What do I do when I thought I went in for a TMJ guard but came out with a bruxism guard? Now my insurance won't pay? My dental office prior to setting the appointment said my dental insurance would pay 80% now that the dental insurance won't pay because only TMJ not bruxism (which are closely related but not the same) is covered. We specifically asked if our insurance would cover this or we wouldn't of had the guard made as it is $1250. Also the insurance is not covering the x-rays either because the dental office didn't send them to the dental insurance for review. I already called the dental office and was told they "never guarantee any coverage by insurance" and would resend the appeal letter. The appeal letter still says in the notification that it is for bruxism so it was denied again. Not one mention when we were at the dentist office about bruxism. What do we do?
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Night guards are a tricky billing situation. The majority of the time, insurance will only cover them for "bruxism", which is grinding of the teeth. Many if not most insurance plans have a TMJ exclusion. So, your dental office did what they thought was best. You are right - TMJ and bruxism are related. Your insurance comapny is being ridiculous and you should be upset with them, not the dental office. I would suggest an appeal in writing from both you, and the dentist. Let them know the night guard will help with BOTH bruxism and TMJ (which is true). Also, there is no reason for them to deny x-rays just because they weren't sent in. There's something wrong with that. Not every x-ray taken is sent to insurance and some companies won't even accept the films or return them if they ARE sent. What your dental office probably should have done was pre-authorize the appliance. For an amout that high, pre-authorization is usually a good idea, especially with a "gray area" procedure.
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Thursday, December 16, 2010
help me choose a dental insurance plan?
I am new at this and dont know what to choose . im a 21 year old college student , financially broke and in need of a wisdom tooth extraction , could you please look at this list and tell me what would be more convenient for me? http://www.dentalinsurance.com/di/web/qu… thanks in advance!
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since you state you need wisdom tooth extraction you will need to find a plan that will accept PRE-existing problems
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since you state you need wisdom tooth extraction you will need to find a plan that will accept PRE-existing problems
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dental insurance question?
Can I be covered by my dental insurance plan and also at same time be covered by my wifes dental plan. They are different companies. I need a lot of expensive work done and only allowed 1000 dollar benefit on my plan. 2,500 dollars on wifes for a total of 3,500 if carry both insurance plans. Can this be done?
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To have 2 dental insurances can be beneficial. The first thing you have to find out is if your wife's dental plan will "coordinate benefits". What that means is will the secondary plan pick up the difference that your plan will not? If they do not "coordinate benefits", then you will still have to pay your patient portion for work that is done until you run out of your yearly maximum. Then and only then will your secondary insurance kick in. The good news either way is that you will have $3500 to go towards dental treatment instead of $1000. Your dental office financial coordinator should be able to answer this question for you as well. Once they have all the insurance information they will also be able to give you a better breakdown of what you would owe for treatment provided. Hope this helps.
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To have 2 dental insurances can be beneficial. The first thing you have to find out is if your wife's dental plan will "coordinate benefits". What that means is will the secondary plan pick up the difference that your plan will not? If they do not "coordinate benefits", then you will still have to pay your patient portion for work that is done until you run out of your yearly maximum. Then and only then will your secondary insurance kick in. The good news either way is that you will have $3500 to go towards dental treatment instead of $1000. Your dental office financial coordinator should be able to answer this question for you as well. Once they have all the insurance information they will also be able to give you a better breakdown of what you would owe for treatment provided. Hope this helps.
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Dental Insurance question?
My friend Allen has a cavity in his tooth, and his plan is to get work somewhere sometime soon with dental insurance so he can save money on the fillings or anything they have to do. I have never really researched this, but is this common practice or some sort of fraud? What might happen?
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It's fine and perfectly legal, unless they don't cover pre-existing conditions and he lies about having one. The dental insurance at most big companies does not have that kind of restriction, so he will probably be fine. However, a lot of companies have cut back on dental coverage during the recession. So it might not be as easy to find as he thinks. BTW, he should not let this go too long. He won't save money if his cavity gets bigger and requires more work. His co-pay on something major (a 3-surface filling or a root canal) might be more than paying for everything on a simple filling. If you are talking a few weeks, it's not a big deal. But if he puts off the filling for months and months, it may not save him anything in money, and it will cost him pain and maybe the tooth itself. I hope this helps. Good luck to you and to him.
