Medical Coverage for Dental Work---The Latest

[Rambling Rose]

Here's a hint for those who have tried or are considering trying to get their health insurance to cover dental work.  I submitted my dental claims to my health insurance.  They actually called me (perhaps because I'd requested a grievance packet) to tell me they believe some may be covered but that I had to submit claims with a medical code number.  Now, dentists don't know medical codes.

Some online research led me to references that contain dental to medical cross over codes.  I was about to buy one for my dentist when it occurred to me to call the oral surgeon I'd seen.  YES!  They have the codes and will work with my dentist to get the dental codes converted.

If this helps just one other person I'll be delighted.  Perhaps we both might actually get something back for all the premiums we've paid for health insurance.

Bonnie

[quiger]

Wow, this is very interesting. Thanks for the info.

quiger

[YICKelly]

I agree.  Thanks.  Now if I could just find a dentist that has even heard of SjS and takes Medicare/aid. 

[Rambling Rose]

I have an absolutely wonderful dentist,  which is a good thing since I'm a difficult patient.  My mouth will negatively react to the cotton rolls they use.  They give me huge ulcerations.  However, I'd kill for a primary care doc or rheumatologist who had and emotional range and concern of something more than a rock.

Since I've done the legwork I'll share.  We found two possible medical numbers.  One is "misc" which in the states is 41899.  The oral surgeon's office said that flies for them when they don't have another number.  The other is preventative medicine:  unlisted services and procedures, which is 99429.  I'll holler here like crazy if any of this works.  I couldn't believe there was no general number for treating an infection.

I do thing people should submit and be refused and then go through the grievance or appeal process.  At least eventually we might make health insurance companies realizes that our dental problems and the repair of them is due to a medical problem and vital to our health!  I think all the "caring concern" from my insurance company is due to the fact they seem to not want me to file that grievance.

Bonnie

[pocahontas_1960]

How many people have had their medical ins. pay for their dental problems?

[pudmott]

I've said it before and i will say it again. You guys in the states have got it bad when it comes to medical coverage. I pay $120 a month and for that i get coverage for medical, dental, optical, chiro, massage, physio, alternative therapies, ambulance and hopsital and a few other things as well. I pay part and they pay the rest. If i go ito hospital i get to choose what hospital i want what dr i want, if i have surgery my insurance pays part and the government pays the rest. i am rarely out of pocket.

Our health system isnt great but boy i'll stick with what we have thanks.

Pud

Goodluck with the dental process

[Patze]

Hi Bonnie,

With my medical insurance, well, let's just say the only thing they pay for is for a routine checkup a couple of times a year, a coupe of regular x-rays, and to have teeth pulled (got to love where the priorities are with this medical company).  I have a supplemental dental policy because I could not afford to pay full price of caps and other dental work again; the first time just about killed me financially.


Patze

[SilberKatze]

I haven't had any dental stuff done yet, but Tuesday I plan to call and get an appointment. Don't sure where, as everyone around here....don't take my medical. But my medical covers all the dental I need.

I guess I should say I got it easy with medical, seening as I don't have to pay a penny for anything that I get. All together I'm probably had 3 x-rays this year, 1 CT scan, 10+ dr. vists(with 3 ER vists), um....lots of prescriptions(That they fully covered), hmmm....I forgot what else

[susanep]

My husband called my insurance about a week ago. (blue cross/blue shield) He explained to them about my severe problems with my teeth needing extracting, and my sjogren's. She couldnt find anything in their policy about sjogren's, but told my husband that I should get my doctor to go through the steps of calling in that I need this done and why, and then she said they almost for sure will deny it, but then to fill out grievance papers as one of you said. She said it may or may not work, but that this is what gets things changed sometimes. She said this is how the insurance started paying for issues with Autism.
  We are going to go through this and see what happens.

susanep

[genko_b]

Nice that you found someone supportive at the insurance to give some advice. My sister was just telling me that she did the same thing, and got something covered that originally they said they would not.

Good luck - hope it works.

Genko

[SeaBreeze]

Medicare will only pay for dentures, nothing preventative... figures.. I kick myself every once in awhile because I had great dental insurance for years for like $1.50 a week... I hated going to the dentist and didn't... Boy, do I regret that now... I always opted for 'just pull-it' remedy... Now I have gaps where there should be bridgework and caps, the rest of my teeth are shifting to fill in the gaps... I have a space in front that I never had before... hate it'...

[Bucky]

Hmmmm . . . . this is something I'll have to check into.  Considering I spent $6,000 recently for oral surgery and dentures and medical insurance wouldn't pay a penny.  We had checked with insurance to see if they would because of SjS and they said "no".  Maybe, we'll have to go file something.  I just happen to be heading to the dentist office tomorrow for an adjustment - I'll ask them.  Actually, it's the oral surgeon that cost the most . . . have to check this out. 

Thanks for the heads up.  Please let us know what you find out.

Bucky