Question:

I need HELP- health and dental insurance won't cover me AFTER I asked and they said they would?

by  |  earlier

0 LIKES UnLike

About 3 months ago I went to the dentist for the first time in about 7 years because I had been having horrible jaw pain and figured I had a bad tooth. Turns out, it was my wisdom teeth, which were fully impacted and developing cysts around them and deteriorating my jaw bone.

My dentist told me I needed to get them out ASAP, and referred me to a maxillo facial surgeon. I called my insurance company first to make sure it was covered, they told me I would have to pay a $300 deductable and they cover the rest.

So I went, had my teeth removed and went through the week of excrutiating recovery. 3 weeks later, I get a letter from my insurance company saying that it in fact will NOT pay for my wisdom teeth removal because it does not cover procedures done on NORMAL, HEALTHY, FUNCTIONING teeth (I do not understand how they were normal or functioning, but oh well) and that I owe this surgeon $1598.

What went wrong and is there anything I can do about it?

Who do I call?

Thanks

 Tags:

   Report

3 ANSWERS


  1. I was turned down by my insurance company for a medical condition.  It makes you sick to think you owe all that money

    Call the insurance company and see what you need to do to petition their decision.   They may simply not have enough information on why the teeth were pulled.  Also, call the doctor who did the oral surgery.  He/she may need to provide the insurance company with more information on the condition of your jaw and why the teeth had to be pulled.  

    You may also want to check with your medical insurance if they cover situations like this.  If the teeth were causing problems for your jaw - you may have a medical issue.

    Good luck!    


  2. Yes, you can do something about it. Call your dentist office because apparently they coded the claim incorrectly. The insurance company doesn't know anything about your teeth; they just know what the dentist office tells them. The dentist will have to file the claim again.



  3. I have met similiar problem before, here is the information that I feel helpful..http://health-insurance.expert-tip.info/...

Question Stats

Latest activity: earlier.
This question has 3 answers.

BECOME A GUIDE

Share your knowledge and help people by answering questions.