What happens if a member wants a more expensive service than the one the plan covers, or that the dentist recommends?
Most indemnity and PPO plans cover the least expensive treatment appropriate for your condition. Even if your dentist feels a more expensive treatment would be better for you, these plans pay for the less expensive treatment, and you have to pay the difference between what the plan pays for the less expensive treatment and what the dentist charges for the more expensive treatment. Under the Managed DentalGuard plan, the covered service that the participating dentists recommends is provided at the defined patient charge, regardless of the relative cost. So you are never caught between what your dentist recommends and what the plan covers. If you want a more expensive, but still covered, treatment than the one that your participating dentist recommends, then you are responsible for the patient charge for the recommended service, plus the difference between the dentist’s fees for the two procedures.
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