How much do you pay for dental cleanings WITH insurance?

[melissad2]

We have dental insurance that pays 100% for twice yearly cleanings. The catch is that it is 100% of *allowed* amount which leaves me paying anywhere from $50-75 per person per cleaning, more if we get x-rays. There are 4 people in my family who see the dentist (one of us has no teeth yet ;)), so the cost for preventitive care is quite high. Is there such a thing as a dentist who takes what insurance allows?

[----]

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[Chris in VA]

Yes, ours does. We don't pay anything for cleanings that are the normal type.

Unfortunately, ours doesn't cover the "white" fillings, and no one does the silver ones anymore, so we have to pay for those. It's always something.

[sgo95]

Ours covers the whole amount of cleanings. Is your dentist a participating provider for your insurance plan?

[freesia]

Yes, ours does. We don't pay anything for cleanings that are the normal type.

Unfortunately, ours doesn't cover the "white" fillings, and no one does the silver ones anymore, so we have to pay for those. It's always something.

Ours does, too. Only according to our rider we pay $15 per cleaning. Our doesn't pay for "white" fillings either and our dentist doesn't do the silver.

[melissad2]

Ours covers the whole amount of cleanings. Is your dentist a participating provider for your insurance plan?

 

Yes. I'm going to get on the phone this morning and call around to see if I can find one that takes what they pay.

[KidsHappen]

None. We are covered for two cleaning per year and x-rays ever other year unless there is a problem. Almost everything else is covered at 50%.

[Durriyyah]

They cover 100%, but I'm sure there would be an allowed amount smaller than the actual amount if the dentist were out of network. It seems that's just how they work.

[regentrude]

nothing.

[Jen500]

We pay 70-100 with insurance...I am feeling jealous of all of you with no/low cost cleanings! Our costs just go up from there with other dental work.

[Acorn]

Yes, ours does. We don't pay anything for cleanings that are the normal type.

Unfortunately, ours doesn't cover the "white" fillings, and no one does the silver ones anymore, so we have to pay for those. It's always something.

:iagree:

[Pawz4me]

We don't have a network for dental care, and at our former dentist we always ended up paying a considerable amount out-of-pocket for routine cleanings and x-rays. We were becoming increasingly dissatisfied with them for several reasons, so we shopped around for another dentist. We found that some wouldn't give prices over the phone, even for routine things like cleaning and x-rays. We were able to find one close to home who told us what their charges were, and their office is much more up-to-date technology wise than our former dentist, so we switched. But in the last year they've inched up on their prices, so now we're back to paying a little out-of-pocket. But nothing like we were at our former dentist.

[TN Mama]

Wait a minute. Your provider is in the network? They aren't supposed to balance bill you.

:iagree:

[Matryoshka]

Not ours. They pay what they pay whether the provider is in network or not. The only difference is that an in network doctor cannot bill you for more than what the insurance pays. An out of network doctor can.

 

Yes, this is standard practice. We switched dentists a few years back when we finally found a good one in-network. If your dentist is in-network, they should not be allowed to charge you the difference between what their normal charge is and what the insurance pays; the dentist agrees to that to be an in-network practitioner.

 

Still have to pay a ton for those darned white fillings (although I wouldn't have amalgam put in in any case). Just annoying that the insurance doesn't pay for what is now pretty much "standard practice". They pay 80% of what they think a mercury filling should cost, then I'm left with the 20% of that imaginary amount, plus then the difference between that and what is actually charged for the white filling.

[BrookValley.]

We pay nothing for twice yearly cleanings and x-rays (yearly or every two years? I forget). My insurance doesn't fully cover composite "white" fillings, but they will pay 80% of what silver fillings would be, so I just have to pay the 20% plus the difference in price between composite and silver (I think the last time I paid for a filling it cost me around $70 total). Pretty much anything else has been covered at 80%. I can't complain. OK, I did complain the last time I had to see the oral surgeon to have a tooth removed and I had to pay 100% out of pocket for the sedation because insurance didn't feel it was necessary for just one tooth. :glare: They obviously don't know how necessary sedation is for someone like me in that kind of situation!

[QueenCat]

We pay nothing for routine cleanings or x-rays. We stay in network as in network has to accept the allowed amount.