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It's fine and perfectly legal, unless they don't cover pre-existing conditions and he lies about having one. The dental insurance at most big companies does not have that kind of restriction, so he will probably be fine. However, a lot of companies have cut back on dental coverage during the recession. So it might not be as easy to find as he thinks. BTW, he should not let this go too long. He won't save money if his cavity gets bigger and requires more work. His co-pay on something major (a 3-surface filling or a root canal) might be more than paying for everything on a simple filling. If you are talking a few weeks, it's not a big deal. But if he puts off the filling for months and months, it may not save him anything in money, and it will cost him pain and maybe the tooth itself. I hope this helps. Good luck to you and to him.
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I need a good Dental insurance can't afford to pay lot. Does any one know one and the price?
I have to get a Dental Evaluation, It is one of the things I need to have done to get on the Kidney transplant list.
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Look on the internet. there is good dental insurance out there...Good luck.
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Look on the internet. there is good dental insurance out there...Good luck.
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how do i find health/dental/vision insurance for my children?
i have m.s. and covered. but my children aren't. they live with my sister in tx. I am unable to take care of them.
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Blue Cross and Blue Shield offers individual policies that you can purchase for the children.
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Blue Cross and Blue Shield offers individual policies that you can purchase for the children.
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I have no credit and no dental insurance dose any one know who can help me?
I have a few cavities and i have called every dentist in the phone book and no one will help me. I brush and floss daily but I have always gotten cavities easily. I am only 21 years old i can't stand the idea of having messed up teeth so young someone please give me some advice. I live in central Ga. thanks
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Find out where the local dental school is. There is usually a small fee and plenty of time involved. But, it's a good way to take care of things now. And sometimes it's better to pay out of pocket for small fillings then wait for insur. and pay for crowns. Good luck!
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Find out where the local dental school is. There is usually a small fee and plenty of time involved. But, it's a good way to take care of things now. And sometimes it's better to pay out of pocket for small fillings then wait for insur. and pay for crowns. Good luck!
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Does anyone know the average cost of a dental visit & cavity filling in SC? We don't have dental insurance...
I'm 24, never had a cavity, but I do now! My husband and I, while we have great health insurance, do not carry a dental policy. However, I'm suffering, and this tooth is going to kill me soon. As we shop for dentists, what's an average range to shoot for?
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Cleaning and filling between $250-$700 depends on the dentist. I would check for a local community health organization. They usually have better prices & charge on a sliding scale.
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Cleaning and filling between $250-$700 depends on the dentist. I would check for a local community health organization. They usually have better prices & charge on a sliding scale.
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I don't understand the Explanation of Benefits from my Dental insurance...?
I was under the impression that the "Patient's Responsibility" amount would be approximately what I 'd be charged from the doctor. I paid the doctor prior to receiving the statement from the insurance, and it was much more than this amount. Why doesn't the amount I paid the doctor match up with the amounts on the explanation of benefits?
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Your doctor's office has likely over-estimated your copayment. You should call and check with your doctor's office, if they have received the payment from your insurance you probably have a credit on your account.
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Your doctor's office has likely over-estimated your copayment. You should call and check with your doctor's office, if they have received the payment from your insurance you probably have a credit on your account.
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Dental insurance in Alabama?
Does anyone know where I can find dental insurance to cover fillings in Alabama? The sooner it takes effect the better.
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YOu are not the only person who have ever met this kind of problem,I met this type of problem before.I have good experience here www.HealthInsuranceFree.info/dental.html to solve the problem.
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YOu are not the only person who have ever met this kind of problem,I met this type of problem before.I have good experience here www.HealthInsuranceFree.info/dental.html to solve the problem.
