If you are contemplating dental insurance, you will most likely come across the “missing tooth clause.” It kind of sounds like the “Santa clause” in the movie of Tim Allen, and in fact, there is a slight similarity. The missing tooth clause is a protective clause for insurance companies against claims for tooth repair that was not covered under the insurance plan.
The only tooth repair that will be covered by insurance is if the damage happens during the time of the coverage. It’s basic just like auto insurance will only cover for damages sustained during the period you insured the car. You cannot make claims for damages sustained either before or after the policy was in effect.
Dental insurance companies have this clause because it helps them deal with the cost if dental insurance. Claim such as these for repair on teeth that were not covered under the plan increases the costs of dental insurance for everyone. It has a domino effect in that rising costs will force insurance companies to raise their premium rates, and this will boomerang on its clients.
In fact, there are other “clauses” in most dental insurance plans such as maximum claims and waiting period. Maximum claims refer to the limit on how much you can claim within a one year period. The average maximum amount is anywhere between $1,000 and $1,500. There is no roll-over which means if you do not reach the maximum amount, you are not allowed to apply on the succeeding year.
There are limited number of dental insurance companies that might consider offering omitting the missing tooth clause, but it would have to be in exchange for something worthwhile for them like booking a huge account with their company.
It must be said that there have been attempts by either the insured and/or the dental clinic Minneapolis in making false claims to override the missing tooth clause. What will happen is that the insurance company might pay for the claim, but they also have audits done regularly. It is also possible to trace your dental history because when you sign up for dental insurance. This is because it usually includes the right for your dental insurance provider to have unlimited access to your dental history.
They can talk to your previous dentists Minneapolis MN and get their files and records on any treatment they may done on you. If your claim has been found to be fraudulent, you could be in huge trouble for fraud, and if the clinic is in cahoots with you, then they could lose their license to operate. The risk is never going to worth the cost, no matter what angle you look at it.
A good idea for having missing teeth replaced is to talk directly with the Minneapolis dentist and ask for a special non-interest rate which will bring down the cost considerably.