Dental Insurance: Should I Challenge the Exclusion?
I’m in need of a night guard because I’ve been grinding my teeth and clenching my jaw at night. I’ve noticed some wear on a couple of teeth, and my dentist discovered a small chip on one of my back teeth, which might be connected to the clenching. Unfortunately, my insurance plan specifically excludes coverage for night guards. However, it seems likely that both my costs and theirs could increase if I don’t get one, since it’s a $750 expense. Is there a way to persuade them that covering this cost would ultimately save them money on future dental repairs, or is that just not feasible?
It’s definitely frustrating when insurance policies exclude necessary treatments like night guards, especially when they could potentially prevent more costly procedures down the line. Here are a few strategies you could consider when approaching your insurance provider:
Obtain Documentation from Your Dentist: Ask your dentist to provide a letter detailing your condition, the reason for needing a night guard, and how it can help prevent further dental issues. Having professional backing can strengthen your case.
Highlight Preventive Care: Emphasize how the night guard is a preventive measure. Explain that without it, you could face more significant dental problems, which would incur higher costs for both you and the insurance company in the future.
Policy Review: Review your insurance policy to see if there are any clauses or provisions related to preventive care that you could leverage. Sometimes, bringing attention to these specifics can help your case.
Request an Appeal: If your initial request is denied, ask about the appeals process. Be prepared to provide the supporting documentation and argue your case again, emphasizing the long-term cost savings for the insurer.
Consider Flexible Spending Accounts (FSAs): If your insurance company remains unyielding, check if your employer offers an FSA. This can allow you to use pre-tax dollars to pay for your night guard.
While it may be challenging to get the insurance company to reconsider, preparing a strong case can help. Good luck!