Dental office wants to charge for it but insurance company says it's my option and not necessary. Who do I believe?
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I can't speak to the necessity of any treatment for you. It's impossible to diagnose over the internet. But this is a game insurance likes to play. They will say they are denying your claims and try to shift the blame to the dentist by saying: 1. The procedure is not necessary 2. The dentist is charging too much. The insurance company has no way to know if you need any specific treatment. You are just a name (or more likely a number) that costs them money if they actually have to pay out instead of just collecting your premiums every month. Has anyone from the insurance company come to look at your mouth and see what your needs are? I'm guessing not. LOL Be up front and ask your dentist if you have concerns. It may very well be optional in your case, but it could also be necessary and important. Your dentist will probably be happy to discuss his reasons for prescribing this treatment.
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Saturday, June 4, 2011
How do you make important budgeting strategies if everything u want to do seems equally imporant?
So, I make a pretty good amount an hour, but have carnote, pay daycare for 2 kids, plus clothes, my half of all expenses from rent, utilities, cheap cell phone bill, blah blah blah........ I am getting child support so that makes it alot easier, but there are sooooo many things that seem high dollar that I need to get done.......I need to make a dental appt (which I know will be about $200), belts replaced on my car engine (up to $400), a new catalytic converter on my car (upwards of $1000 possibly more. Had to afro-engineer it last year to get thru marta), my car painted, get insurance on my car (down payment will hurt on that one - have a high insurable car) and pay off alot of other bills (not big amounts, just small) ...........I need it all done NOW, but I dont know what to concentrate on, I feel like if I do one, then another will bite me in the butt.......any suggestions?
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First off I want to say I'm sorry for what you are facing. That is a big load to carry and I tip my hat to you for all you need to do. Well I'm assuming you need your car to make money. If this is the case you need to focus on the mechanical issues first. Painting it should be last on the list. If you can then get it fixed, gt insurance. If you cannot get it fixed, let your insurance lapse and while using public transportation take the extra insurance money and save it to fix the car and get your teeth fixed. Then start making bigger payments on your other debts. The best thing you can do right now is not get overwhelmed, take things day-by-day, don't miss out on the wonder of being a mother by worrying about tomorrow. You can and will make it through this and you will be stronger as a result.
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First off I want to say I'm sorry for what you are facing. That is a big load to carry and I tip my hat to you for all you need to do. Well I'm assuming you need your car to make money. If this is the case you need to focus on the mechanical issues first. Painting it should be last on the list. If you can then get it fixed, gt insurance. If you cannot get it fixed, let your insurance lapse and while using public transportation take the extra insurance money and save it to fix the car and get your teeth fixed. Then start making bigger payments on your other debts. The best thing you can do right now is not get overwhelmed, take things day-by-day, don't miss out on the wonder of being a mother by worrying about tomorrow. You can and will make it through this and you will be stronger as a result.
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Dentist said they participate with my insurance, but they don't. Now I'm stuck with the bill. What options?
My husband has been going to one dentist for years. This past November he had to get his widsom teeth out. They said they verified payment, but they must not have. Wisdom teeth extraction falls under medical, not dental, and they don't participate with my medical insurance. Now we're stuck with a bill for $2300 and I already paid about $500 out of pocket before the surgery. What can I do at this point? I never would have gone to them if I knew it wouldn't be covered. Do I have any recourse??
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First $2300 for IV sedation and 4 surgical extractions is very reasonable. The big problem is which insurance, dental or medical, is responsible for the bill. Is the medical and dental insurance the same company? Is this an HMO or PPO and you can only see certain providers? Either or both insurances should be responsible for the procedure. They are probably saying that you did not use one of their providers. Call their offices and file a grievance with them. Also send a letter to your state insurance commission (along with a copy to the insurance companies). You may have to fight for the payment but you should prevail. Good luck
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First $2300 for IV sedation and 4 surgical extractions is very reasonable. The big problem is which insurance, dental or medical, is responsible for the bill. Is the medical and dental insurance the same company? Is this an HMO or PPO and you can only see certain providers? Either or both insurances should be responsible for the procedure. They are probably saying that you did not use one of their providers. Call their offices and file a grievance with them. Also send a letter to your state insurance commission (along with a copy to the insurance companies). You may have to fight for the payment but you should prevail. Good luck
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Insurance question...?
Can I get divorced and then get remarried in a month so that I can elect to cover my spouse and children under my insurance plan? There is no open enrollment, only when you first get hired or for a major life event. I am married to a great guy with joint custody of his two kids. He is required to provide health insurance for the children. Last year, I took a new job that had union negotiated health care benefits with much better coverage for the whole family, including my step-kids. My premiums for the family were about $350/month and his are $500/month. His deductable is $1000 and total out of pocket is five thousand. My new insurance is $250 deductable and five hundrend total out of pocket. My co pays are $10 and his are $30 per doctor visit. And it is with the same major insurance company and list of providers - the same ppo. Here is the problem, his x wouldn't let him drop his old insurance without us agreeing to some ridiculous terms. There is a court order to provide insurance through his employer, so his employer wouldn't drop the coverage without a court order saying it was ok to cover the children with either insurance. We couldn't afford both monthly premiums, so we couldn't elect to get my new coverage for the family. I was able to get dental and vision though. Vision was free for family and the coverage that they provided for the children's braces was more than the dental premiums so that was a good financial decision. Now that the x is seeing how great the coverage is - the eye doctor told her he had never seen this good of coverage... they cover everything even transition lenses, bifocals, and designer frames 100% - she is starting to be more reasonable. It will save her tons of money too since we split the out of pockets and co-pays with her. Is that legal to do? and how hard would it be to do?
