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Frank24
Contributor

We are buying the dental plan that is $74 a month for 2 of us.  Used it for the first time a couple of weeks ago.  The front of our card says, "Diagnostic & Preventative Care In-Network and Out-of-Network 100% no deductible."  Well, that couldn't be further from the truth.  Had cleaning, exam, and one focused x-ray for a total bill of $201.  Just got my Explanation of Benefits (EOB) and the insurance only paid $61 leaving my responsibility $140.  We have already paid in premiums well above the $201 cost of my service.  Additionally, the EOB shows a $35 charge for the x-ray and says, "Your plan covered 80%"  but it paid $0. Therefore, in reality the plan covered 0% and the math does not match the written explanation!!  I expect the insurance to say what it means and mean what it says.  We feel ripped off and are afraid to agree to any further dental work because we don't know what kind of bill we'll be left owing!

1 REPLY

You can file a complaint with the DOI (Department of Insurance) in your state. USAA won't give you a straight answer and won't take any responsibility. They will make it seem like you made a mistake understanding coverage rather than they misled you in what your coverages are.