Long shot but hey... US insurance Q

[_sterlingroses_]

So it seems my dentist put in composite fillings on posterior teeth, when my insurance only covers amalgam (silver) on rear teeth. I had no idea, until now

Comments

[mrs_ralph]

You are allowed to call the insurance company and make their lives miserable until they change their minds. They put this dentist on their approved list so if he did something they don't approve perhaps they should take it up with HIM. You can also argue no prior knowledge and medical neccessity i.e. amalgam fillings used to contain trace amounts of mercury and some people blamed them for assorted health problems so that may be why he uses composite, though he should have informed you of the charge for them and he should have known they weren't covered and informed you since most dentists are kept up to date by their billing department. If in doubt about charges for services you can ask at the front desk of the doctor or dentist's office there is usually someone there who can answer your 'does my health insurance cover this' questions though I think they expect you to know at least up to a point

[_sterlingroses_]

Thank you for the reply.
I think I will call the insurance company to be sure they know that it was him and his decision to use white fillings instead of amalgam. The silly thing is, I have several silver fillings already from a military dentist while we were stationed at RAF Lakenheath. So why he decided to put white ones in makes no sense!
I think a payment plan will be the only way of dealing with it though :( Just sucks. I hate going to the dentist with a passion, and having to worry about insurance as well just raises my anxiety level even more.
I am entitled to medical care through Tricare, you are correct on that, but at the base we are stationed dental care is reserved for Active Duty personnel only. No dependents :/ so that means we have to seek care off base and use United Concordia for insurance. Sucks but hey, better than nothing!!!

[tisiphone]

Didn't you get an estimate before having the work done? Most dentists are pretty good about that - you're not the first person to run into this problem :) Duking it out with the insurance company is pointless, they're not going to budge, but talking to the dentist might help. It could at least get you a payment plan, especially if you point out that he didn't note it wouldn't be covered by your insurance. That's a pretty common restriction on insurance. (I'm assuming that your dentist direct-bills, rather than you sending in the paperwork. If you sent in the paperwork it really was your responsibility to make sure whatever work you're going to have done is going to be covered.)

[_sterlingroses_]

No :( no estimate, kicking myself for that now! But assumed it would all be covered by my insurance like it has been in the past (but with a different dentist)
They bill the insurance company, so I've just found all this out by getting the paperwork from them informing me that they paid part of it, but i'm responsible for the rest :o
Worst possible time of year! Holiday season is upon us, I'm trying to save to fly myself and my 9 month old daughter home (UK) for Christmas as my husband is deployed to the middle east! When it rains it pours eh?

[tisiphone]

Ugh! I know what you mean :( It sucks when stuff like this happens, especially since sometimes it's completely inexplicable.

[malvino]

Don't worry about it, the employees at your insurance company will have stripped the walls for copper wire and split by the time any court summons appears, you can blame them for non payment and they won't be around to say you weren't covered.

[_sterlingroses_]

I am kicking myself for assuming that what was routine small fillings that I assumed would be covered. Were actually not! :( Lesson learned I guess

[ocicat_bengals]

Idiots, eh? My NHS dentist told me they only cover amalgam, but put in composite. Isn't she a gem? Good luck. I would be terrified of living here in the states again. :-( My stepson moved to California in March and had to go to the ER in April. He's now $3,000 in the hole It totally bites.

[_sterlingroses_]

Tricare insurance is pretty reasonable about covering most things. So life isn't as terrifying as it is for the average American. I'm blessed for that.

[ocicat_bengals]

My daughter just switched from individual coverage to employer paid coverage which doesn't cover dental. I would like to see her get individual dental coverage again, but I think it would stretch her pocketbook.