Wednesday, November 20, 2013

Trying to outrace insurance changes

With my medical insurance plan changing, and since it was time to do so anyway, all 4 of my kids had their wisdom teeth pulled this past Spring, prior to the new plan date (effective 7-1-13). Little did I realize that doing so would mess up coverage for any dental work the remaining of 2013, as we were maxing out dental coverage for 2013 for each of the kids. Routine cleanings got processed and we are being billed for 100% of the in plan rate.

I called my insurance plan company this afternoon.

Our new medical insurance went from being a calendar year plan to a fiscal year plan-did this apply to dental as well? No. (Hmm . . .didn't get THAT memo)

Since each kidlet received $1500 in coverage for their teeth, the insurance company won't pay anything out until Jan 2014. So, gotta change a late December appointment to Jan to get back on benefit.

Since I had the rep. on the phone, I also asked about mouth guards, which 2 of us have received recommendations from the dentist to acquire them. I remain with benefit, so will coordinate an appointment with the orthodontist to get mine addressed by the end of 2013. Kidlet, however, needs to wait until Jan, to be back in benefit. Each of us would have a $150 deductible and since the orthodontist is "out of plan" they will only pay 50% of reasonable and customary up to $254.50, after the deductible. It's something at least. I still have funds in  my HSA and can use that if needed.

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