If you have dental insurance, chances are you pay
hundreds of dollars each year to cover your family for the basics and in case
something goes wrong. So if the time comes along that a major procedure is
warranted, shouldn’t your insurance provide some help in covering a procedure
that will give you the best long term result? The answer should be yes, but you
will be disappointed to learn that this is not always the case.
A common example of dental insurance trying to dictate
the treatment you need is when you want to replace missing tooth with a dental
implant over a dental bridge. Dental implants are long lasting, cosmetic,
functional, and are non-invasive to your other teeth. Over the course of your
life, they typically result in the least amount of long term financial
investment because they will last longer than a dental bridge. This also means
the insurance company will have to contribute less over the long term. But for whatever reason, many insurance
companies will deny you coverage on the dental implant but will approve the
dental bridge. Both procedures require a large financial commitment, and the
difference in coverage is often the difference maker if you need your tooth
replaced. Thus, the insurance company can push you towards one option over
another.
So what can we do if your insurance company denies
coverage to a recommended procedure? In some cases, no matter what we do, the
insurance company will simply not provide any coverage for certain procedures.
But in other situations we can submit a new request for coverage along with a
narrative explaining our rationale for the treatment needed. There are times
when reason wins and coverage is granted, but unfortunately it doesn’t always
work out that way.
Before signing up with an insurance carrier or package, I
would recommend doing some detailed research on what procedures may be covered.
If you are overwhelmed by all of this or confused, I encourage you to call us
and we can help you sort through what plan may be best according to the needs
and dental history of you and your family.
For more information, visit www.brownandkupper.com.
Lee T. Brown, DDS
Brown and Kupper, DDS Inc.