My son was hit in the mouth with a baseball seven years ago. His teeth had to be wired in place. One of the four damaged teeth was worse than the others. That one required a follow up root canal. The baseball insurance covered all expenses as we were uninsured at the time. Now, 7 years later, the tooth that had the root canal is still deteriorating, and we just had to extract the tooth and in 6 months will be doing an implant (after the healing completes itself). We do have dental insurance, however, it will only cover less than $1,000 of the costs. The total bill is going to be close to $7,000 or better. I feel the insurance company should still be liable to help with the expenses. The company says they only are liable for 156 weeks. They never told us that before. What can be done? We are not asking for pain and suffering (although with the pain he has been through, we SHOULD).
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I am sorry to say this, but think about it, how long is this insurance company supposed to be on the hook? For 156 weeks, that is over 3 years. You could go to the dentist for the next 20 years and provide a bill and expect them to pay it. Would you do this? Pull out the paperwork you signed. (Believe me, you signed it and most likely then not read it, or was told they would cover, but did not HEAR that it was for X and X amount of months). You were just happy they covered it and would pay for any other problems. As for the dental implant, that appears pricey, I have seen that the average is around $3,500, based on my own experience of doing claims. My suggestion is to call the dental schools where you live. Many will do procedures for over 50% less than a licensed dentist since they need the experience and have licensed dentist to oversee the procedure. Also, since you have dental insurance, see if they can find a dentist to do. Even though a dentist charges say $2,000, the contract with the insurance maybe they will allow only $1,500, meaning you would owe only $500. good luck
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