Coverage Benefits – Baby Dental
Benefit Schedule Vs. Usual, Customary, and Reasonable (UCR)
When you review dental insurance plans that show benefits on a fee schedule (like an HMO dental insurance plan), the list’s schedule shows the amount you pay for each treatment or dental service rendered under the insurance plan. Thus letting you know your cost for each dental service covered under the dental plan. When you are reviewing insurance plans that pay coverages based on usual, customary and reasonable (like PPO dental insurance plans), charges will not specify an amount; it provides benefits up to the reasonable and customary charge (the prevailing or average fee charged by a dentist for the service in the area) Coverages usually are paid by a percentage ( Example: 100% for preventive 80% for basic and 50% for major dental services up to UCR )
