Question
I have a dental HMO. No deductibles, no copays. I am six mo. pregnant and went in for a broken tooth. The plan pays all costs for porcelain crown fused to base metal. The dentist had on the plan for high noble (gold) fused with porcelain. When I went in for the crown I was told the dentist would under no circumstances change what he would do. I could only have the most expensive option (the gold) and if I didn't have that one done, the facility wouldn't work on me at all. He was not the dentist who worked on me or ever saw me. He was the one that owned the office. Is this legal? I felt trapped. It would take me another month to get on another dentist's roster and I had a quarter of my molar gone.
Answer
Hi Laura!
I am assuming the Dentist will charge more for the gold thus getting more from your plan.
I don't think it is illegal if this is what he thinks needs to be done, I would assume just his opinion however if I were you I would call your HMO plan and see if this is okay with them.
HMO plans are very strict and your dentist may not be following their guidelines.
Tricia
