Question: I have a PPO that has a waiting period for almost everything. Since I have the plan for seven months, I only have five more months until I can have significant services. When I bought the plan, I did not think waiting periods would be an issue and that I could wait them out. Now, I need a crown that will cost about $900.00. After the waiting period, the insurance company that I am with will cover 50% of the cost.

I need the crown now; are there better ideas than waiting five more months? My dentist said I should get the crown now since it will help protect my chipped tooth. Can I get the crown and file the claim after the waiting period? That way, I will at least get my $450.00 back in the five months after I file the claim. I hate spending money that my insurance company should pay out for.

Reply: I can understand your frustration with waiting for the insurance company to cover the cost of your crown. It’s good that you have consulted with your dentist and know the importance of getting the crown to protect your chipped tooth. 

Consider asking your dentist if they offer any payment plans or financing options. A payment plan could allow you to get the crown and pay for it over time rather than waiting for your insurance to kick in. 

I would advise against filing the claim after the waiting period. Most insurance companies have policies requiring claims to be filed within a specific time frame, typically within a few months of the service date. 

It’s important to understand that filing a claim for a service received during a waiting period but saying it was after could be considered insurance fraud. If someone files a claim with false information, the insurance company may deny it, revoke the policy, or even pursue legal action.

Suppose an individual receives crown treatment during the waiting period of their insurance policy and submits a claim stating that the treatment was accepted after the waiting period. In such cases, the insurance company considers this act as fraudulent. If the insurance company uncovers this false information, it will reject the claim and inquire into the policyholder’s other claims and medical history. This could result in a considerable hike in insurance premiums or even policy cancellation. Moreover, most dental offices file the claim to the insurance company, and it is doubtful that they would mistakenly mislead the insurance company about the date of service.

In short, honesty is always the best policy for filing insurance claims. It’s essential to follow the insurance company’s rules and regulations and not engage in fraudulent activities. If you have any doubts or questions about your insurance policy, it’s always a good idea to contact your insurance provider for clarification.

Ultimately, the decision is up to you. It may be worth weighing the pros and cons of waiting for insurance coverage versus paying for the crown out of pocket and considering any payment options that may be available to you.

Consider a Temporary Crown for Your Chipped Tooth: Benefits, Insurance Coverage, and Advice from Dentist

You could discuss with your dentist the possibility of getting a temporary crown until your waiting period is over. Temporary crowns are acrylic and designed to protect your chipped tooth, maintain your bite, and prevent further damage until the permanent crown is ready.

Temporary crowns are typically much less expensive than permanent crowns, which could make them a more affordable choice for you. Some dental insurance policies cover the cost of temporary crowns, even during the waiting period before placing a permanent crown. It’s always a good idea to check with your dental insurance company’s member service to verify if they cover temporary crowns. If they do, it can help you make an informed decision about your dental care and save you money. Feel free to ask your dentist about the pros and cons of temporary versus permanent crowns and which option might suit your situation.

However, it’s essential to remember that temporary crowns are less durable and long-lasting than permanent crowns and will eventually need to be replaced. Your dentist can advise you on whether a temporary crown is the best option for your situation and help you make an informed decision.  

Getting a Dental HMO Insurance Plan

An alternative solution to consider when needing a crown during a waiting period is to purchase a dental HMO insurance plan that does not have waiting periods. This option can help reduce the crown cost if you have yet to start any work on the tooth that needs the crown. 

However, it’s important to note that this may require you to change to a different dental office that accepts the HMO plan. Fortunately, many dental offices accept HMO plans, so finding a new provider that meets your needs should not be difficult. Be sure to consult with your dentist and insurance provider to discuss this option and determine whether it is the right choice.

Dental Discount Plan May Help You Save Money During a Waiting Period

Dental discount plans are an alternative option that can help you save money on dental services, including crowns, during a waiting period. These plans are not insurance policies but membership-based programs offering discounted rates for dental services. 

Dental discount plans typically have no waiting periods and can be used immediately. You can enroll in a dental discount plan and access discounted dental services, including crowns, immediately, even if your current dental insurance plan has a waiting period.

