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Dental Benefit – Dental ADA Codes

Monday, Jan. 6th 2020 5:57 AM

Question: I have a dental HMO plan though my job that I thought would be very helpful to me since I have not been to a dentist in a while. However, it seems whenever I go to the dental office I am being told I need dental services that are not covered under my plan.

Which I would think things like crowns and cleanings would be covered they show on my plan that they are. I call the insurance company and they stated can not confirm plan benefits without knowing the ADA codes. Where do I get ADA codes so I can check with the company that what the dental office is telling me is true.?

Reply: You would have to call the dental office as aske for all the ADA codes for the services they provided and or quoted to you so you can compare them with your plan benefits. Although you current HMO plan may cover for crowns there are many different types of crows and they many not provide benefits for all of them. That is why knowing the ADA codes for the services render is important in making sure you are having dental care services that are actually covered by your plan.

Dentist typically do not care what type of insurance you have and how it may or may not benefit you. They are out to fix your teeth. Sometimes suggesting higher cost crowns or crowns that are not offered under your insurance plan.

This is not done to charge you more, it is what they feel is best needed. It is up to you to make sure that they are providing or quoting you services that are provided under your plan and if not they provide you with a good enough reason as to why so you can make the best choices for you and what fits your budget

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Posted on Monday, Jan. 6th 2020 5:57 AM | by carol | in Dental Benefits | No Comments »

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