我的保险补牙cover 80%,不过white filling仅限前门牙,大牙只cover汞合金,差价自己补. 看似差不多,实际上自付能差十倍,因为保险不cover的部分牙医能够漫天要价. 举个例子:
汞合金补大牙:
Submitted Amount (牙医要价): $200
Approved Amount (保险合约价): $105
Insurance Paid (保险报销): $84
Patient Share (自付): $21
white filling补大牙:
Submitted Amount (牙医要价): $283
Approved Amount (保险合约价): $105
Insurance Paid (保险报销): $84
Patient Share (自付): $199
区别在于汞合金补牙就算牙医要价很高(几乎贵一倍),但是保险公司会限价,病人也不用付Submitted Amount和Approved Amount的差价. white filling 就是没人帮你限价, 自己要付Submitted Amount和Approved Amount的差价. 自付$199几乎是汞合金的两倍.
再来一个white filling补前门牙的例子
Submitted Amount (牙医要价): $306
Approved Amount (保险合约价): $156
Insurance Paid (保险报销): $125
Patient Share (自付): $31
保险公司直接将价钱砍到$156,可见white filling大牙的合理价钱也不应该超过两百,可以和牙医讲价的吗?
