I need to have my 4 wisdom teeth out. The bottom 2 are impacted, and top two are only in about halfway, and slightly crooked outward. My dentist told me I needed them out (they are not symptomatic) so I went to an oral surgeon. He did the intial exam..x rays, etc. The X rays obviously showed the bottom ones are crooked facing frontwards, and pushing against the 2nd molars. Well, he told me my dental ins doesn't cover it (metlife), so he was going to try my health ins (Tufts). well I just got a letter from tufts saying they denied his request because oral surgery is excluded from my benefits. This seems insane, shouldn't one of them at least cover PART of it? The worst part is I can't get braces until they are out, and I'm already 23, and feel like I'm never going to be able to have a perfect smile http://www.healthboards.com/ubb/frown.gif
Anyone have any ideas what I can do? I just got this denial letter, so I'm assuming the dentist is going to call me to tell me it was denied, and I'll see what they say. I can file an appeal if I'd like. The worst part is, my benefit enrollment for next yr ended this week, (although I still may be able to make changes) so I can change my dental to Cigna or my medical to United health care or Harvard Pilgrim if they would cover it, but how do I know?
Sorry it's so long, thanks for anyone who can help

crap! i'm 27 and i'm going through the same exact thing! hell, i even have to pay for my own fillings! i gotta get all four wisdom teeth pulled and after that, i gotta get braces! all out of my own pocket cuz no insurance is gonna pay for that....crap!

I have a $75 deductible on fillings. That's ridiculous, the only thing I go to the dentist for is 2 cleanings a year, and rarely a filling, I shouldn't have to PAY for it!

Worst part is, I can't afford to get my wisdom teeth out, which means I can't get braces until I CAN http://www.healthboards.com/ubb/frown.gif I swear I'll be 40 before I get the perfect smile http://www.healthboards.com/ubb/frown.gif

Well guys, I'm looking at $30,000.00 worth of dental reconstruction, and my dental insurance covers $1,500 per year per person, period. I'm trying to see if my health insurance will help pay because this is so extensive my entire health is affected. But I'm not getting much help here, so I sincerely doubt that if they won't cover me when I'm on a mostly liquid diet, in face pain, have swelling, ear problems, and infections,... I wouldn't hold out much hope for them helping with a few extractions.

There are so many injustices with the whole insurance system and how it works, and what it covers.

They will pay for us when we're sick and dying, they'll pay for years of prescription drugs, they'll pay for ongoing treatment and especially they'll pay tens of thousands of dollars for surgical interventions, especially if they hold promise of having to be repeated, but you know, there's nothing in it for people trying to stay healthy and responsible and strong,....you know, the PREVENTATIVE STUFF! The stuff that, IF we do it, will be more cost-effective for them, produce greater profits for them, provide less pay out on their part,... seems to make sense, doesn't it?

But it's in the best interest of the medical community to "treat" not to "cure." The reason for this is that through "treating," the very nature requires repeat care and ongoing costs. To provide a "cure" would mean they've lost control and have no guarantee for income.

As long as we're sick and in need of help, we'll keep coming back. But get us all fixed up or educate us to tend to ourselves, and they've lost the niche.

It bites, eh?