Thursday, March 3, 2011

Health Insurance Question?

I got my wisdom teeth taken out last summer, and here is what happened. I turned 23 a week before the operation, and my dental insurance policy ended on my birthday. My dentist's office called the insurance company, and they also did not realize I was not covered, so they told the dentist to go ahead and do the operation because I was covered. Now, 6 months later, they notified me that I was not covered, which is true, but they put me under the pretense that I was covered before the operation. Is the insurance company responsible for telling me I was covered when I wasn't?
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Nope. You should have been aware that your coverage would be ending as of your 23rd birthday. It was your responsibility to make sure that you scheduled the surgery before your coverage ended. There can be some lag time in updating a system to show a termination, which is why there is always a disclaimer that any quote is subject to the benefits being in effect for the date of services. If your policy was canceled, you have no grounds for an appeal or dispute. Eligibility issues are pretty cut and dried - either your policy was active on the date the services were performed, or it wasn't. Unfortunately, you'll be responsible for the entire bill. Try working out a payment plan with the dentist.
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