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#32381 - 02/25/08 12:17 PM Insurance and Amalgam removal
manonash Offline

Senior Member

Registered: 02/19/08
Posts: 75
Has anyone had any success getting insurance to pay any portion? What about if you had a physician order to have it done. I think the new doc I'm seeing in two weeks will order it. I called the dentist I'm interested in and the receptionist said that medical insurance may pick up part in this case. I'm still looking at a LOT of money.

I did forget to ask though, if there is a crown over an amalgam will the charge be for a crown, or for a filling replacement and a crown? Hmmmm.

Thanks!
Shonda

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#32382 - 02/25/08 12:34 PM Re: Insurance and Amalgam removal
Sunshine P Offline

Master Elite Member
*****

Registered: 07/31/07
Posts: 1599
Loc: London, UK
Yes, you can do it on insurance, but you must economise on the truth. Your dentist will need to economise too. No mention of mercury or amalgams. Just needs billing as dentisty….or whatever you make up. You will need to look at your policy and see what is covered and what is not covered.

If you mention the real reason for doing it, ie. tell the truth…..100pct they will toss it out the window.

You must decide yourself if you are happy “economising”, your dentist needs to be willing too.

_________________________
"All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third it is accepted as being self-evident."

Sunshine

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#32383 - 02/25/08 01:05 PM Re: Insurance and Amalgam removal
manonash Offline

Senior Member

Registered: 02/19/08
Posts: 75
No problems "economizing" here Not sure about the dentist, although when I talked with the receptionist, she said they would just bill it as a "filling" or "crown." Since I have so many that would be done within one month, I wonder would it raise suspicion in the insurance company if it were billed that way?

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#32384 - 02/25/08 01:17 PM Re: Insurance and Amalgam removal
JK98 Offline

Master Elite Member
***

Registered: 09/28/07
Posts: 1407
Loc: NYC
I think you need to find someone who is very knowledgeable about your specific insurance provider. Perhaps in some instances the insurance company might be willing to pay for composites but not for inlays or onlays, even if inlays or onlays make the most sense. Perhaps with some plans crowns might be paid for(or partially so) but not inlays or onlays. It would not be a good circumstance if one needs to choose a composite or a crown to have it covered if the best option is an inlay or onlay.

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#32385 - 02/25/08 01:41 PM Re: Insurance and Amalgam removal
manonash Offline

Senior Member

Registered: 02/19/08
Posts: 75
Yup, there's no way they're gonna pay for CEREC, but they may pay part (the same amt they would pay for the lowest cost option), at least making it less expensive. My main concern is that they'll deny any coverage.

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#32386 - 02/25/08 02:41 PM Re: Insurance and Amalgam removal
mommy24 Offline

Master Member
***

Registered: 08/11/06
Posts: 364
Loc: Kansas, US
I would love it if my medical insurance paid part of mine, but I don't think that would ever happen. I have heard that most insurance companies will pay for replacement of amalgams, if they are over 10 yrs old (they have outlived their usefullness at 10 yrs, and are due for replacement) and mine are 16 yrs old. If they only cover the equivilent of what an amalgam would cost, that is ok, I will pay what is above that for the non-metal filling. The only thing that sux is my ins. will only cover up to $2000 per person/per year, and I'm hoping my dentist can pull something off, where we can get a lot covered. I have to get this done this year, and soon, I am only getting worse. My first appt is next Monday, I'm hoping he'll see what terrible shape my mouth is in, and want to get started right away!! I don't think I can stand waiting another 3 weeks for another appt. I am scared and excited all at once.
_________________________
"Some things have to be believed to be seen." - Ralph Hodgson
~Autism is what we call Mercury Toxicity in our young, Alzheimer's is what we call it in our old.~ myspace.com/mercurypoison

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#32387 - 02/25/08 04:02 PM Re: Insurance and Amalgam removal
mikey Offline

Elite Member
***

Registered: 06/03/07
Posts: 611
my insurance paid for about 75 % of the removal/ replacment last year when I had my 9 amalgams removed ,the dental insurance company did not ask why I was removing them and I left it at that , I was lucky to find a dentist In my area that knew how to remove them safely ,as for a doctor I think that It would of complicated matters for me with the dental insurance company , plus I live in a small town and all doctors in this area are traditional and don't believe in mercury piosoning from fillings , I had to pay a little extra about 20.00 per tooth for composite fillings

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#32388 - 02/25/08 04:56 PM Re: Insurance and Amalgam removal
mommy24 Offline

Master Member
***

Registered: 08/11/06
Posts: 364
Loc: Kansas, US
Uh yea, that's where I am. I live in a little town, with a tiny population. We don't even have a dentist, but the neighboring towns do. NONE of them believe , everyone is pretty traditional here. They are even mostly that way in the city. There are several that will not place mercury, and only one that will remove safely (that I know of, and it took me 2 years to find him), and HUNDREDS that put in amalgam. This is a city of half-a-milion people, where I grew up. It is ridiculous.

