Dental insurance question- help!

[Smurf]

So I have a bit of a dental insurance question for people. I recently found a new NHS dentist miraculously taking new patients, after my last dentist stopped doing NHS work and a very long hiatus. Had my initial appointment on Wednesday. I expected a list of issues, and wasn’t disappointed- it will cost a fair bit. The only urgent issue however was fixed for now with a temporary filling. Having only now looked into private dental health insurance, it’s much more affordable than I always imagined, and not just because I need all this work done.

But my concern is about ‘pre-existing conditions’. Technically, as I said the rest of the work is not urgent, but genuinely needs doing to prevent further decline. It’s mainly upgrading old fillings with eg, crowns where all enamel has been lost etc, rather than cavities. The one filling is the only really pressing matter. My question is, if I were to sign up for dental insurance now, would the non urgent stuff count as a ‘pre existing condition’? Perhaps even if I went privately to another practice just for this work, it would be identified as new work to them. I should think I’ll have to pay for the filling replacement, but that’s affordable.

 

[Kennethk]

So I have a bit of a dental insurance question for people. I recently found a new NHS dentist miraculously taking new patients, after my last dentist stopped doing NHS work and a very long hiatus. Had my initial appointment on Wednesday. I expected a list of issues, and wasn’t disappointed- it will cost a fair bit. The only urgent issue however was fixed for now with a temporary filling. Having only now looked into private dental health insurance, it’s much more affordable than I always imagined, and not just because I need all this work done.

But my concern is about ‘pre-existing conditions’. Technically, as I said the rest of the work is not urgent, but genuinely needs doing to prevent further decline. It’s mainly upgrading old fillings with eg, crowns where all enamel has been lost etc, rather than cavities. The one filling is the only really pressing matter. My question is, if I were to sign up for dental insurance now, would the non urgent stuff count as a ‘pre existing condition’? Perhaps even if I went privately to another practice just for this work, it would be identified as new work to them. I should think I’ll have to pay for the filling replacement, but that’s affordable.

Most offices have a office manager that deals in all sorts of insurance related stuff. Most offer a yearly $2,000 max with waiting periods 6-12 months and only cover 30-70%. I recommend you call insurance and ask for a copy of explanation of benefits, as well as having the office send a predetermination. You can ask the offices to fax or send digital but most take up to two weeks. This isn't a final form of payment more or less an agreement that your insurance covers procedure. If anything goes erupt appeals are options.

 

[Smurf]

Most offices have a office manager that deals in all sorts of insurance related stuff. Most offer a yearly $2,000 max with waiting periods 6-12 months and only cover 30-70%. I recommend you call insurance and ask for a copy of explanation of benefits, as well as having the office send a predetermination. You can ask the offices to fax or send digital but most take up to two weeks. This isn't a final form of payment more or less an agreement that your insurance covers procedure. If anything goes erupt appeals are options.

Thanks, KennethK. I hope this isn't a US only forum, I should have stipulated that I am in the UK. I appreciate the advice and am sure it generally corresponds with insurance here.

If there are any Brits out there with similar experience, I'd very much welcome your thoughts!

 

[MattKW]

The best person to ask might be the dentist or their manager. A similar thing happens here in Australia - people join up and sometimes the health fund tries to negate treatment. The key is to avoid going in gung-ho with complicated treatment. Wait a few months, then start as a "New" patient with the usual "New patient" item numbers, and then progress slowly into the bigger stuff.