Dental related... need help with insurance questions

I have this bump-thing behind my lower teeth, and its destroying the bone.

I'm going to have to have one of my bottom teeth extracted because they need to remove it and some of the bone, which means I am going to have to wear a "flipper" for a year.

Thats like a retainer thing with a false tooth.

I am devastated.

after the healing, which they said overall will take a year, I have to decide between a bridge or an implant. I am paying for the flipper out of pocket since thats the cheapest, and my dentist told me that if insurance pays for that, then they won't pay for anything else.

He also told me they'd sooner pay for a bridge than for an implant, but he doesn't recommend the bridge because that would mean the filing down of healthy teeth.

I am so worried about what will happen. I have Cigna PPO. Has anyone had experience with them regarding oral surgery and what they will cover?


Also, if I change jobs and possibly have to get new dental, will this be covered or will this be considred a pre-existing condition?

i don't know what to do? I never had problems with my teeth before, and I'm so upset about this....

Re: Dental related... need help with insurance questions

I don't know much about the coverage, but I do know that pre-existing condition laws do not apply if you do not have a lapse in coverage of more than 90 days.

I work in the medical billing field, not dental, but i do know that many things can be covered even if originally denied if you get letters of medical necessity from the doctor. If you keep fighting and go to higher and higher levels of appeal, you have a chance of getting it covered. Good luck, and feel free to FM me if you have any insurance questions!

Re: Dental related... need help with insurance questions

Re: Dental related... need help with insurance questions

I have this bump thing too behind my lower teeth. The dentist said it was a boney deposit and I shouldn't worry about it. Now I wonder if I should??

Anyway, I was not born with a second set of two of my molars (lovely, huh). So when they fell out, I was left with empty spaces. I decided on a bridge one one side of my mouth because I had to have a root canal in a tooth next to it, so as long as 1 tooth had to be compromised, they did the bridge. It was a hassle, it got infected underneath and 2 years later, had to have it done all over again

On the other side of my mouth, I opted for the implant and it was the best decision. It was not covered by my insurance, but the $3000 I layed out should last a lifetime, whereas I will always have to have maintenance on that stupid bridge.

SO I would definitely fight to have your insurance cover the implant. In your situation, it doesn't sound cosmetic to me at all.

Good Luck!

Re: Dental related... need help with insurance questions

They said that there is a bump that should be there - but something happened with mine that is wreaking havoc... why me????