Reimbursement on Invisalign with Cigna DPPO Maximum?

Hi, I’m new to this sub and unfamiliar with dental insurance. I called Cigna for information but wanted to see if anyone else experienced this. Not sure if i’m in the right place, let me know if not!

I just signed up for Invisalign ($5,500) this month and paid $1k down payment. Balance: $4,500.

Insurance info here! My state is NY and dental insurance is Cigna DPPO. In and Out-of-network benefits are the same. I have $2,040 left for 2020 Annual Max. According to the Cigna associate, if it gets approved, they will reimburse me every 3 months (4x per year) but also have to make sure I plan my cleanings accordingly to get it covered with my max. I understand it may be difficult to understand what will happen since it hasnt’ been approved yet.

  1. How long does it take for Cigna to approve invisalign and would there be a reason they’d deny?
  2. If I get approved this month (Dec 2020), does the first reimbursement get taken out of 2020 or 2021’s max?
  3. How do they split the costs? If my max is $2,300 and they’ll reimburse every 3 months, does that come out to $575? How is it re-calculated if I get cleanings in between?
  4. Any additional things I should be aware of or should ask Cigna?

Sorry if these are quite obvious, I’ve always used my dental insurance for cleanings only. Let me know if I need to share additional info! Thanks!

submitted by /u/christeeeeeea
[link] [comments]
Hi, I’m new to this sub and unfamiliar with dental insurance. I called Cigna for information but wanted to see if anyone else experienced this. Not sure if i’m in the right place, let me know if not! I just signed up for Invisalign ($5,500) this month and paid $1k down payment. Balance: $4,500. Insurance info here! My state is NY and dental insurance is Cigna DPPO. In and Out-of-network benefits are the same. I have $2,040 left for 2020 Annual Max. According to the Cigna associate, if it gets approved, they will reimburse me every 3 months (4x per year) but also have to make sure I plan my cleanings accordingly to get it covered with my max. I understand it may be difficult to understand what will happen since it hasnt’ been approved yet.
How long does it take for Cigna to approve invisalign and would there be a reason they’d deny? If I get approved this month (Dec 2020), does the first reimbursement get taken out of 2020 or 2021’s max? How do they split the costs? If my max is $2,300 and they’ll reimburse every 3 months, does that come out to $575? How is it re-calculated if I get cleanings in between? Any additional things I should be aware of or should ask Cigna?
Sorry if these are quite obvious, I’ve always used my dental insurance for cleanings only. Let me know if I need to share additional info! Thanks!
submitted by /u/christeeeeeea [link] [comments]Read Morer/HealthInsurance

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