Another Teamcare concession

Mugarolla

Light 'em up!
Ok.

Where is the link ?

How about a pic ?



-Bug-
I will dig out the book and take a pic for you if that will make you happy. Busy at the moment but should do it by the end of the day. I guess the post showing implants covered was not good enough for you. That came direcly from the pdf of the scanned book. I scan all that stuff. Always have it with me. No link to link to. It's on a local disk.

But even if I posted the pdf to the cloud and gave you the link, it sounds like you would challange the validity of the pdf. Over tooth implants. I will get you a picture.
 

Harry Manback

Robot Extraordinaire
It is not my fault that some of you are always content in what you have and are never willing to fight to get what you deserve. You are the type that never files a grievance and lets the company walk all over you.

Read my past posts. The one thing that I pushed on this new contract was the medical. I said "why do you want to bring me down to your level instead of fighting to bring yourselves up to my level."

So basically, if you don't want to fight, I really don't feel sorry for you. Everybody wants everything for free.

Welcome to TeamCare.


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Mugarolla

Light 'em up!
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Ok.

Where is the link ?

How about a pic ?



-Bug-
As you can see. implants are under covered services. Nothing about implants in non covered services.
 

Mugarolla

Light 'em up!
:biggrin:




Uh.... No.

They are listed under "What is not covered".

With the caveat, that Upstate pointed out.


It hasn't changed.... in 15 years ?


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They both, have the same verbiage. It didn't change.


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-Bug-
Uh.... No.

They are listed under "What IS covered".


With the caveat, that Upstate pointed out.
 

Mugarolla

Light 'em up!
If specifically approved in advance being the key terminology here.
Agreed. My coworker got his approved. I would be curious to see the percentage approved and denied in the old plan. The new plan, Teamcare, Will have a 100% denial.

Bagels posted a picture from his UPS plan showing implants in the not covered column. My plan showed implants in the covered services column, granted it said prior approval is necessary. I would like to hear from any BC here that got an implant denied who was in the company plan.
 

Bagels

Family Leave Fridays!!!
Agreed. My coworker got his approved. I would be curious to see the percentage approved and denied in the old plan. The new plan, Teamcare, Will have a 100% denial.

Bagels posted a picture from his UPS plan showing implants in the not covered column. My plan showed implants in the covered services column, granted it said prior approval is necessary. I would like to hear from any BC here that got an implant denied who was in the company plan.

Per TeamCare's website --
"Dental implants are generally not covered. However, if the patient has no teeth present in either the upper or lower jaw, they may be considered under your medical plan. Otherwise, alternate treatment may be considered. In these cases a pre-determination of benefits is required."

Per Teamcare SOB, under not covered --
Implantology (except for endosseous staple implants and subperiosteal to support full dentures)

UPS' language is much more ambiguous, but in listing implants under both covered & not covered columns followed with pre-approval notation, I'd imagine criteria would be similar. As I mentioned earlier, I had a tooth removed adjacent to a long gone wisdom tooth and UPS refused to cover an implant, even though it was clearly leading to medical problems as well as discomfort. Internet research shows UPS denying implants in several cases, including one in which somebody got into a motorcycle accident and lost a fair number of teeth.

I'm also interested in hearing about implant success stories, but overall, it doesn't appear there's any change in coverage here. Your co-worker probably got lucky... it happens.

Dentists/oral surgeons charge insurances $4000-$6000 for implants while the cash price is typically $1000-$1500. I just have a hard time believing UPS freely paid for them, based on this & my own experience/research.
 
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HBGPreloader

Well-Known Member
I had a bad molar that needed a lot of work.

It started with a root canal and a crown due to an old filling that failed.

Then it became infected and was extracted.

And, just before the new plan, I had a bridge installed.

Everything was covered under the old plan at 80% of the "negotiated" rate.

Everything that could be preauthorized was and all of the work covered by the insurance - up to the maximum benefit amount. Fortunately, all the work was done over 2 "insurance" years and I had co-insurance to make up most of the difference.

The bridge was the most expensive procedure and still cost more than $600 out-of-pocket.

My dentist does not participate the new dental plan. This means a higher cost for regular visits and paying more out-of-pocket to make up the difference. My co-insurance only reimburses at their negotiated rate. But, thanks to the bridge and maxing out their benefit, they're not reimbursing me for anything for the rest of the year.

I've heard some bad comments about the prescription plan. An employee said he tried to get a 30 day prescription filled and expected to pay $5. However, the pharmacy said his co-pay was over $200. I have a feeling there's more to this story though because I believe it was a maintenance prescription which, from what I understand, should be filled via mail order in order to qualify for the $5 co-pay.
 

Whatbrownwontdoforyou

Well-Known Member
A lot of healthcare plans also changed because of the affordable care act......different requirements and regulations........doctors and dentists aren't dealing with some of these things .......I went to a dentist who said he doesn't take any insurance..cash only


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HULKAMANIA

Well-Known Member
I'm waiting for the YES voters to explain this one

I agree! Problem is the majority of the people that voted yes had no idea what they were voting yes to. Thats what I hate about it. Most just vote without informing themselves about anything. The yes voters explanation would most likely be like Obama's explanation of why healthcare costs have doubled every year since hes been in office. Whether you like Obama or not his explanation was absolute stupidity. I am not making this a political debate about Obama, I am simply making a comparison.
 
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