General Question

VoodooLogic's avatar

Did I just get gypped?

Asked by VoodooLogic (724 points ) March 14th, 2008

I’m double covered under two dental insurance plans.

One is a discount plan, meaning they take 25% off the cost of my dental work.

The other is a typical work plan. I get two free cleanings, an allocated amount for dental work.

I recently received one root canal, one cap/crown, and one filling.

It hurt worst in the wallet as I assumed that being double covered meant that any personal money I put down would come back to me. This was not the case.

My work insurance dried up after the root canal and only $98 dollars was applied to my crown. When I talked to the billing dept. the lady told me that in addition to the $375 I already paid, I will owe $130 in additional costs.

I also found out that they used my work insurance first. This means that my dental office used up money in my primary insurance. Had they applied my discount first, there would be more money in my work insurance to cover more of the cost.

At least that’s how it works out in my head… Maybe I’m just being a tight wad who got away with paying very little for some major dental work.

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9 Answers

scamp's avatar

Your insurance from work is your primary carrier, and that is why the office billed them first. A discount plan is not insurance. Sorry that happened to you. Whenever you are having a costly procedure done, it’s a good idea to ask your insurance company how much will be covered in advance. I learned that lesson the hard way. My knee surgery was applied to my deductible, and I have to bear the entire cost myself. Now here I sit on disability, with very little income for several months, and I have a huge medical bill to pay.

Spargett's avatar

@scamp

Man, I’m so sorry to hear. What’s happened to this once great country?

robmandu's avatar

@spargett, I feel bad for scamp, too… I’ve made my own share of medical billing mixups.

But how’s that the fault of the U. S. of A.?

scamp's avatar

The ironic thing is that I work in a Doctor’s office. I should have called the surgeons office and asked what ICD-9 code they would bill under, then called the insurance company to ask about the coverage on it. If I had done that, I would have been more prepared. if you simply call an insurance company and ask if something is covered without that code, they may tell you something is covered, but not how much of it is your responsibility.

Spargett's avatar

@robmandu

The scenario is more of a barometer of how far behind the United States is in treating it’s tax paying citizens. The US is the only “Western” country left without socialized medicine. Only leaving us privatized, corrupt health care.

scamp's avatar

@Spargett I wholeheartedly agree! I think the lack of accessible healthcare is inexcusable in this country!

robmandu's avatar

@spargett, at the risk of going offtopic… I know and work with folks from countries with socialized medicine… and while there are certainly things wrong that need fixing, they all agree on one point, government socialization of healthcare typically leads to worse conditions, not better.

Action does indeed need to be taken… but let’s not be so quick as to just do what feels good, but put some serious thought into coming up with a smart approach (not endorsing that link, but the reporter makes some analysis that I think is worth some consideration).

scamp's avatar

@robmandu Thank you for that second link. It’s definitely food for thought. I see merits on both sides, and I really hope something is done soon to improve our nation’s healthcare issues.

robmandu's avatar

@scamp, true that!

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