Insurance question for "pre-existing condition"

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#1 Post by **SideKick3QT** » Thu Oct 18, 2007 6:28 am

I am a full time student and my father is retired military. He is looking into enrolling in the delta dental plan through his retiree program which is a very good program considering his crappy one that he has from his job. Anyway, I was in the process of getting consultations for my wisdomt teeth extractions. I recently went to a dental school to get my xrays looked at to get the procedure done. I was wondering, if he enrolls in this program, am I able to go back to the same oral surgeon with a new dental insurance, or would I have to go to another surgeon so that it is not looked at as a "pre exisiting condition" so that they will take the insurance?

There has to be a way around it. I mean...would wisdom teeth really be considered a pre existing condition for me?

#2 Post by **lab117** » Thu Oct 18, 2007 6:57 am

I am not exactly sure how dental insurance works, but I would check back with the oral surgeon and find out what his policy is. I can't imagine that they would use 'preexisting condition' clauses for most dental work as they are not usually chronic conditions and only require a one-time treatment. That is not to say that chronic dental conditions don't exist, but extractions certainly would not fall under that category.

Sorry for not giving a direct answer, but a simple phone call to the surgeon will clarify this situation. If you do have to switch surgeons do get your x-rays and charts from him to prevent paying for having them taken a second time at the new office.

Good Luck!

#3 Post by **KikiloSugilo** » Thu Oct 18, 2007 8:36 am

I don't think that having wisdom teeth, qualifies as a pre-existing condition. In terms of keeping the same oral surgeon, you may need to inquire as to the insurance plans that the office accepts.

#4 Post by **Boolajoojoo** » Thu Oct 18, 2007 10:33 pm

Oh my goodness, insurance can be so tricky at times.... There are probably insurance companies that would try to deny you treatment, but I don't think that's really fair. It's normal and happens all the time for people with "pre-existing" conditions to wait until they have insurance so they can get treated... since medical procedures are sooo expensive. (Ever notice how an operation on a dog is like a tenth the price for the same operation on a person? I'm going to the vet if I ever break a leg) I think it would be different if you were in the middle of some sort of long term treatment plan like braces... I KNOW insurance companies don't like to jump in and start paying for treatment that you are in the middle of before you joined the insurance company... for something like wisdom teeth, I sure HOPE they aren't investigating every single insurance claim and looking for a way to NOT pay for it. I actually have Delta dental, and they've been pretty good, but they like to randomly scare me and send me large bills for stuff that I thought was covered, but then they'll change it to where I only owe a small co-pay. That's annoying, whatever happened to paying exactly what you owe in the office? I don't like waiting a month to find out that something I thought was $10 might actually be $200...

I think just ask your question about the insurance at the dentist's office where you already have the X-rays, they work closely with the insurance companies, and they'll hopefully be able to tell you if you'll get your procedure covered even though you've been diagnosed by them already. I just had to go on my own little rant. It's not like you already had your wisdom teeth removed and are planning to file a claim when you get insurance.