Thursday, September 25, 2008

Insurance, ugh!!!!!!!!!!!!

I am so frustrated! Back in 2007 I posted about orthodontics-for-7-year-olds and I have been meaning to take some before and after pictures, because Megan and Ryan have had great improvements with their teeth.

About 6 weeks ago, the orthodontist recommended extracting Ryan's 2 upper canines to help create room for 2 of his permament teeth to come in. We arranged this with the dentist and had it done recently.

Turns out that our dental insurance is very particular, to put it nicely! They automatically across-the-board assume that extraction of those particular teeth must be orthodontic related and therefore they apply the cost of the extractions to the lifetime maximum on orthodontics - which of course - Ryan is maxed out on!!!!!! So, it seems the $125 fee per tooth will be coming out of our pockets. Insurance will not pay even one thin dime, nor will they re-consider their ruling.

Even medical insurance is paying for less and less each year though the premiums go up. The insurance representative states: "it isn't that we don't pay for the blood work or tests - but it is applied to your $1000.00 deductible first".

Whatever !! It all makes me want to skip going to the Dr. at all.

***FOLLOWUP:
Turns out there is nothing to be done about the extractions being applied to the orthodontic lifetime maximum. We can pay out the remaining $203. Oh joy!

6 comments:

Huse Yo Mama said...

Let ME call them. I'll flip the switch on 'em!!

Syndi said...

so, can the dental office resubmit the bill with different "codes" that might allow this to be covered outside of the ortho coverage? Worth an ask if you haven't already.

Tripletblessed said...

I hate insurance it's such a necessary evil! Sorry they are being so rough.

The Murray Crew said...

grrrrr. grrrrr. That's all I have to say. Thank goodness we aren't having to fight with insurance over Synagis shots this year! Glad we've grown out of that battle! grrrrr.

Anonymous said...

the surfaces read your blog!

Anonymous said...

Jamie. I read your blog everytime you send the reminders. Very entertaining and allows me to catch up when we haven't had a chance to talk. Shayne will be getting his braces off his next visit. Praise the Lord! One down one to go.