In December 2013 I started the dental implant process on my front tooth and this also coincided with braces for my top front 6 teeth. I have been with my Dentist since 2001 and up to this point I have had zero complaints and we have a great relationship. So when I was told by my dentist that my Delta Dental PPO would not cover the implant and braces, I took his word for it at 100% trust that I was being given accurate information. Overall, I ended up paying close to $6K out of pocket for the implant and braces. Literally today, July 8, 2015, I called Delta Dental and found out that my Delta Dental PPO actually DOES cover a single tooth implant (up to $2500 cumulative lifetime) and orthodontics (up to $1000 cumulative lifetime). I also learned that this coverage was available to me in December 2013 when the procedure was started. Now, the problem with me getting reimbursed is that the procedure was started over 1 year ago and so Delta Dental says I would not be eligible for reimbursement, even if my dentist submits a claim retroactively.
Now, I have some questions for all of you:
Thank you very much!
Now, I have some questions for all of you:
- is it my responsibility as a Patient to double check the information that my dentist gave me - that the implant and the braces were not covered? Or, was I within reason to take his word for it since I have a great relationship with him?
- Any solutions to the problem of not being reimbursed because the claim is over 1 year old? We literally live paycheck to paycheck and are severely struggling financially so the $3500 that I could have saved if my dentist filed the claims through my insurance would REALLY help me. We wanted to take a small vacation to Disneyland for my children's birthdays in August but we can't afford it right now. The $3500 would allow us to give our children that experience and so much more.
Thank you very much!