Why are insurance forms and regulations written at the 27th grade level? We’re not sure if even Metlife knows. Reader Tim certainly doesn’t, all he knows is Metlife can’t figure out how to get his dang teeth replaced. Sadly, the three teeth wouldn’t need implants if it weren’t for the first dentist delaying in removing the first tooth.

No doubt he was still trying to figure out how the insurance coverage worked…

(Photo: imorgan73)

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Tim writes:

Metlife supposedly has very high standards for the dentists they select for the clients -myself- to select from….. It seems these professionals would be well versed in Metlife’s payment protocols……

After one dentist delayed in removing one tooth, I lost another tooth and that being part of a bridge cause me to loose a third tooth. The company details of the dental plan state implants can be used for single tooth replacement or a lifetime total of four to hold a denture to replace all upper or lower teeth.

I quit that dentist –

The next dentist tried pushing a retainer with teeth attached on me after I had repeatedly told her no retainer with teeth – implants or nothing. She proceeded with getting the retainer and after shoving the “we can yank whatever and ruin whatever in your mouth waiver” I got irritated and she terminated the business relationship.
I contacted the credit card company – they removed the charges. I contacted Metlife and they were full of reasons why they cannot remove the charges. After several phone calls they removed most of the charges – but put one back on my account.

After that I found a decent dentist. He recommended a periodontist to provide the implants. The periodontist contacted Metlife for my insurance coverage and Metlife responded with a fax that shows coverage, but not the details – coverage for up to four implants, but not under any particular conditions. Now Metlife has come up with many versions of why they can refuse to pay – one says I should have gotten a pre-assessment, then next says a pre-assessment does not mean anything – it is subject to change, one says single tooth replacement means only one tooth, not replacing one tooth and then two more teeth.

I am not a dentist – I and the general public have to rely on the professionals to work with the insurance professionals. When an insurance company pulls this underhanded, vindictive behavior – there is something wrong!

An industry that needs streamlining if there ever was. It used to be that people lost teeth because of lack of dental care. Now they’re losing them because of it. — BEN POPKEN

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