Dental- Medico Vs UCT

[Frank Stastny]

So help me out with this. Do these plans reimburse their percentages based on "usual and customary" charges, or based on "actual" charges?

I believe they do "usual and customary".

It would be impossible for them to reimburse on actual charges. A dentist could charge $500 for an extraction and split the difference for what he would normally charge with his patient. Or something like that.

In essence what they are doing it setting a limit on how much they will pay. Some dentists are like doctors, way too "proud" of what they do.

 

[retread]

So help me out with this. Do these plans reimburse their percentages based on "usual and customary" charges, or based on "actual" charges?

"Usual, Customary, and Reasonable" - (UCR)

UCT: Fair Health - zipcode @ 85th %ile
Medico: Ingenix - " 90th %ile

 

[alicia]

UCT has an annual membership fee.

 

[retread]

UCT has an annual membership fee.

Yeah, but they go to 90% reimbursement the 4th year.

 

[senior-advisor-indiana]

Medico seems like the better choice for the price/benefits.

 

[retread]

Medico seems like the better choice for the price/benefits.

UCT is a better choice in my opinion... YMMV. I look beyond the monthly premium, and it's only a few bucks now... no tellin' what it will be next month. Medico is raising rates.
- - - - - - - - - - - - - - - - - -

UCT has an annual membership fee.

Yep....... $1.50/month.