Dental Coverage out of network help
I have a Cigna PPO with my new job. My Dentist is out of network with them. The plan allegedly covers 80% for Restorative (Basic) Services after $50 deductible with 1.5k max (no spending yet).
So I need to do a few fillings. My dentist charges $290 per tooth. I expected that Cigna will not cover actual 80% due to out of network so I called to confirm how much I will owe.
The rep told me they cover the “Average” cost of filling in the area which he said is $70 which is complete BS. There is not a single normal dental place that would do a filling under $150 around here. EVEN the ones in network.
So pretty much they want to cover nothing, like $60 after deductible for a $600 bill. This is insane on a lot of levels to me. What a joke. Why do I even need this BS “coverage”
My question is, is there anything I can do? Who can I complain to explaining that a $70 expectation for a filling is ridiculous? Cigna? My employee? Local representatives? Anybody really who would listen. Has anybody had luck with this or has advice?
I am well aware that in-network is much cheaper and that is what they want you to do. I had done it before and dentist messed up badly. There is a reason good dentists are out of network usually.