Rethinking Dental Insurance Exclusions
I’m in need of a night guard because I’ve developed a habit of clenching my jaw and grinding my teeth while I sleep. I’ve noticed some wear on a couple of my teeth, and my dentist even discovered a small chip on one of my back teeth, likely caused by the clenching. Unfortunately, my insurance specifically excludes coverage for night guards. However, it seems like both my medical costs and theirs could increase if I don’t address this issue now, especially since the night guard would cost $750. Is there any way to persuade them that covering this expense could ultimately be in their best interest by preventing future dental repairs? Or is this just not feasible?
It’s definitely frustrating when necessary treatments are excluded from dental insurance coverage. You might want to consider a few strategies to advocate for coverage for your night guard:
Document Everything: Gather all documentation from your dentist about your condition, including any diagnosis related to bruxism (grinding) and the potential for further damage to your teeth. Having a strong case backed by professional opinion can help.
Write a Letter of Appeal: Draft a formal letter to your insurance company explaining your situation. Highlight the potential future costs of dental repairs due to tooth wear and damage, and emphasize how a night guard could mitigate these expenses in the long run. Include any supporting documents from your dentist.
Consult Your Dentist: Sometimes, your dentist can help advocate for you. They may be able to provide additional documentation or even submit an appeal on your behalf, explaining the medical necessity of the night guard.
Explore Other Insurance Options: If your current insurer is unwilling to budge, it might be worth exploring other insurance plans or providers that might offer better coverage for dental appliances like night guards.
Check for Discounts or Payment Plans: Some dental offices may offer payment plans or discounts for services paid upfront. It might make the $750 more manageable if you spread it out over time.
While getting insurance to change their stance can often be challenging, presenting a solid case can sometimes lead to exceptions. Good luck!