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Need about 2500 dollars done on dental work, no insurance and?
don't really want to apply for credit, will most dentist work out a plan to pay them directly?
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Some will, but most offer a 1 year no interest/low interest payment option that is actually through an independent company.
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Some will, but most offer a 1 year no interest/low interest payment option that is actually through an independent company.
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How come my dental office hasnt found out my insurance was cancelled?
I have braces, which I am currently paying the copayment for it which was part of the insurance, my insurance was canceled 8 months ago, how come they havent found out? My current price will definately change if they found out..
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They probably already got paid on the braces. My understanding when it comes to orthodontic claims, is that an initial fee is charged at the very beginning and one single claim is paid, not individual claims every month. But if that is not the way it is done, then shame on you for thinking you deserve free braces.
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They probably already got paid on the braces. My understanding when it comes to orthodontic claims, is that an initial fee is charged at the very beginning and one single claim is paid, not individual claims every month. But if that is not the way it is done, then shame on you for thinking you deserve free braces.
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what is a good health insurance that covers dental work?
mine dont cover enough i need to change my insurance.
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Most health insurance policies do not include dental, and those that have dental as an option are usually very limited. Visit a local agent that works with all the major companies in your area. The agent can explain the dental options and find the best plan for you. You can also get stand alone dental plans that are not associated with the health insurance. The agent should be able to help there as well. Be aware that with most plans there is a waiting period for major procedures. You can also try a Fee for Service discount plans. No deductible, no annual maximum and no waiting periods. Many dentist will accept the plan (check providers first before signing up with any plan). When you use the plan there is a set fee that the dentist will charge you. I'm an insurance agent and my personal plan is the fee for service plan because I find it much more cost effective. I got mine here http://www.dpbrokers.com/default.aspx?lo… specifically the Aetna Dental Access plan but which one you get depends upon your area and comparing the fee schedule to find the best for what you need covered.
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Most health insurance policies do not include dental, and those that have dental as an option are usually very limited. Visit a local agent that works with all the major companies in your area. The agent can explain the dental options and find the best plan for you. You can also get stand alone dental plans that are not associated with the health insurance. The agent should be able to help there as well. Be aware that with most plans there is a waiting period for major procedures. You can also try a Fee for Service discount plans. No deductible, no annual maximum and no waiting periods. Many dentist will accept the plan (check providers first before signing up with any plan). When you use the plan there is a set fee that the dentist will charge you. I'm an insurance agent and my personal plan is the fee for service plan because I find it much more cost effective. I got mine here http://www.dpbrokers.com/default.aspx?lo… specifically the Aetna Dental Access plan but which one you get depends upon your area and comparing the fee schedule to find the best for what you need covered.
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taxes and insurance question can a portion of health life dental and disabillity insurance be deducted on tax?
just need to know if theres a tax benefit that allows you to deduct any of the money we spend for health insurance
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If you're paying for your insurance through a plan at work you need to check if the premiums are being paid with "pre-tax" dollars. If they are being paid with pre-tax dollars you will NOT be able to deduct them on a Schedule A. It's because you've already seen the tax benefit of paying for them with pre-tax dollars. Paying with pre-tax dollars is very common. And really, it's the better deal, so be happy. This, along with the 7.5% AGI requirement on the Schedule A, prevents many people from being able to deduct insurance premiums on their tax return.
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If you're paying for your insurance through a plan at work you need to check if the premiums are being paid with "pre-tax" dollars. If they are being paid with pre-tax dollars you will NOT be able to deduct them on a Schedule A. It's because you've already seen the tax benefit of paying for them with pre-tax dollars. Paying with pre-tax dollars is very common. And really, it's the better deal, so be happy. This, along with the 7.5% AGI requirement on the Schedule A, prevents many people from being able to deduct insurance premiums on their tax return.
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Dental Insurance Coverage?
I have a wisdom tooth that it causing severe pain, and it needs to come out. Unfortunately, my dental insurance doesn't kick until the beginning of next month. Will insurance companies partially cover anything at all before the coverage starts or typically will I have to wait? Thanks in advance!
