Dental Treament with sjogrens

[Tivia]

Does anyone have their insurance companies pay for their dental upkeep with this illness? Mine wont cover it and view it as normal dental stuff. I am concerned now because the last two weeks I notice some alarming mouth changes. I dont know if my gums are shrinking or what but gaps are forming and more tooth surface is being exposed fast. Not to mention a painless lump has formed on the front part of the roof of my mouth. No pain or redness just this smooth lump. Can we get this covered as a medical instead of dental..has anyone had any success getting the dentist to work that way with the insurance company?

[Jellyb]

Hi Tivia,I have not had any of my dental procedures covered by medical insurance and I have no dental insurance and like you, I have had some significant mouth/teeth changes in the last year. I suppose it's worth a call to our insurance company to check it out.

I do not have vision coverage either, but my eye doctor appointments have been covered as medical appointments. You have inspired me to persue this

[bjnc]

I don't really think dental issues can be covered under medical insurance, though I wish that they could, as I've had so much dental work done in the past year. 

We just switched our dental insurance to Ameritas (an individual not a group plan).  The coverage is very good as far as dental plans go, and I found an experienced dentist that I like who is in network with them, which will save a lot of money. Our oral surgeon is also in network with them.  I don't think any dental plans are absolutely great, but if you have a lot of dental work done, it might be worth checking it out. 

The only problem you might have is that they have a waiting period for certain procedures (which was waived for us because we were coming from another dental insurance plan).  The checkups and xrays do not have a waiting period.  Even with the waiting period, it would probably be worth it if you think you'll be having a lot of dental work done in the future.

Becky

[Tivia]

The reason I bring this up is my doc thinks if coded as the medical condition sjogrens it will be treated by the insurance company as medical treatment not dental. I dont know but its worth a shot, the insurance companies in this country are terrible. Americans get less coverage and pay more than most first world countries imo

[Ginger]

Does anyone have their insurance companies pay for their dental upkeep with this illness? Mine wont cover it and view it as normal dental stuff. I am concerned now because the last two weeks I notice some alarming mouth changes. I dont know if my gums are shrinking or what but gaps are forming and more tooth surface is being exposed fast. Not to mention a painless lump has formed on the front part of the roof of my mouth. No pain or redness just this smooth lump. Can we get this covered as a medical instead of dental..has anyone had any success getting the dentist to work that way with the insurance company?

I also have noticed this with a couple top teeth on one side. The gumline pulling away or shrinking.  Luckily I do have dental coverage. I was able to get my medical to pay for my eye exams as long as they code them for the sjogrens.

[mambo]

Your best bet is to have it classified as a periodontal or gingivitis condition induced by Sjogren's.  Go to Find a Code and search for Periodontal. 

http://www.findacode.com/search/search.php

There is no code that ties periodontal/gingival to Sjogren's.   In fact, the relationship between periodontal diseases and Sjogren's is still controversial.  My aunt got her dentures in her fifties and had her entire teeth extracted.  She wasn't dxed with Sjogren's until she was 69, however. 

It may be an uphill battle.  Good luck. 

The reason I bring this up is my doc thinks if coded as the medical condition sjogrens it will be treated by the insurance company as medical treatment not dental. I dont know but its worth a shot, the insurance companies in this country are terrible. Americans get less coverage and pay more than most first world countries imo