Estimating Insurance for Percentage Medicare Plans

Plan Type

Calculations

Dental Percentage Medicare Plan

Bluebook Entry

No Deductible

The allowed amount is subtracted from the fee. The difference is the estimated write-off amount. The estimated write-off amount is added to the insurance payment entered in the bluebook.

In the example:In the example:The $75 allowed amount is subtracted from the $88 fee, leaving $13. The $13 difference is added to the $60 insurance payment entered in the bluebook. The estimated insurance payment is $73.

Dental Percentage Medicare Plan

Bluebook Entry

Deductible Subtracted First

The deductible is automatically subtracted from the allowed amount. The difference is multiplied by the coverage percentage. The product is added to the estimated write-off (the fee minus the allowed amount).

In the example:In the example:The $25 deductible amount is subtracted from the $75 allowed amount, leaving $50. The $50 difference is multiplied by the 80% coverage percentage, leaving $40. The $40 product is added to the $13 estimated write-off amount ($88 fee - $75 allowed amount). The estimated insurance payment is $53.

Dental Percentage Medicare Plan

Bluebook Entry

Deductible Subtracted Last

The coverage percentage is automatically multiplied by the allowed amount. The deductible is subtracted from the product. The product is added to the estimated write-off (the fee minus the allowed amount).

In the example:In the example:The 80% coverage percentage is multiplied by the $75 allowed amount, leaving $60. The $25 deductible is subtracted from the $60 product, leaving $35. The $35 difference is added to the $13 estimated write-off amount ($88 fee - $75 allowed amount). The estimated insurance payment is $48.

Dental Percentage Medicare Plan

No Bluebook Entry

No Deductible

The coverage percentage is automatically multiplied by the fee.

In the example:In the example:The 80% coverage percentage is multiplied by the $88 fee. The estimated insurance payment is $70.40.

Dental Percentage Medicare Plan

No Bluebook Entry

Deductible Subtracted First

The deductible is automatically subtracted from the fee. The product is multiplied by the coverage percentage.

In the example:In the example:The $25 deductible is subtracted from the $88 fee, leaving $63. The 80% coverage percentage is multiplied by the $63 product. The estimated insurance payment is $50.40.

Dental Percentage Medicare Plan

No Bluebook Entry

Deductible Subtracted Last

The coverage percentage is automatically multiplied by the fee. The deductible is subtracted from the product.

In the example:In the example:The 80% coverage percentage is multiplied by the $88 fee, leaving $70.40. The $25 deductible is subtracted from the $70.40 product. The estimated insurance payment is $45.40.

Medical Percentage Medicare Plan

Bluebook Entry

Deductibles Do Not Apply

The allowed amount is subtracted from the fee. The difference is the estimated write-off amount. The estimated write-off amount is added to the insurance payment entered in the bluebook.

In the example:In the example:The $75 allowed amount is subtracted from the $88 fee, leaving $13. The $13 difference is added to the $60 insurance payment entered in the bluebook. The estimated insurance payment is $73.

Medical Percentage Medicare Plan

No Bluebook Entry

Deductibles Do Not Apply

The insurance coverage percentage is automatically multiplied by the fee.

In the example:In the example:The 80% coverage percentage is multiplied by the $88 fee. The estimated insurance payment is $70.40.