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Ask your dentist if they can wait to bill it. OR go to a dental school where they will work on it for reduced cost. OR offer to trade your dentist for some service such as office cleaning. OR get out a pair of pliers and....nevermind.
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Ask your dentist if they can wait to bill it. OR go to a dental school where they will work on it for reduced cost. OR offer to trade your dentist for some service such as office cleaning. OR get out a pair of pliers and....nevermind.
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Dental insurance companies?
I want to fix my teeth but I'm on a fixed income.my question is if there is such thing as a dental insurance that would benefit me, for example like paying a copay for dentist visits and where I only have to pay a deductible for major stuff like braces or molar removal.and if so which insurance company would you recommend?
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With most dental insurance plan you don't even have a co-pay for a basic checkup and cleaning. However, the major stuff will have a deductible which averages $100, a waiting period which averages 12 months, and co-insurance which averages 50%. There is also a annual maximum. Which companies are better will depend upon where you live because most companies do not operate in all states. Contact a local agent that works with several companies. They can tell you what is available and can explain how the plans work. You could also check a dental school where you can get good service for a reasonable cost. You can find the nearest one here: http://www.yourhealthplanadvisor.com/Den…
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With most dental insurance plan you don't even have a co-pay for a basic checkup and cleaning. However, the major stuff will have a deductible which averages $100, a waiting period which averages 12 months, and co-insurance which averages 50%. There is also a annual maximum. Which companies are better will depend upon where you live because most companies do not operate in all states. Contact a local agent that works with several companies. They can tell you what is available and can explain how the plans work. You could also check a dental school where you can get good service for a reasonable cost. You can find the nearest one here: http://www.yourhealthplanadvisor.com/Den…
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Do you need cheap Health and Dental Insurance?
Here's a great blog for cheap Health and Dental Insurance. http://healthdentalinsurance.blogspot.com/
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I thought soliciting wasn't allowed... LOL
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I thought soliciting wasn't allowed... LOL
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vision and dental insurance?
Can anyone tell me where I can look for vision and dental insurance in Illinois? Please do not tell me Delta Dental, as I currently have Delta Dental and they do not cover anything except a cleaning and this is through my employer. Someone help.
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Unless you have a bad mouth, dental insurance isn't worth the $$. By the time you pay the monthly premiums, in a year you are behind what a regular doc would charge for cleaning, exams, x-rays, crowns, etc.
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Unless you have a bad mouth, dental insurance isn't worth the $$. By the time you pay the monthly premiums, in a year you are behind what a regular doc would charge for cleaning, exams, x-rays, crowns, etc.
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low cost health & dental insurance programs in los angeles . . . .?
my boyfriends job doesnt offer health or dental insurance only workers comp if he is injured (he is an electrician) we have a two year old son and we dont qualify for healthy families or medi-cal but we cannot afford to pay three or four hundred a month. is there a program that offers low cost health and dental for people whose jobs dont offer insurance? I need my four wisdom teeth pulled so dental is a big deal. Any insurance programs you know of like that?
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Kaiser Permanente Health Savings Account If your young and basically healthy, this is the best deal for you. Probably less than $250 a month.
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Kaiser Permanente Health Savings Account If your young and basically healthy, this is the best deal for you. Probably less than $250 a month.
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Is There an Affordable Dental Insurance Plan Available??
I would like to have my teeth worked on however I do not have dental insurance, are there any good ones?
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there are some plans, you have to weigh the cost of the monthly premium aagainst what it pays for. A lot of the policies are worded-" pays 100% of cleanings and preventive-" and then gives you a 80%for fillings, perio work and extractons, 50% for crowns and bridges and dentures. You must ask questions! 100% of what they allow may be only $30 of your $240 cleaningYour part then becomes the remaining 210 and you paid a premium to the insurance company. A lot of individual policies also have a year waiting period or longer for anything other than a cleaning. Some times it is a really good idea to look for a loan that will pay the dentist in full- Care Credit is online and you apply for a credit card that can be used at participating medical. dental, eye docotr etc. I am sure they are other companies as well, and your dentist may have just one he works with , so call ahead. Group insurnance is usually the best through work place for benefits, but even that can get tricky with going to the right provider( a dentist who has agreed to do the work for the allowance fee of the insurance company.. ) If money is an issue always ask for a predetrimination from the dentists. You can call the customer service number yourself on your policy and give them the insurance codes and find out if you are going to owe a ton or not for procedures. Their are sometimes clinics available that do work for a sliding fee- just ask any office you call, or ask your church if they have a connection to a dentist or clinic.
