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Respected Contributor
Posts: 4,214
Registered: ‎03-28-2010

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?

Esteemed Contributor
Posts: 6,271
Registered: ‎03-09-2010

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.

 

 

Honored Contributor
Posts: 70,645
Registered: ‎03-10-2010

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.

New Mexico☀️Land Of Enchantment
Respected Contributor
Posts: 3,429
Registered: ‎12-14-2018

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.

Esteemed Contributor
Posts: 5,593
Registered: ‎03-09-2010

Re: Dental Coverage

[ Edited ]

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.

Respected Contributor
Posts: 4,214
Registered: ‎03-28-2010

@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.

Respected Contributor
Posts: 2,192
Registered: ‎03-10-2010

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!

{*_*}

 

 

ETERNITY: your choice... smoking or non smoking!
Trusted Contributor
Posts: 1,267
Registered: ‎06-08-2011

Re: Dental Coverage

[ Edited ]

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.  

Respected Contributor
Posts: 2,961
Registered: ‎03-09-2010

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.


Respected Contributor
Posts: 4,968
Registered: ‎12-02-2013

@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 #.

We make a living by what we get. We make a life by what we give.
Sir Winston Churchill