[Melissa B]

$0

 

X-rays are only free once every two years, so that is when we get them.

[Matryoshka]

$0

 

X-rays are only free once every two years, so that is when we get them.

 

:iagree: Oh, that too. You shouldn't be charged for X-rays unless you're getting them more often than your plan allows. Ours I think allows bitewing once a year and panoramic every three years (the latter is probably only for pediatric patients).

[Mrs Mungo]

Yes, ours does. We don't pay anything for cleanings that are the normal type.

Unfortunately, ours doesn't cover the "white" fillings, and no one does the silver ones anymore, so we have to pay for those. It's always something.

 

Same here.

[Mommyof4ks]

$5 for kids and $8 for adults

[TheApprentice]

We don't pay anything for cleanings.

[Joker]

We all go twice a year for cleaning and x-rays. We don't pay anything.

[Murphy101]

100% in network but there are no in network dentists (there are TWO ped dentist) I'd take my dog to.

So we go out of network.

Cleaning and X-rays are 80%

All else is 50%

We only do white fillings, so there's a price difference here. We also get sealants for any teeth that quality. That's about $12 a tooth.

 

It pays to shop for any healthcare if possible. Sometimes it's not just for a better price, but better treatment options.

[Acorn]

:iagree: Oh, that too. You shouldn't be charged for X-rays unless you're getting them more often than your plan allows. Ours I think allows bitewing once a year and panoramic every three years (the latter is probably only for pediatric patients).

 

Twice I been charged for periapical xrays. It was at separate dentists. The first time, I just assumed that they were using normal xrays (bitewings) and didn't question until after I recieved the large bill. For the second time, I had authorized bitewings in writing to the pediatric dentist, nothing was discussed about changing that, so the dentist waived the charge for the periapicals.

[itsheresomewhere]

50 % of the allowable for in network dentists. So cleanings cost anywhere from 80-120. We only get white fillings so that is more.

 

FYI- If it is a child getting a filling and it is a white filling. Under 7 is not recommended to have silver fillings anymore and you can fight your insurance company to make them pay it just like if it was a silver. Your dentist should have a copy of the Dental assoc. recs on this.

[Pamela H in Texas]

100% of the allowable and every dentist has always accepted the allowable.

[mommymilkies]

It cost me $90 to get my 4 yo's teeth cleaned. No x-rays or fluoride. :glare: this is in network. It's $60-100 every 6 months for each kid. I don't go because I can't afford it. This is with BCBS dental.

[LMA]

Cleanings and x-rays are covered 100%. However, you have to a cleaning once a year for any other problems to be covered by insurance. For example, this means that if you don't do your cleaning and you need a root canal, they may not cover it.

[Lady Florida.]

We don't pay OOP for cleanings or exams. Both are allowed twice a year. Even the deep cleanings that I require are 100% covered. When I was working and had my insurance through the school board, it didn't cover deep cleaning.

[trlt]

Ours are covered 100%...we use an in-network provider. If we used an out of network provider we would have to pay the difference of what the provider charges and what the insurance company covers.

[lynn]

We pay nothing for regular 6month cleanings or yearly xrays.

[QueenCat]

It cost me $90 to get my 4 yo's teeth cleaned. No x-rays or fluoride. :glare: this is in network. It's $60-100 every 6 months for each kid. I don't go because I can't afford it. This is with BCBS dental.

 

We're BCBS Dental but all prevention is covered at 100% (cleanings, x-rays, fluoride, sealants). The amount of coverage is going to based on your actual plan and not who the provider is. Providers have many have plan options for employers and individuals to choose from.

[PuddleJumper1]

We pay nothing for cleanings (twice a year). We have a $75 ded for eveything else then 100% covered up to $1000 a year.

[Haiku]

Is there such a thing as a dentist who takes what insurance allows?

 

Yes. We pay nothing out of pocket even though the insurance only pays the dentist slightly more than half of what he charges.

 

Are you seeing an in-network dentist? ETA: Looks like you are. You're getting scammed, then. As others have pointed out, they are not allowed to bill you the difference.

 

Btw, my son now has braces. :glare: The orthodontist we were referred to accepts our insurance but is not in-network. He says he doesn't like to be in networks because he is then dictated to about treatment. He accepts the out-of-network payment and doesn't charge us the extra, even though legally he could.