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there are some plans, you have to weigh the cost of the monthly premium aagainst what it pays for. A lot of the policies are worded-" pays 100% of cleanings and preventive-" and then gives you a 80%for fillings, perio work and extractons, 50% for crowns and bridges and dentures. You must ask questions! 100% of what they allow may be only $30 of your $240 cleaningYour part then becomes the remaining 210 and you paid a premium to the insurance company. A lot of individual policies also have a year waiting period or longer for anything other than a cleaning. Some times it is a really good idea to look for a loan that will pay the dentist in full- Care Credit is online and you apply for a credit card that can be used at participating medical. dental, eye docotr etc. I am sure they are other companies as well, and your dentist may have just one he works with , so call ahead. Group insurnance is usually the best through work place for benefits, but even that can get tricky with going to the right provider( a dentist who has agreed to do the work for the allowance fee of the insurance company.. ) If money is an issue always ask for a predetrimination from the dentists. You can call the customer service number yourself on your policy and give them the insurance codes and find out if you are going to owe a ton or not for procedures. Their are sometimes clinics available that do work for a sliding fee- just ask any office you call, or ask your church if they have a connection to a dentist or clinic.
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Best dental insurance in Central California?
Anyone know of a good individual dental plan for someone in Central CA? Looking for one good prices on dental procedures (implants, root canals, fillings) good yearly rate.. Thanks
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I live in central Ca myself and signed up for dental benefits with the company below. Its not insurance. It cost me $19.95 for my entire family and they saves us up to 80% on our dental work. You also get free vision, free prescription and free chiropractic care with your dental. I broke a tooth a few weeks ago and it saved me a lot of money. I would look into them. There are no waiting periods of paper work to feel out...thats one thing I liked about them. Good luck to you
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I live in central Ca myself and signed up for dental benefits with the company below. Its not insurance. It cost me $19.95 for my entire family and they saves us up to 80% on our dental work. You also get free vision, free prescription and free chiropractic care with your dental. I broke a tooth a few weeks ago and it saved me a lot of money. I would look into them. There are no waiting periods of paper work to feel out...thats one thing I liked about them. Good luck to you
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i'm having trouble deciphering my dental insurance claim...?
i received an insurance claim for a dental procedure and having trouble figuring out how much i have to pay. amount claimed $1,021 amount allowed $ 400 deduct applied $ 50 patient resp $ 120 amount paid $ 120 can someone please explain what each line means? thank you
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It's not a ponzi scheme. And to the dentist who hates insurance companies: yeah, if people didn't have dental insurance, they wouldn't even go to the dentist to begin with: 60% of all dental patients have insurance. This more than likely looks like the dentist belongs to a network and the CLAIMED fee isn't what the dental insurance company is going to pay him. Looks like you had a major procedure( I'm guessing crown) and normally the dentist charges 1021, but he agreed to a lower fee to belong to the insurance company's network. Amount allowed is, I'M GUESSING around 50% of the actual amount the insurance company allows the dentist to charge, since most companies pay out major procedures at 50%... but your insurance plan may be different. Check your certificate of insurance to make sure. After you paid your deductible at the office, the dental office probably sent off the claim to the insurance company, and the insurance company came back with that payment. It is now the dental company's responsibility to send you the bill for the balance, if there is any at all. Call the insurance company's customer service line. Hope you don't have METLIFE... they suck.
