Just like basic a deductible and yearly max will apply to this coverage. Major coverage includes crowns, bridges, partials, dentures and implants.
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Cleanings, exams and x-rays typically fall under preventative. All patients should know if their plan has Preventative, Basic, and Major coverage.
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Below is a list of common rules based on the type of coverage. The provider is not obligated to provide your coverage information, but will make inquiries as a courtesy to the patient because they know what questions to ask. This is why we encourage our patients to please read the handbook that is given to you when you sign up for your benefits. The next section will give you an outline of some of the many rules or limitations that are present on a lot of plans. Unfortunately, insurance plans often place rules or limitations on coverage. This break down is very generic and we wish things were that simple. Patient coverage is 80% of the Insurance Fee Schedule or $120.00 Below is a hypothetical example of how this works. What does that mean? Since we participate with those two plans, we have agreed to use their fee schedule (prices insurance sets for treatment). To start, WPDA is in network with Delta Dental Premier and Cigna PPO. That being said, lets get into some of the common questions we get as a team here at Westport Plaza Dental Associates in regards to insurance plans and some of the crazy rules that insurance has that can lead us into the never-ending maze of questions. I thought now would be a good time to give everyone the reminder that most insurance plans reset January 1 so if you have benefits left now is the time to use them or you will lose them. It’s getting close to the time for open enrollment.