Dental Insurance Coverages, Is there any way around the waiting periods?
I have a PPO that has waiting period for almost every thing. Since I have the plan now for seven months I only have five more months until I can have major services. At the time I bought the plan I did not think waiting periods would be an issue and that I would be able to wait them out. Now I need a crown that will cost about $800.00 After the waiting period the insurance company that I am with will cover 50% of the cost which is still a lot of money.
The thing is I need the crown now and waiting five more months is not a good idea. My dentist said I really should get the crown now since it will help protect my tooth that I chipped. Can I just get the crown now and file the claim after the waiting period? That way at least I will get my $400.00 back in the five months after I file the claim. I hate having to spend money that my insurance company should pay out for.
Wednesday, Jun. 23rd 2010 8:20 AM at 8:20 am
Sorry but that would be insurance fraud. You can not have work done but file it five months later as if you then just got it done so that you will be covered for it. I do not think any honest dentist would do that for you.
Wednesday, Jun. 23rd 2010 8:47 AM at 8:47 am
Why don’t you pick up a dental discount plan to get your dental crown. At least this way you will get the saving off the crown and in most cases discount plans start within the next business day.
That way you do not have to try anything shady that could get you into trouble.
Wednesday, Jun. 23rd 2010 9:19 AM at 9:19 am
Are you for real? You must know that doing something like that is wrong. The one reply were it stated it would be insurance fraud is correct. No dentist would be willing to do that.
If you file the claim that way the insurance company will call the dentist to confirm when the dental services were done. It would be a mess waiting to happen if you went ahead and did what you are thinking.