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It's not a ponzi scheme. And to the dentist who hates insurance companies: yeah, if people didn't have dental insurance, they wouldn't even go to the dentist to begin with: 60% of all dental patients have insurance. This more than likely looks like the dentist belongs to a network and the CLAIMED fee isn't what the dental insurance company is going to pay him. Looks like you had a major procedure( I'm guessing crown) and normally the dentist charges 1021, but he agreed to a lower fee to belong to the insurance company's network. Amount allowed is, I'M GUESSING around 50% of the actual amount the insurance company allows the dentist to charge, since most companies pay out major procedures at 50%... but your insurance plan may be different. Check your certificate of insurance to make sure. After you paid your deductible at the office, the dental office probably sent off the claim to the insurance company, and the insurance company came back with that payment. It is now the dental company's responsibility to send you the bill for the balance, if there is any at all. Call the insurance company's customer service line. Hope you don't have METLIFE... they suck.
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low cost health & dental insurance programs in los angeles . . . .?
my boyfriends job doesnt offer health or dental insurance only workers comp if he is injured (he is an electrician) we have a two year old son and we dont qualify for healthy families or medi-cal but we cannot afford to pay three or four hundred a month. is there a program that offers low cost health and dental for people whose jobs dont offer insurance? I need my four wisdom teeth pulled so dental is a big deal. Any insurance programs you know of like that?
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Kaiser Permanente Health Savings Account If your young and basically healthy, this is the best deal for you. Probably less than $250 a month.
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Kaiser Permanente Health Savings Account If your young and basically healthy, this is the best deal for you. Probably less than $250 a month.
Source
Is There an Affordable Dental Insurance Plan Available??
I would like to have my teeth worked on however I do not have dental insurance, are there any good ones?
--------------------
there are some plans, you have to weigh the cost of the monthly premium aagainst what it pays for. A lot of the policies are worded-" pays 100% of cleanings and preventive-" and then gives you a 80%for fillings, perio work and extractons, 50% for crowns and bridges and dentures. You must ask questions! 100% of what they allow may be only $30 of your $240 cleaningYour part then becomes the remaining 210 and you paid a premium to the insurance company. A lot of individual policies also have a year waiting period or longer for anything other than a cleaning. Some times it is a really good idea to look for a loan that will pay the dentist in full- Care Credit is online and you apply for a credit card that can be used at participating medical. dental, eye docotr etc. I am sure they are other companies as well, and your dentist may have just one he works with , so call ahead. Group insurnance is usually the best through work place for benefits, but even that can get tricky with going to the right provider( a dentist who has agreed to do the work for the allowance fee of the insurance company.. ) If money is an issue always ask for a predetrimination from the dentists. You can call the customer service number yourself on your policy and give them the insurance codes and find out if you are going to owe a ton or not for procedures. Their are sometimes clinics available that do work for a sliding fee- just ask any office you call, or ask your church if they have a connection to a dentist or clinic.
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there are some plans, you have to weigh the cost of the monthly premium aagainst what it pays for. A lot of the policies are worded-" pays 100% of cleanings and preventive-" and then gives you a 80%for fillings, perio work and extractons, 50% for crowns and bridges and dentures. You must ask questions! 100% of what they allow may be only $30 of your $240 cleaningYour part then becomes the remaining 210 and you paid a premium to the insurance company. A lot of individual policies also have a year waiting period or longer for anything other than a cleaning. Some times it is a really good idea to look for a loan that will pay the dentist in full- Care Credit is online and you apply for a credit card that can be used at participating medical. dental, eye docotr etc. I am sure they are other companies as well, and your dentist may have just one he works with , so call ahead. Group insurnance is usually the best through work place for benefits, but even that can get tricky with going to the right provider( a dentist who has agreed to do the work for the allowance fee of the insurance company.. ) If money is an issue always ask for a predetrimination from the dentists. You can call the customer service number yourself on your policy and give them the insurance codes and find out if you are going to owe a ton or not for procedures. Their are sometimes clinics available that do work for a sliding fee- just ask any office you call, or ask your church if they have a connection to a dentist or clinic.
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