no copayment to see my primary Dr , $150 for prescription glasses , all my prescriptions are free through their mail order !