Thursday, March 17, 2011

Pre-existing condition / Diabetes for Group Health/Dental Insurance?

The last time I saw my doctor for my Type 2 diabetes in the U.S. was in August, 2003. I went overseas soon after that and didn't come back until recently (I didn't have coverage during this whole time). I just got a job which offers group health insurance, does my diabetes counts as pre-existing condition. (I'm choosing a BCBS PPO plan), and can they impose exclusion period? I live in Pennsylvania, and according to my research, Group health plans in PA can count as pre-existing conditions only those for which you actually received (or were recommended to receive) a diagnosis, treatment or medical advice within the 6 months immediately before you joined that plan. So it appears to be that I should have no problem if I go to see my doctor for my diabetes right after my policy become effective on Jan. 1st, 2008, right? I want to make sure. Similarly, I had dental surgery for gum problems in 2002, will my group dental plan look back 6 month only? Thanks for your answer
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If you have diabetes you've had "treatment" for the past 6 months, even if it was just diet to control your blood sugar. So yes, the insurance company will consider that a pre-existing condition. Also, if you have any type of health condition, even if you haven't had any treatment, it is still considered a pre-existing condition. However, it also depends upon the BCBS group plan. Group plans can be tailored in any way (unless it's contrary to state law) so the only way to know is to contact the insurance company or your company HR department.
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HELP!! Emergency dental issue.. I cracked a front tooth right down the middle & no insurance!PLEASE HELP!?

Somebody please be my guardian angel here! any help at all is much appreciated.. i'm in tears and a sitting duck at this point.......... i'm a ft student, don't have dental insurance, and am supporting myself as best i can. I drank a lot of soda as a kid and long story short, i have quite a few cavities. I brush, floss & waterpik daily but I guess the damage had been done. My tooth right behind my canine, or maybe it is my canine (not sure) got a cavity right in the center of it and even with me caring for it daily has grown and grown to literally become what can only be described as a hollow tooth I guess. Well this morning while eating it finally cracked, of course the half that fell away was the front part of the tooth. Now it looks like i'm missing a tooth entirely. =* ( I don't have insurance, and barely have the money to get by day to day. I work and go to school full time. I'm hysterical and desperate... ANY advice, suggestions, ideas, ANYTHING anyone can offer is GREATLY appreciated. I'm only 24 and i'm lost on this one. Forget smiling, even when im just talking you can see it clear as day. =* ( I live in the greater los angeles area, can anyone point me in the right direction? I'm seriously desperate. Thank you for taking the time to read this, either way. please, ANYTHING!
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Go to a local dentist and schedule an appt, they will tell you everything that is wrong or that you need to fix and you should be able to set up a payment plan. Make sure that the dentist that you pick sets up payment plans before scheduling the appt. Most dentists do, so you should not have a problem.
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What can I do about my no insurance and tooth issues, ive never had insurance dont want to get scammed?

I've had several teeth pulled, I'm afraid something else could go wrong, I have no dental insurance at the moment and I have a temporary filling. I live in California at the moment, and I don't know what to do, should I look into getting some dental insuance, I don't want to get scammed , with regards to paying for a policy that can't do anything for me when I really need it, but if anyone has some names of some dental insurance companies that might work and actually get some results rather than be a scam, please share?
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There are so many out there to chose from, but for my family we have this wonderful plan. I would encourage you to visit this great website: www.healthsavings.ourperfectcard.com I signed up online over 5 years ago and they have saved me thousands of dollars on all of my dental services. From extractions to xrays, fillings, crowns, Cleanings, and even my braces. They even had my affordable benefits active in 2 hours and was able to use them the very same day. Good luck and Hope this helps.
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Are Dental Bridges bad?

I am 22 years old and am getting my braces removed in two weeks. I have a missing tooth on my upper left jaw in the front between my front tooth and canine tooth(not good with dental terminology), and I was instructed that i needed either a bridge or implant. I have opted to go with a bridge because my dental insurance covers it and i dont have money to get an implant. However when i went to see my dentist who specailizes in cosmetic dentistry, I was told that it was a VERY BAD idea to get a bridge and that I should invest the 4000+ dollars to get an implant. Im scared of getting an implant because of the surgery and healing process as well as the financial burden it will impose on me(im in grad school). Do bridges look fake, and do they damage your teeth badly? If anyone with(or has had) a bridge can respond that would be great. Thanks
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Bridges are considered legitimate restorations and for the longest time have been one of the few options for replaicn missing teeth, partial being the other alternative. I am big skeptical if your doc said they are very bad, since they are considered legitimate restoration by all state boards and the american dental resotration. My point is I think hes trying to sell you an implant. Implants are a nic eoption but the VERY BAD! statement bugs me. Also you shouyld not let the insurance dictate the treatment, bc if you go with a bridge the insurance cover they are going to down grade it to base metal which can corrde and leave a purple mark on you gum line, so pay a little extra and ask for a bridge with nobel metal (gold for the core) I would seek a second consult efore proceeding with this dentist bc like i said the "its very bad bugs" Dentist like that are putting money ahead of the patients well being, and basically lieing to you. Had he given you the options and explainto you that there are several alternatives than I would have understood, but that was not the case here.
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How do I make a dental complaint?