One of the benefits of dental discount plans is that they often offer significant discounts on dental services. The discounts can vary depending on the plan and the provider, but they can range from 10% to 60% off the regular cost of dental services. 

Another advantage of dental discount plans is that they are generally easy to use. Once you sign up for the plan, you can present your membership card at the dental office to receive the discounted rate. No claim forms or waiting periods; you can use the plan as often as needed.

It’s important to note that dental discount plans are not insurance policies, so they do not cover the entire cost of dental services. Instead, they offer discounted rates to help you save money on dental care. Dental discount plans may be a good option for people who do not have dental insurance or who have a waiting period on their current dental insurance plan.

Cash Discount May be an Option 

If you choose to get the dental crown during the waiting period, it’s worth discussing with your dentist whether they offer a cash discount for services not filed with insurance. Some dental offices may provide a discount for patients who pay in cash, saving them the time and cost of filing an insurance claim. It’s always a good idea to ask your dentist about any discounts or payment options.

Additionally, a cash discount could help you save money in the long run, especially if you don’t plan on using your insurance for any other dental procedures during the waiting period. However, it’s essential to remember that not all dental offices offer a cash discount, and the discount amount can vary. 

Therefore, it’s essential to discuss the cost of the crown with your dentist and any payment options available. Being transparent with your dentist about your financial situation can help them better understand your needs and find ways to work with you to provide the best possible care.

Finding Affordable Dental Insurance Plans with Dental4Less.com

In conclusion, waiting for insurance coverage for necessary dental procedures can be frustrating, but it’s essential to avoid committing insurance fraud. Filing a claim with false information can lead to severe consequences, including policy cancellation, legal action, and a considerable hike in insurance premiums. Therefore, it’s crucial to consider alternative options when needing immediate dental care, such as payment plans, temporary crowns, or purchasing a dental HMO plan without waiting periods.

Dental4Less.com offers a wide range of dental plan types that can assist you in finding an affordable and reliable dental insurance plan that meets your specific needs. Our team of experts is available during business hours of M-F 8-4, and we’re always happy to help. We understand that dental care can be expensive, and we aim to provide options that make it more affordable while ensuring you receive the care you need.

We believe honesty is always the best policy when filing insurance claims. Therefore, we encourage you to avoid fraudulent activities and follow your insurance company’s rules and regulations. If you have any questions or doubts about your policy, please don’t hesitate to contact your insurance provider for clarification.

In summary, exploring alternative options and finding a dental insurance plan that meets your needs is a better and more honest approach than filing a claim with false information. Dental4Less.com can help you find affordable and reliable dental insurance plans that fit your budget and dental care needs. Contact us today at 310-534-3444 during our business hours of M-F 8-4, and let us assist you in finding the right plan for you.

Scared of going to the dentist in New Jersey:   I am really scared about going to the dentist for anything more then just a cleaning.  And even though a cleaning I am a nervous wreck.   I was told at my last dental appointment that I need to have three small filling done.

I asked the dentist would they be giving me Valium in order to help me relax and was told no.  That they do not give out  Valium for just filling and that they would numb me up so I would not feel anything but they do not get that I can not have filling done unless I am a little out of it.  What can I do?  My mom will not take me to see any other dentist.

Connecticut Dental Care: For a long time now I hear people staying how our old silver filling are really bad and should be removed.   I have like six or seven old silver fillings.   I got them when I was a kids.  I am no longer a child and I have had my filling for many years without any problems.   Should I really be worried about then now?

Connecticut Dental Fears: I need advise please.   My mom made me get one of your dental discount plans since that was what I could afford and the Careington dental plan did look preety good.  However, my problem is that I have dental fares that really keep me from going to the dentist.

However my mom is calling up dentist in the plan net work and is going to make me go to the dentist for a check up and cleaning.   I scared and she does not get it.  I know I am twenty but I still scared.  How can I feel better about going to the dentist?   Tips and advise would be nice.

I will be getting a dental discount plan my dentist  told me about which was how I found your website.   The thing is I have four missing teeth that insurance will not cover but my dentist takes the Careington dental plan which I bought here from you.