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I think there must be an easier way than getting a divorce. I am surprised there is not an annual open enrollment where you can add your family. If you are sure of this, then find out what a life changing event might consist of. Talk this through with your HR benefits rep. I am stunned that they would put a family in the position of getting a divorce. Their logic is to keep healthy people from refusing the insurance and then expecting to be added after they get sick not to keep a young healthy family out of the risk pool, in fact they should welcome that.
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I think there must be an easier way than getting a divorce. I am surprised there is not an annual open enrollment where you can add your family. If you are sure of this, then find out what a life changing event might consist of. Talk this through with your HR benefits rep. I am stunned that they would put a family in the position of getting a divorce. Their logic is to keep healthy people from refusing the insurance and then expecting to be added after they get sick not to keep a young healthy family out of the risk pool, in fact they should welcome that.
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How to REALLY know how much house I can afford!?
OK I know this has been asked many times, but the main thing I want to know is why do they say X% of your GROSS pay should go to housing instead of X% of your NET pay? I live in an expensive area, and spending around 26% of my monthly GROSS pay on mortgage+insurance+taxes (no PMI) is the only way I can buy any kind of house. If I used the 30-40% of NET pay formula I wouldn't be able to afford a shack. So what is the story? I don't want to be house poor, but the amount leftover after tax/medical/dental/401k deductions is much different than the gross income!
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The reason they say gross pay instead of net pay. In theory that percentage already takes into consideration that taxes are coming out. They also assume that you can cancel insurance/401k contributions if you have to in order to make your bills, those are all voluntary. Non-voluntary deductions (garnishment, child support payments) are taken out of your income before they figure the ratio. As you've probably been told this is the number the lender will use to qualify you for the amount. Please only use this as a guideline. The main question is if you, personally, can budget the payment. If you don't want to cancel your voluntary deductions or change your lifestyle, the number you can really afford will probably be different. The real way to figure how much you can afford is to get your mortgage payment on a 30 year fixed loan, add in your taxes and insurance, and have all that add up to what you're able and willing to invest in a home. You can find a decent calculator here: http://www.easyonlinerefi.com/Calculator… That will figure out payments on the mortgage for you.
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The reason they say gross pay instead of net pay. In theory that percentage already takes into consideration that taxes are coming out. They also assume that you can cancel insurance/401k contributions if you have to in order to make your bills, those are all voluntary. Non-voluntary deductions (garnishment, child support payments) are taken out of your income before they figure the ratio. As you've probably been told this is the number the lender will use to qualify you for the amount. Please only use this as a guideline. The main question is if you, personally, can budget the payment. If you don't want to cancel your voluntary deductions or change your lifestyle, the number you can really afford will probably be different. The real way to figure how much you can afford is to get your mortgage payment on a 30 year fixed loan, add in your taxes and insurance, and have all that add up to what you're able and willing to invest in a home. You can find a decent calculator here: http://www.easyonlinerefi.com/Calculator… That will figure out payments on the mortgage for you.
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Comfort Dental - anyone else have bad experience?
Ok, so I went 3 years without a cleaning which is not like me. For one though I had a couple of kids, and decided that since I was on my husband's dental plan I should use that, which unfortunately my Dentist that I have been going to since I was 5 was not on the list. So recently I decided I better get in, and also my son needs his first checkup. I came to realize that the only place I could go is Comfort Dental. The Dr. does a quick check of my teeth and tells me that since it's been 3 years I need a 'deep cleaning'. Come to find out as I was checking out that it will cost me (with my insurance) $320 ! And she said they don't do payment plans, and was snotty with me when I said that I didn't have that kind of money to put up front. I ended up calling my old dentist and the receptionist there said she was disturbed that I was told I needed a 'deep cleaning'. I have decided that I will actually save more by paying out of pocket going to my old dentist who I actually trust. Comfort Dental felt like they were just trying to get money out of me. Plus I was also displeased as I was sitting in the waiting room and I heard the receptionist on the phone (with an insurance company I presume), tell them a SSN# out loud. If I wanted to I could of written it down and used it! Where are the HIPPA laws on that? I guess I'm wondering if others are displeased with Comfort Dental, and if anyone knows who I could make a complaint to. Somehow I think complaining to them won't make much of a difference.
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Sounds like a mill....you have to be with someone you trust! Do payment plans, whatever....it is worth it!
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Sounds like a mill....you have to be with someone you trust! Do payment plans, whatever....it is worth it!
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How to get rid of a huge toothache?
my husband has a horrible toothache, he dont have insurance and is laid off currently, so there for no money, what can we do for this? can we get free dental help somewhere and what can we give him for it to help the pain??
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Painkillers such as Tylenol work for the pain, and drinking something cold can also numb it. I'm not sure where you can find free dental help, though. Hope things get better!
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Painkillers such as Tylenol work for the pain, and drinking something cold can also numb it. I'm not sure where you can find free dental help, though. Hope things get better!
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