I’m having some serious issues with my Aetna DMO plan, and I could use some advice. Recently, my dentist recommended a deep cleaning that I was sure I didn’t need, but I went ahead and paid for it anyway to avoid any potential problems with my teeth. Now, I’ve been told I need two inlays. According to my insurance, they should cost around $115, but the receptionist at the dental office rudely informed me that because they use Emax materials, it would actually cost $750 as an upgrade.
It’s frustrating to pay so much for treatments, especially when I’m not convinced I really need them in the first place. What are my options here? Should I consider finding a highly-rated dentist and pay for services out-of-pocket? Or would it be worthwhile to look into getting my own insurance? I’m not sure if any outside plan would be better than my employer’s current Aetna DMO coverage. Any suggestions would be appreciated!
It sounds like you’re facing a frustrating situation with your Aetna DMO plan and your dental care. Here are some steps you can consider:
Get a Second Opinion: Before proceeding with any recommended treatments, seeking a second opinion from another dentist can help you confirm whether the deep cleaning and inlays are truly necessary. This can also help you gauge if the proposed treatments and costs are reasonable.
Review Your Insurance Plan: Familiarize yourself with the specifics of your Aetna DMO plan. Understanding what is covered and the associated costs can help you advocate for yourself with your current dentist’s office.
Communicate with Your Dentist’s Office: If you’re facing billing issues or unclear charges, it might be helpful to address these concerns directly with the dentist’s office. Ask for a breakdown of costs and inquire about alternative materials or treatment options that could reduce your expenses.
Check In-Network Providers: Since Aetna DMO operates through a network of dentists, ensure that you are seeking care from in-network providers to avoid unexpected out-of-pocket costs.
Consider Going Cash-Pay: If you find that in-network providers are still too expensive or not delivering the care you expect, you could look into well-reviewed dentists who offer cash discounts. Sometimes, paying out of pocket can be more cost-effective than going through insurance, depending on the situation.
Explore Additional Insurance Options: If your current plan consistently leads to high out-of-pocket costs, you might want to look into supplemental dental insurance plans that could cover some of these expenses. Researching different plans might help you find a better fit for your needs.
File a Complaint: If you believe that you have been misled or treated unfairly, you can file a complaint with Aetna or your state’s insurance board. This may not resolve your immediate situation, but it can help prevent similar experiences for others.
Seek Financial Assistance Programs: Some dental clinics offer financial assistance or payment plans. Check if there are any options available that can help lessen your financial burden.
Ultimately, taking proactive steps to gather information and communicate effectively can often lead to better outcomes. Good luck!