 

Tara

Edited October 4, 2012 by TaraTheLiberator

[Wendi]

Two cleanings at year for free. I go every four months, because I just tend to get a lot of tartar no matter what I do. So once a year I pay $50.

 

Wendi

[ILiveInFlipFlops]

Yes, ours does. We don't pay anything for cleanings that are the normal type.

Unfortunately, ours doesn't cover the "white" fillings, and no one does the silver ones anymore, so we have to pay for those. It's always something.

 

Same here. Ours doesn't cover laughing gas either, and I need that to get through the shot and any drilling that needs to be done :( But I'm glad to have the coverage we do have.

[ILiveInFlipFlops]

Are you seeing an in-network dentist? ETA: Looks like you are. You're getting scammed, then. As others have pointed out, they are not allowed to bill you the difference.

 

Oh, I should have read the whole thread. Yes, this exactly. Call your insurance to be sure their rules support this, and then call your provider and straighten them out :glare:

[Soror]

$0 here for twice yearly, we use dentists that are in network and pay a bit more for the "Deluxe" plan but it is about $12 a month.

[LucyStoner]

I see a dentist that is on my dental plan so he is contracted to accept their allowable amount as payment in full. So $0. We pay 20% for basic things like fillings and 50% for serious restoration type work.

[nukeswife]

I don't pay anything for my kids, but when I go I have to pay about $37 now (that includes the bitewing xrays) because Tricare recently switched from United Condordia to Met Life for dental. My dentist decided to not accept the terms so he's no longer and in-network dentist, but he also adjusted his rates a bit so that we wouldn't be paying more than $50 per cleaning if we stayed with him.

 

They will not cover white filling 100%, but the last time I had fillings I thought they paid the allowable amount for the silver ones and then I had to pay the difference between that and what the dentist charges. I've had no problems with my white filings but had lots of problems with silver ones so I prefer to pay the extra for the white ones. I've not had to have fillings since the change, so I'm not sure if it will work that way. I guess I'll burn that bridge when I come to it.

 

One nice thing is that they upped the orthodontic amount by $250 so that will at least help a little bit.

[Garga]

Worked for health insurance paying claims for 10 years.

 

If your dentist is in the insurance's network, they cannot bill you for amounts above the allowed amount.

 

Double check that the dentist is in network. If s/he is, then s/he needs to give you your money back.

 

And don't get too upset. Mistakes like this happen all the time. It's often a simple clerical error.

[Sneezyone]

I have Met Life since the United Concordia/Tricare change. I paid nothing for bitewings and a cleaning last month. I don't even know if my dentist is in-network but since the office had to look up allowable costs on the Met-Life Web site, probably not. Maybe the prices are just cheap and the allowable was more than enough?

[ktgrok]

I pay zero out of pocket for cleanings and xrays.

[*lifeoftheparty*]

We pay absolutely nothing for cleanings (including x-rays and fluoride), twice a year.

[DianeW88]

We pay nothing for cleaning, and 20% for anything else with a network doctor.

[Sarah CB]

We have dental insurance that pays 100% for twice yearly cleanings. The catch is that it is 100% of *allowed* amount which leaves me paying anywhere from $50-75 per person per cleaning, more if we get x-rays. There are 4 people in my family who see the dentist (one of us has no teeth yet ;)), so the cost for preventitive care is quite high. Is there such a thing as a dentist who takes what insurance allows?

 

We must have great insurance. We don't pay for any routine dental work - cleanings, scalings, fillings, sealants, etc.

[melissad2]

Wait a minute. Your provider is in the network? They aren't supposed to balance bill you.

 

Really?

[airforcefamily]

We pay cash up front for a pediatric dentist and accept the covered amount from insurance. Four kids for cleanings and x rays comes to about $750. We get back about $575. If we took them to a network provider we wouldn't pay anything.

[nmoira]

Nothing for preventative services performed once per six months.

[Cinder]

We pay nothing for twice yearly cleanings and once yearly xrays. We also pay nothing for fluoride treatment up to 13yo. (That's a recent change as ds1 got fluoride included up to 16yo.) Other treatment we have to pay a percentage.