Another Teamcare concession

Mugarolla

Light 'em up!
View attachment 17584

Here's the now defunct UPS Administered National PT Health Plan. Implants are explicitly listed under "what's not covered;" the exception is unless it's specifically approved in advance. The problem is that the verbiage favors UPS -- "not covered" and absolutely no definition of what would make it approved in advance. UPS told me that implants would be approved ONLY when medically necessary, as I noted above. There are oodles of examples of people having doctors sign off their claim as medically necessary and UPS rejecting it for various reasons.

Your co-worker got lucky, but this is no change to benefits.
Don't know what plan you were in. I see the exclusion for dental implants in your summary unless medically necessary. Here are the exclusions in the plan that I was in. Nothing about dental implants. Trust me, implants were covered in my old plan. They are not in Teamcare.

What is Not Covered Under

Dental Options 1 and 2

In addition to services not specifically

listed in Covered Expenses above, the


following expenses are not covered

by the dental options:

• Remineralization (Calcium Hydroxide,

temporary restoration) as a separate procedure

only

• Occlusal adjustment (unless following

periodontal surgery) or retainers if charged

separately from orthodontic treatment

• Claims received more than 12 months

past the date of service

• IV sedation, except in certain circumstances;

call Aetna at 1-800-UPS-1508

• Appliances, restoration or procedures

needed to alter vertical dimensions or

restore occlusion or for the purpose of

splinting or correcting non-severe attrition

or abrasion

• Dentures and bridgework when they are

for the replacement of teeth that were

extracted before the patient was covered

by a UPS-administered dental plan

• Orthodontic treatment begun before covered

by a UPS-administered dental plan

• Root canal therapy, if the pulp chamber

was opened before the patient was covered

by a UPS dental option

• Relines and adjustments of dentures and

partial dentures within six months after

installation

• Cosmetic dental services and supplies,

including personalization or characterization

of dentures

• Prosthetic devices and appliances, including

bridges and crowns, and expenses

for fitting or modifying them, if installed

or delivered more than 30 days after the

patient’s coverage ends

• Replacement of lost, stolen or broken

appliances

• Replacement of congenitally missing teeth

• Education programs, such as plaque control

or oral hygiene instruction

• A charge for a replacement or modifi -

cation of a partial or fully removable

denture, a removable bridge or fi xed

bridgework, or for adding teeth to any

of these, or for a replacement or modifi -

cation of an inlay, onlay, crown or cast

processed restoration, within fi ve years

after installation

• Localized delivery of antimicrobial

agents; such as Actisite®, Atridox®,

Arestin® and PerioChip®

• Local anesthesia or nitrous oxide,

as a separate charge

• Any prescription drug

• Full mouth debridement

• Guided tissue regeneration

• Desensitization treatment

• Precision attachments except as noted

under Major Services in this section


• Infection control

• Behavior management

• Canal preparation, if submitted as

a separate charge

• Rubber dam

• Services not required for the treatment of

a specific condition or to maintain good

dental hygiene, as determined by Aetna

• Services not reasonably necessary or

customarily performed, as determined in

keeping with guidelines adopted by Aetna

• Services not furnished by a licensed

dentist, except services provided by a

licensed hygienist under the direction of

a dentist or X-rays ordered by a dentist

• Services covered by the medical options

• Charges for a missed or broken

appointment

• Charges for the dentist’s travel
 

Harry Manback

Robot Extraordinaire
I'm waiting for the YES voters to explain this one

Imagine, if you can, the horror of knowing only, $1500 annual dental benefit TeamCare provides.

Imagine again what it might be like to have your spouse diagnosed with Rheumatoid Arthritis. Your spouse might be prescribed a drug that runs about $3700 per month.

Good ole TeamCare will say," Nah, ChickenLegs, for you? That'll be $5."

You might find yourself slightly grateful and (yikes!) a little more willing to brush/floss your teeth twice per day.


Sent using a Potato
 
I hate the look of a gold crown on front teeth but sometimes they are actually the best material to use. I have a gold crown on one of my back teeth. Not for show, just because it is stronger.
I lost a molar. It got cracked from a steel toe to the head back in the day. I think a good one would look good.
 

Harry Manback

Robot Extraordinaire
I lost a molar. It got cracked from a steel toe to the head back in the day. I think a good one would look good.

You know what time it is...
ImageUploadedByBrownCafe1411783651.503120.jpg



Sent using a Potato
 

Mugarolla

Light 'em up!
Not only did my old plan pay for dental implants, but in your scenario, my plan would not have even asked for $5. I had a $0 copay. Teamcare is a major concession.
 

Mugarolla

Light 'em up!
Imagine, if you can, the horror of knowing only, $1500 annual dental benefit TeamCare provides.

Imagine again what it might be like to have your spouse diagnosed with Rheumatoid Arthritis. Your spouse might be prescribed a drug that runs about $3700 per month.

Good ole TeamCare will say," Nah, ChickenLegs, for you? That'll be $5."

You might find yourself slightly grateful and (yikes!) a little more willing to brush/floss your teeth twice per day.


Sent using a Potato
Brushing/flossing teeth has nothing to do with breaking a tooth.
 

Harry Manback

Robot Extraordinaire
Not only did my old plan pay for dental implants, but in your scenario, my plan would not have even asked for $5. I had a $0 copay. Teamcare is a major concession.

How much sleep did you lose for your union brothers and sisters who didn't share in your healthcare benefits over the years, brother?




Sent using a Potato
 
Last edited:

Bubblehead

My Senior Picture
How much sleep did you lose for your union brothers and sisters who didn't share in your healthcare benefits over the years, brother?




Sent using a Potato
Who knew, and how could we???
Honestly, if the "have nots" would have made the noise we did, I would have listened.
I now ask, whose responsibility was it to negotiate a fair contract "across the board"?
I hate when somebody tries to bring themselves up by bringing someone else down.

All I ever wanted was for everybody to have what I "had".
It was certainly attainable from a company recording record profits, in a down economy, with nothing but upside in their future.
I'm losing sleep now.
Does that make you feel better?
 

oldupsman

Well-Known Member
Not only did my old plan pay for dental implants, but in your scenario, my plan would not have even asked for $5. I had a $0 copay. Teamcare is a major concession.
Yes it was. And everybody knows it.

How much sleep did you lose for your union brothers and sisters who didn't share in your healthcare benefits over the years, brother?

So that's your solution. Instead of fighting to bring you up to our level let's roll over and bring everybody
down to your level. Now we all have the same lousy plan you have. You feel better?



Sent using a Potato
 

oldupsman

Well-Known Member
Who knew, and how could we???
Honestly, if the "have nots" would have made the noise we did, I would have listened.
I now ask, whose responsibility was it to negotiate a fair contract "across the board"?
I hate when somebody tries to bring themselves up by bringing someone else down.

All I ever wanted was for everybody to have what I "had".
It was certainly attainable from a company recording record profits, in a down economy, with nothing but upside in their future.
I'm losing sleep now.
Does that make you feel better?

You beat me to it Bubble.
 
Top