But my plan says that my dental exams, cleanings and certain other procedures are covered 100%

Dr. Sheila Dobee

Family, Cosmetic and Implant Dentist

Date : 06/05/2020

This can be confusing since the insurance tells you they are covering it at 100% but the question is 100% of what fee? The problem is that it is usually 100% of what the insurance carrier allows as payment toward the procedure, not what your dentist may actually charge (which could be different and depends on the many factors). For example, let’s say your dentist charges $70 for an exam. Your carrier may allow only $55 as the 100% payment for that exam. That leaves $15 for you to pay.