Guest guest Posted June 20, 2005 Report Share Posted June 20, 2005 Beth, I agree it is stupid but sadly most insurance companies don't cover ortho on those of us who are over 19. I know mine certainly doesn't. A few insurances are willing to cover about $1000 but as we know, that doesn't cover much of the total cost. I would however concentrate on whether your insurance will cover the surgery as that is one hefty cost! Sara Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 20, 2005 Report Share Posted June 20, 2005 The most annoying part is in my new hirer training they said it would be covered. and now that's not true. It was only 1500.00 but still I don't see why they would exclude adults. I guess I'm just need to more on, I was just looking forward to that coverage. Your right there are bigger expenses here. > Beth, I agree it is stupid but sadly most insurance companies don't > cover ortho on those of us who are over 19. I know mine certainly > doesn't. A few insurances are willing to cover about $1000 but as we > know, that doesn't cover much of the total cost. I would however > concentrate on whether your insurance will cover the surgery as that is > one hefty cost! > > Sara Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 20, 2005 Report Share Posted June 20, 2005 Beth, I didn't mean to downplay the cost of ortho work. It is expensive and you have every right to be annoyed. I was too when I found out. It's just that the way I see it, it's better to know that they cover at least the surgery. No point in getting braces on if you then find out that you have to fork out on your own for surgery (cost can vary from $11,000 to $100,000 depending on what you get done). Now that would be a major bummer and some people on this board have had to encounter that disappointment. I am still awaiting approval from my insurance and I am post-op so I've already forked out the dosh and am now praying I get it back. Fingers crossed for you and me:-) Sara > > Beth, I agree it is stupid but sadly most insurance companies don't > > cover ortho on those of us who are over 19. I know mine certainly > > doesn't. A few insurances are willing to cover about $1000 but as we > > know, that doesn't cover much of the total cost. I would however > > concentrate on whether your insurance will cover the surgery as that is > > one hefty cost! > > > > Sara Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 20, 2005 Report Share Posted June 20, 2005 Isn't that age discrimination? > My last email didn't seem to go through, so I'll send it again. > > I'm frustrated!!! I was told by my employer that ortho isn't covered > on people over the age of 19. This is stupid. I'm wondering if this is > even legal. > > Has anyone else fought this and been sucessful? I'm not sure if it's > worth my time or not, but it would be nice if they did cover some. > > thanks for letting me vent. rrrrrr Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 20, 2005 Report Share Posted June 20, 2005 Hi Beth, Insurance limitations are there to limit the money insurance has to pay out. Many times it makes no sense in the care coverage a holder of the insurance needs or should receive. My insurance does not pay for ortho for adults either, but they are paying for my surgery! Go figure! To me, the ortho is only necessary FOR the surgery, not separately. But insurance coverage is often separated between medical and dental coverage, even when lab tests and xrays are covered if they are for surgery, they are not covered for dental. Again, we are whole people. Our teeth are not separate from our medical health issues. But it doesn't have to make sense for it to be legal. DId you check to see if medically necessary surgery of the jaw is covered? Many times, they deny this surgery, only to approve the surgery itself when it is shown to be medically necessary. Most OD will take payments with no interest (at least around here), so having the help of insurance for the surgery is actually more helpful. I hope this helps! Hugs, Fran > My last email didn't seem to go through, so I'll send it again. > > I'm frustrated!!! I was told by my employer that ortho isn't covered > on people over the age of 19. This is stupid. I'm wondering if this is > even legal. > > Has anyone else fought this and been sucessful? I'm not sure if it's > worth my time or not, but it would be nice if they did cover some. > > thanks for letting me vent. rrrrrr Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 20, 2005 Report Share Posted June 20, 2005 Beth, sorry to hear about your frustation with the dental insurance. I was fortunate to have limited coverage with two different policies - with no age limit. One paid $1000, and the other $750, which at least helped with a small portion of the total $6000 for orthodontics. I don't know if there's any way to appeal those age limits. The problem is most of the time we aren't allowed to read the insurance brochures until we're hired. Now, for my surgery it's a different story as I'm having to pay upfront $6000, but probably more depending on what my insurance pays as my surgeon is a non-participating. I hope you find some alternative. Wish I could be more help. Shirley Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 21, 2005 Report Share Posted June 21, 2005 I don't know if you can fight that or not. But most dental insurance comes with a lifetime limit on ortho treatment anyways, so it may not cover much of your treatment depending on how expensive it is. My insurance covered C$ 2,500 but my total cost for ortho treatment was C$ 10,000. > Ok, so I'm annoyed... > > I found out yesterday that the little ortho coverage that my employer > provides won't cover me. They said the coverage has a age limit of 19. > Ridicules! Like I'm doing this just for comesitic reasons. rrrr > > Can they do this legally, it seems like they are doing anything and > everything not to pay. Has anyone tried to fight this with any luck? > > Thanks, > Beth Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 21, 2005 Report Share Posted June 21, 2005 Different health insurance policies cover different things. I have an Aetna policy which doesn't cover Orthodontics on anyone over the age of 21. This wasn't such great news when I needed to pay for a palatel expander and braces for myself ... along with the same for my Son. The policy also only covered $1500 as a LIFETIME MAXIMUM for my Son. I've asked around and been told it's not uncommon. I don't believe that there is anything to " fight " . If that's your policy ... that's your policy. Best of luck, Carol > My last email didn't seem to go through, so I'll send it again. > > I'm frustrated!!! I was told by my employer that ortho isn't covered > on people over the age of 19. This is stupid. I'm wondering if this is > even legal. > > Has anyone else fought this and been sucessful? I'm not sure if it's > worth my time or not, but it would be nice if they did cover some. > > thanks for letting me vent. rrrrrr Quote Link to comment Share on other sites More sharing options...
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