Thursday, November 12, 2009

Insurance coverage of full sedation for dental work on autistic child?

My 11 year old has autism and is totally non compliant with the dentist beyond a basic cleaning. He has some issues that need to addressed and the only way that will happen is in a pediatric OR under full sedation. Our dentist is wonderful, but we know our insurance company will turn down the full sedation (they only cover it if children under the age of 5). We are planning to appeal as there is no other way to do the needed work. I had been told at one time that since our child has diagnosed special needs that would make working on him in a tradtional way impossible, the insurance company must cover the costs. If anyone has any idea on where to look or a link to a site that discusses this topic, I would appreciate it. We live in MD, in case it is a state by state issue, Thanks so much!

Insurance coverage of full sedation for dental work on autistic child?
My jumpy grandson had to be sedated for dental work and they wanted the money up front and then Metlife or Metrolpolitan reimbursed us within a month. It went thru my job's insurance. Call them up!
Reply:You might try to see if you can get him/her approved for medicaid. Many times you can get medicaid for children w/ disabilities. However, this probably will not be approved if you have insurance. But, if you got approved for the medicaid they would most likely pay if you found a clinic that takes medicaid. However, you would then have difficulties getting the insurance back.


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