I need as much information as I can get on a having a dental bridge done.  Is having a bridge comfortable?  Will it hurt having it put on? Will the bridge look just like my teeth or will people know I have it?

I need to have three teeth pulled.   I was looking at your discount plans since I need to have this dental work done ASAP.  I am in a lot of pain and can not aford to wait for dental coverages.  That said I do not see anywhere on the plans about anestheis.   I am a big baby and I will not have my teeth pulled while I am awake.  What kind of discounts if any do you get for being put to sleep?

Right now I do not have any dental insurance for myself or for my six year old daughter.  I work part time and do not get dental insurance.  Although I get some governmental help I do not get dental only medical care for my child.

That being said,  my daughter may have a cavity since she says one of her teeth hurts her on and off.  Knowing that I can not afford to take her to a general dentist I took her to a dental  clinic that said they offer free dental services to minors of low income families.

I was glad to find a place but my daughter was only with the dentist for less then a few minutes when they tell me that they can not help me since my daughter is scared of them and is kicking and screaming.   Well she is only six so what if she is scared I was so mad that a place that is suppose to help low income families kick us out.

I want to file a complaint on them for not helping us out.   They were very rude and did not give my daughter any time to adjust.  I was told I could try again when my daughter is able to behave.  What can I do now?  This has to be a joke.

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My job just changed their group dental plans that they offer to us.  Prior to the change I had Delta Dental that let me choose my dentist.  Now do to cost they change to a net work plan where my dentist is not listed.   I want to stay with my dentist but my dentist told me that since they are not a network dentist I would not have coverage and I would be paying them in full if I choose to stay with them.

I do not know what to do.  My dentist is important to me.  She was the first dentist that I really like since going to the dentist is a big fear of mine.   I do not want to risk having a different dentist but my job does not offer any other type of dental insurance.  Is there a way to keep my dentist and still have dental insurance.

I have a dental insurance plan where I am able to go to any dentist I choose.  My family dentist I have been seeing most of my life retired last year and I need to go to the dentist.  I called my insurance company for a dental office recommendation but was told they do not tell us were to go because they are a non network plan.

Not 100% sure what that means.  However, how do I go about getting a recommendation to a good dentist.   I have to admit to being  dentist phobic. That was way I really like my last dentist he was always so kind to me which helped me a lot.

I have very crooked teeth since I was a kid.  I want to get them fixed so I was thinking about getting braces and talking to an Orthodontic dentist for a consult.  What I am worried is that I heard tales that in order to straighten out your teeth sometimes they have to pull out a few teeth.

I am not worried about the braces I can deal with that but I really do not want have to have any teeth pulled.  Pulling teeth is scary to me and I do not like being in pain.  Is it true that the Orthodontic dentist may have to pull my teeth.

I would like to know if there is a way of telling if you have a cavity before it starts to hurt you.  Please  no answers about me going to the dentist because I am talking besides going to the dentist.  I really do not like the dentist so I would rather put off seeing one unless I have no choose about it.   However that does not mean I want to be in pain either.  I hear cavities when they get too big will hurt like heck.  How can you tell you have a cavity before it gets to that point?

I have big time dental fears so I can not go to just any general dentist since even for just a cleaning  need to have a specialist knock me out of it.  Because of my fears  I have to pay big time dollars for my dental services which my current dental insurance will not cover.   They will only cover me on UCR for general dental prices.  Where can I get a dental insurance that will insured for specialist?  I try explaining to my dental insurance that I do not see a specialist just to have it cost more but they state it does not matter it is up to me where I go and the coverages are what I get if I go to a specialist for my fears.

I am having to get two teeth pulled and the dentist that will be pulling them will not be giving me Valium.  I told the dentist that I really do not like dentist or having to have dental work done.  I get really scared and nervous to the point that it makes me sick.  I was told that she does not use Valium but would numb me up so that I will not feel anything.  First is that possible to numb me up well enough that I will not feel any type of pain?  Second do all family dentist not use Valium?  I do not have insurance that covers me to go to a surgeon but can not understand why a general dentist refuses to use Valium.