Mikey, do you mind me asking what your total was around, out of pocket for your removal? I'm very interested to see what I'm up against. Also, what area are you from? Thanks.
_________________________
"Some things have to be believed to be seen." - Ralph Hodgson
~Autism is what we call Mercury Toxicity in our young, Alzheimer's is what we call it in our old.~ myspace.com/mercurypoison

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#32389 - 02/25/08 05:59 PM Re: Insurance and Amalgam removal
manonash Offline

Senior Member

Registered: 02/19/08
Posts: 75
Thanks for all your input. Maybe insurance will pick up part of this.

I know what y'all mean about small towns. I live in a rural area too. I'm going to have to go about 3hrs away to have this done. There is one dentist an hour away, but he hasn't had as much experience as I'd like, considering how much work we're talking here. (16 fillings, 8under crowns, with one root canal, and possible cavitation). I'm nervous to say the least.

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#32390 - 02/25/08 08:58 PM Re: Insurance and Amalgam removal
chigirl Offline

Senior Member

Registered: 11/18/06
Posts: 69
I had 7 amalgams replaced with composite and 80% was paid by my dental insurance. I did plan this out and switched from the HMO to the PPO and waited several months before getting it done. The HMO would not have covered any of it. In fact, they would only pay for the cost of the amalgam if someone wanted a composite filling. The PPO covered it just like a regular filling would be covered, but there was a yearly max of $1500. I did some at the end of the year, used up my money, and had the rest down in January! My regular dentist listed them all as "defective".

I did have a crown put on my back tooth and was surprised to find out there was metal in there. My insurance paid for the metal crown and less then a month later I discovered it had metal underneath!! I freaked out at my Dentist. Asking him how he could put metal in my mouth without my consent!! It explained why I felt so nasty though! So, he replaced it with a porcelean crown for only the cost of the material he used. This thing eventually cracked and insurance would not pay for the replacement. My dentist said that insurance will not pay for an all porcelean crown on a molar because it is not strong enough in their opinion. There is actually true because I've had a lot of problems with the non metal crown. I had to spend a lot of money to have another made. close to $900. And guess what. It cracked again!!! I was about to have the tooth pulled when my dentist said that it just needed cemented back on. So, there is a lot to think about when getting a crown replaced. If you do decided to spend the money on an all porcelean crown it may not last longer then a year. Mine didn't. I have already decided that I will get it pulled if it cracks again. I can't be spending $900 every 2 years on a crown! Maybe it will be for the best anyway. That root canal can not be good for me.

chigirl


Edited by chigirl (02/25/08 09:00 PM)

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#32391 - 02/25/08 10:51 PM Re: Insurance and Amalgam removal
mommy24 Offline

Master Member
***

Registered: 08/11/06
Posts: 364
Loc: Kansas, US
Thank you for the insight, Chigirl. I was hoping to get all of my work started before the first of the year, so I could've done what you did (carrying some work over to the next year), but it just didn't work out for me. The timing was not right. I have a crown that will need replaced, a root canal tooth that never got crowned, and may possibly need some crowns in the back, because there is not much tooth left, they are mostly metal. I guess I will find out when I go, what can be saved. I will just have to see what insurance will cover, and figure out how to come up with the rest. It just has to be done. I feel that there is not much time left for me to wait. I've had a severe decline in health in the last few years, and I just know it's time.
_________________________
"Some things have to be believed to be seen." - Ralph Hodgson
~Autism is what we call Mercury Toxicity in our young, Alzheimer's is what we call it in our old.~ myspace.com/mercurypoison

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#32392 - 02/26/08 08:57 AM Re: Insurance and Amalgam removal
manonash Offline

Senior Member

Registered: 02/19/08
Posts: 75
Ooooh, I hope that doesn't happen to me. I have 8 crowns! I've read that the all porcelain last longer if the dentist knows how to work with it and properly put it in. That's part of the reason I want to go to someone who has lots of experience with the material. There is a more local dentist that the one I'm currently interested in, but he doesn't have as much experience with the CEREC.

It may be a while before I can get this done since I'm still nursing my daughter, but as soon as she stops, I'll be scheduling an appt.

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