Archived Dental

[RedX]

Ok so I'm pretty lost on how benefits work. I have the target enhanced dental and I'm wondering how to figure out coverage. Last time I called and they said they'd cover a certain amount and I got stuck with paying the entire bill. Is there a way to figure out what's not covered? I went in and they said I may need a root canal is this covered by benefits?

 

[Hardlinesmaster]

Go under targetpayandbenefits for dental coverage info.

 

[garbage]

Ok so I'm pretty lost on how benefits work. I have the target enhanced dental and I'm wondering how to figure out coverage. Last time I called and they said they'd cover a certain amount and I got stuck with paying the entire bill. Is there a way to figure out what's not covered? I went in and they said I may need a root canal is this covered by benefits?

As long as your dentist accepts Delta Dental, you'll be coverages. If I remember correctly, DD only works by covering a set amount of the cost and you paying the rest. The charge is not going to be 100% coveraged.

 

[tgtguy]

Enhanced dental is well worth the extra money. If your dentist is in network they can and will contact delta dental and see what they will or won't cover and how much they will pay and you psy the remainder. Enhanced pays 80% of covered procedures( reg dental only covers 40 %). They even cover implants so I am sure they will cover a root canal. You can call delta and ask or your dentist office. If the dentist office doesn't know they can find out for you.

 

[DialMforMonkey]

Sorry to bring back an old thread but I'm fairly clueless with benefits. I have the enhanced dental. It says max annual coverage is 2500 after deductible. So if I get a procedure that is $10,000, does that mean I get 8000 covered and the rest is covered under that 2500 after I pay the deductible?

 

[GoodyNN]

My guess based on my own personal coverage is that you first pay any co-pay for each visit. Then you pay all bills out of pocket until the deductible is met. At that point, the insurance will then cover expenses after the co-pay up to the $2500 annual limit. Anything beyond the $2500 annual coverage becomes patient responsibility again.

So that $10,000 procedure is going to cost you approximately $7500 out of pocket. But call the insurance provider to verify.

 

[Times Up]

Sorry to bring back an old thread but I'm fairly clueless with benefits. I have the enhanced dental. It says max annual coverage is 2500 after deductible. So if I get a procedure that is $10,000, does that mean I get 8000 covered and the rest is covered under that 2500 after I pay the deductible?

Subtract your deductible from $10,000. The insurance will pay the balance, UP TO $2,500.

In your example, your policy pays no more than $2,500.
Unfortunately, you owe the rest.

 

[DialMforMonkey]

Subtract your deductible from $10,000. The insurance will pay the balance, UP TO $2,500.

In your example, your policy pays no more than $2,500.
Unfortunately, you owe the rest.

Hmm, I'm confused, where does the 80% coverage come into play?

 

[Times Up]

What's your deductible?

 

[redeye58]

Hmm, I'm confused, where does the 80% coverage come into play?

After you meet your deductible.
THEN your plan pays 80% of covered costs UP TO $2500 for the year.

 

[DialMforMonkey]

Got it, thank you.

 

[Times Up]

Sorry, didn't realize that 8,000 represented your Co-insurance percentage.


Ok, for a $10,000 bill, you pay your deductible. The remaining balance is divided up between you and your insurance. You pay 20% of this balance and insurance pays 80%. However, once your insurance hits $2,500, you pay the rest. If I knew your deductible, I could plug it into this example.

 

[TargetLounger]

It's costing me $50 a year for unlimited services up to $2500 I believe. Which is perfectly fine with me.

I got a root canal, a cleaning, etc for those 50 dollars. The crown is a little different and that's costing me $210 while the insurance covers the rest.

 

[Ringwraith917]

I just got an extraction friday, of $140 fee, i had to pay 68. I have definitely not met my deductible. I don't understand insurance either

 

[Marvin Martian]

I also have Target insurance. I pay for myself and husband. Some of the co-pay's for work I need done I don't have the money for. So for me the insurance is not worth it but for medical for the husband it is pretty good just not dental.