“Insured” in America

Oh, gotta love it. I knew something like this would happen.


Because it always does. Always. Every single time I gather up my courage or things are so horrible they cannot be avoided and I go to the friggin’ dentist my “insurance” never wants to pay for it. That goes for every dental plan we’ve ever had but currently we’re talking about the Guardian Group dental “insurance”.

In case you don’t know teeth aren’t particularly considered a ‘medical necessity’. Truth! I swear! They’re not. They’re considered ‘cosmetic’. I guess dental “insurance” places figure it’s good for your digestive system and your overall health if you either gum your food or keep an all soft/liquid diet your entire life. No veggies for you unless you put them through the juicer first.

Yes, the Denial of Benefits showed up in my mail box. I was pissed. I was hoping against hope, (Damn it, Red!) that they would just put it through and be human beings about the whole thing but no. The reason they won’t cover a new plate is always the same: it didn’t happen on our watch.

I’m not kidding. That’s their reasoning. I wasn’t in an accident and suddenly lost all of my teeth (in which case they’d fight it out with Blue Cross and whatever auto/business/homeowners insurance was involved to see who paid the $1,060.00 for the plate) so it’s ‘sorry Charlie’. To me this is like looking at someone who was born without a leg and got their first prosthetic leg when they were very young. Every time they need a new one the insurance companies look at them and say: Real sorry about your missing limb but we didn’t do it so here’s a wheelchair kiddo. Be happy we gave you that much.

WTF? Why am I paying them? Why was it so important that we get the dental in the “insurance” package? I dunno. The eye care is almost as bad–we’ll discuss that another day.

I sat here for a while yesterday afternoon torn between laughing, crying, calling the Guardian Group Dental Insurance and saying several choice and unpleasant things to some lowly operator who has nothing to do with this. (You know you’ll never get through a real ‘decision maker’…ever.) Then I had an idea, I figured, other people do it all of the time and for some stupid shit too, I could create a GoFundMe account. Why not? I don’t have much to give in return for someone’s kind donation but I have books and I can do formatting and I have photographs and I can build you a website if you want to foot the entire bill for the new plate.

Hubby got home, asked me how my day was, and I told him what happened and how much. He looked at me without flinching and said: “Let’s do it.”

“Excuse me? It’s $1,060.00.”

“Yeah, let’s do this. How much do we have on the HSA card?”

How the fuck would I know? I ignore that fuckin’ thing.

For those of you who don’t know that’s a Health Savings Card. The insurance is so shitty and the company saved so much giving us the shitty insurance that they could afford to ‘sweeten’ the deal by “giving” us a thousand dollars on an HSA card. Of course more money comes out of the check every pay period to go on the card that’s only for use buying medical stuff. ANY medical stuff. You can take that puppy to CVS and stock the house with OTC supplies. I know cuz I did that once many years ago. Vitamins, herbs, bandages, anti-biotic salve,pain killers, pain rub, sleeping pills, you name it. You can buy it and they won’t bitch. Make co-pays with it, put it towards a doctor bill…whatever.

There should still be a couple of hundred bucks on it. He used it to pay off our part of getting his finger stitched. I’ll wager there’s at least half the cost of the new plate just sitting on that card. After work today, I’ll go up to Doctor Hannah’s office and ask them to run it for a balance. If we have half I’ll try to talk them into taking payments for the rest. If they say ‘no’ I can either wait until the card fills up or I can go to Aspen Dental (very close by) and get a set of Comfy-Dents for $300.00.

In the meantime, the Guardian Dental Group is no longer on our list of companies to pay. They only shell out 60% anyway and that’s sporadically at best, they’re very picky/choosy about what they cover. Tonight I’ll ask hubby to drop it completely from our plan.

So, with any luck at all, I’ll still get the new plate. I’ll just have to make sure it stays in really good shape until I’m old enough to get on MediCare! Well, that’s only 17 years away and I have had the current one for near 20 so…maybe it’s not such a stretch. At least MediCare expects to pay for dentures. They’re not happy about it but they pay.

Gee, ya know, when I finish “Kingdoms” and summer rolls around and I go to the doctor to finally have my hands operated on for the carpel tunnel I hope Blue Cross doesn’t look at me and say; Sorry, kiddo, this didn’t happen on our watch, so here’s a couple of nice splints for you and some pain pills.

About lbdarling

Beware...the truth is spoken here. If you can't handle that...buh-bye.

Posted on 30/04/2014, in Uncategorized and tagged , , , , , , . Bookmark the permalink. 4 Comments.

  1. So true! You spend so much for these policies and inevitably when you go to use them they don’t cover what you need. Good luck!

  2. Totally sucks! But that is normally how it always happens. You pay and pay and when you actually need to use it they act like it is a big deal. Hope there is enough there that you are covered! Good luck

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