OT - Health Insurance Question | Arthritis Information

Alright, this has nothing to do with RA, but everything to do with health insurance coverage. I thought I'd ask you all since you've always been an overflowing wealth of knowledge for me :)

Justin has Crohn's, as many of you know. He's got it so bad he doesn't retain a lot of vitamins and minerals, mainly potassium, magnesium, and calcium. His teeth have suffered for it, too. He really needs to go in, and have about half of them pulled, a few of them capped, and some of them I don't know what with. Basically, it's a LOT of work.

What I'm wondering is: Our dental will cover a fair amount of this, BUT.....do you suppose there's any possibility of health insurance covering a portion, since it's CAUSED by the Crohn's? It's not as if he doesn't try to take care of them, and I'm pretty sure a GI could vouch for that.

Has anyone ever run across a situation like this? I want to say that it might be possible, but I don't want to run around wasting my time if it's not - like for legal reasons or something. But man if it's a possibility, that would help on the cost *A LOT*

Thanks everyone!! :)

I would call your insurance claims dept. and see. It is worth a shot. Also most dental surgeons have a payment plan option and most of them are no interest. We are doing that for our daughter's wisdom teeth.

Just a side question, does Justin have any joint pain or psoriasis?

I used to work for BCBS of TX. There are several situations where dental care is covered under the health policy (at least with BCBS there were.) Dental due to accident was one and there were even scenarios where the patient required dental surgery and extensive anesthesia or an inpatient stay. Does the primary member work for a large corporation? Sometimes the group (usually the company's HR department) can make benefit exception requests. Your best bet is to contact your insurance company and explain the situation. You can also have the doctor sumbit a letter for consideration of benefits.

Best of luck to ya! Let us know how it turns out.

Melanie

Thanks guys!!! I will call them. :)

Shelly - yes, he used to have psoriasis pretty bad, but it stays at bay now pretty well. His fingers and ankles are the joints that swell on him. Poor guy's already had a small bowel resection, and part of his colon and stomach removed. He's been through SO much, and he just wants his teeth to look okay. I'm trying everything I can to make it happen.
Katie - the misconception about dental is that its a SUPPLEMENT, not insurance. That's why its capped. Good luck and give it a shot, your insurance company might move it to health coverage. You're so right! I still call it insurance, it's habit. We have some folks at work who just RANT and CUSS about our dental. It's as if they expect it to cover 100%. I've never heard of dental being that helpful, so I think our plan is pretty average. Oh well! My health insurance covers my jaw issues since it is RA. The same is true
with my eye stuff.

beckyOur health insurance really has no dental coverage except for covering extractions. It took forever for me to find a solution. First, find a dentist that is going to take the time to deal with you. Then, get the ok from the health insurance for whatever part they will pay. The dentist should be able to help you with this and getting a letter from your doctor is an excellent idea. On top of this you can check out the dental plans listed on the Internet. If you carefully choose one, they will have a set price for the work that needs done which will be lower than with no insurance. This can be several hundred less than without the plan. You just have to make sure that the dentist accepts it. You can get one of these plans to cover both of you from about a year. With Julie we saved on 5 root canals, around 0, so it was worth it.

Then her father paid the rest of the bill. But they do have credit plans at the dentist that charge no interest for a certain time period. But you want to bring your overall amount down first as you can still be paying a couple of hundred each month and I know that's not likely for you. It wouldn't be for me either.

Another option is to find a dental school and see if they have one of these programs where they discount services for a shot at a real mouth. Some communities actually have real dental programs to meet this need. To find out, go to your city and your state web sites and see if they list anything.

It is also important to know the time schedule for the dental work. For instance, Julie's needed the caps all put on at the same time for the best result. That meant we had to hit her dad pretty hard. Still we are getting about 00 of dental work for 00. Maybe you can get some help from the parents as well even though you would hate it.

Good luck and be creative.
Awesome Deanna, thank you SO much. Of COURSE you would have an answer for me!! :) We do have dental coverage, so that'll help, I'm just looking at more ways to lower the bill!
I wonder, if he were to go to his General Practicioner and if that doctor were to write a Rx to get his teeth fixed because it could potentialy cause further health problems. Maybe that could be a way to get his tooth work done under normal health insurance?

After all the advertising about how bacteria in the mouth can cause heart disease, I would think this a very pratical request. Just an idea.Alot of insurance plans cover some dental. The first thing you need to do is call the HR and see. If you have a book, look in that. Alot will pay for extractions that have to be done under anesthesia. Check with the HR and the dentist and have the dentists office help you figure out the most cost effective way to do it.

Good Luck!

Good advice all. I often work on charts done in the outpatient section of the hospital for dental patients. Even Medicaid wised up and found out that it was cost effective to take of major dental problems all at once under anesthesia.

It always drives me nuts to read charts and find that patients without any dental coverage who end up with abscessed teeth to the emergency room. To have it get to that point, when some minor dental procedures could have helped it drives me nuts.

An abscessed tooth can cause major health issues.

Katie did you call? Good luck and let us know what you find out. Hopefully some of it can be covered under health.

Peace & Love...Neasy

Not yet! Sorry, we're all rushed to do this concert thing this weekend - picking up the house, finishing *all* laundry (we're one of those houses that has a constant stream of laundry, not a laundry day...lol) and allllll the other stuff that goes along with vacations!! We leave Wednesday, and I haven't TOUCHED the bathroom yet. UGH. Plus, I gotta dye my hair again (Christine messed it up the first time around) *whew*

Anyway, I'll be calling sometime when we get back. Ish. *sigh* I don't know, because when I get back, I have a job interview for a higher up position at work soooooooo Gah! LOL Oh well.....I'll do what I can as I can!