I had a root canal and crown treatment in Fall 2006. The root canal treatment taking more than six hours to complete. The crown recently came off, and, consulting a new dentist, she took an x-ray, which showed that there appeared to be a problem with the root canal. She immediately referred me to an endodontist, who, upon examination found that the root canal had not been properly completed in the first place and was too short, and that a piece of a file had been broken off and left in the root. This repair has cost me $227 out of pocket, and $1,200 of my annual dental insurance allowance, and the crown must now be replace, which will cost even more. Consequently I am out of pocket, and have used the majority of my annual dental insurance allowance, on a repair, that I should not had to have had. Please advise how I stand the best chance of getting the dentist who originally performed the work to reimburse me?
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go back and talk to your dentist about the findings. Have the endodontist draft his findings in a letter. Go in there with an honest attitude instead of storming the front desk or accusing the dentist. You will get better results this way. You may also have signed an informed consent that may not help you. if you don't get good results, write back!
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Discount dental plan for braces?

I have Blue Cross dental insurance, but it's terrible. It does everything in its power to avoid paying anything for orthodontics, and my niece (who's moved in with me) needs braces badly. We have many, many expenses to help get her healthy, and I can't afford $5000 for braces. Are there any discount dental plans that are good for braces and don't impose a long waiting period? Most have a 12 month waiting period. Please do not link to any specific sites because it will look like spam. You are more than welcome to name programs you think are good!
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Take pictures of the mouth, and make the rounds yourself. Try to negotiate the plan you want in person. Too lazy to research anyway
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What dental procedures will I need (please read all)?

I am 20 years old and have never been to a dentist in my life. My parents never had dental insurance and I am currently on Medicaid. I was taught proper hygiene and even voted best smile in middle school despite never having a routine exam. However, here I am today at 20. My lateral incisors and two front teeth have begun to completely fall apart. Two of my molars have been eaten away by plaque, leaving large gaping holes and abscesses. I am sure that there are cavities elsewhere in my mouth (if not in ALL of my teeth). I have bad breath on a daily basis no matter how often I brush or rinse. When flossing, my teeth feel like they are going to crumble. Hypothetically, let's say that I need 10 extractions, 10 fillings, some root canals, and then I decide I want dental implants. How long will these procedures take (to have my mouth looking good again), and around how much will it cost?
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When I went to mine for the first time back in April, it had been 11 or 12 years since the last time I had set foot in a dentist's office. It can vary really on what your dentist suggests (you should really make an appointment with one), what your insurance covers, and how much you can afford to pay out of pocket. Most insurance companies will only cover a portion of dental work, usually routine cleanings, fillings, and other minor work. More major work (root canals, crowns, extractions, bridgework, etc.) may not be covered by your provider, or will only be covered partially, leaving you to pay the remainder out of pocket. Schedule an appointment with a dentist close to your home or work that is on your insurance plan. Make sure he or she knows you haven't been to a dentist at all. On your first visit, either the dentist him/herself or one of their assistants/technicians will begin cleaning your teeth. They will ask you if you've had any issues with your teeth (sensitivities to hot/cold foods, when you bite does it hurt, any pain during weather changes, etc.). After the technician has done the initial cleaning, the dentist will take a look in your mouth, and make a few notes. They may want to take X-Rays of your mouth as well. After all that is done, they may schedule another appointment at least a week or two after your first appointment. If they can make the decision right there, they will tell you what needs to be done, and will work with you to schedule the procedures in such a way so that they will become affordable. When my dentist looked in my mouth, after everything else had been done, he scheduled me to come in a couple of weeks later. When I went in, one of the assistants told me what all needed to be done. They had worked up two potential plans. First, they said that regardless of which plan I chose, I needed some fillings. Second, some of the teeth would have to come out completely. One of the plans involved a couple of extractions, some bridgework, root canals, crowns, fillings, and a partridge in a pear tree. The other plan involved just a few fillings, several extractions (about 11 or 12 teeth total), and partials. Both plans showed what the insurance would cover, and what I would have to pay out of pocket. The plan involving everything under the sun was to the tune of over $5,000. That's what I would have had to pay out of pocket. The other plan, dealing with extractions and partials, would only cost me $1,800. After talking it over with my parents, I wisely chose the extractions and partials. I had already intended on doing that one, since it was cheaper, and my dad had said it would be best because root canals and bridgework can go bad on down the road. Partials and extractions are easier to handle. So, I told them I wanted to do the extractions and partials. For the last few months they did the fillings, and today they did the first of what will be many extractions, and pulled only two teeth. I had one fall out about three or four weeks ago, and luckily it was one of the ones slated to be pulled. After all the teeth are pulled, I will be fitted for partials. Some dental clinics may offer payment plans and will work with you to make the necessary work affordable, where you can pay on a weekly, bi-weekly, or monthly basis. In short, make an appointment with your dentist, and see what he or she says.
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