This is long, but I am in a tough situation and have no idea what to do about it.
So in February 2019, I started Invisalign with a Cigna PPO plan (employer sponsored) that paid for about half of my treatment (I can’t remember exactly the coverage amount – would need to dig around to find that). I completed treatment in October 2019 and paid off my portion in November 2019 (I made monthly payments during treatment).
Apparently, Cigna was only paying my dentist THEIR portion every 3 months — not monthly like I was paying. As such, their final payment was supposed to be sent to my dentist in March 2020. Unfortunately, my employer forced us to switch insurance starting January 1st, 2020. I had no choice but to switch to an Anthem Dental PPO. When this happened, it didn’t even cross my mind to consider how this would affect the insurance payments towards my Invisalign. In my mind, insurance just paid my dentist the balance in one payment – or at least in monthly installments, like me.
On February 28th, 2020, I left that job and my Cigna Dental PPO plan ended on March 1st, 2020. I didn’t have health insurance coverage again until about June 2020. Then, I went to ANOTHER new job and got NEW coverage (Guardian) starting September 1st 2020. I am currently still with Guardian dental PPO, employer sponsored.
SO. Throughout 2020, I didn’t visit my dentist due to Covid. I finally went to my dentist on March 22, 2021 for a routine cleaning. During that visit in March, my dentist did not tell me ANYTHING about an Invisalign balance or insurance issue, until NOW… because my dog chewed my Invisalign retainer and I need to replace it. So I called my dentist to replace my retainer, and only now – August 2021 – is my dentist telling me I have a remaining balance because Cigna did not finish paying for their portion of Invisalign.
I asked why Cigna wouldn’t pay it, and the dentist told me it’s because I wasn’t covered by them during the time when they were supposed to pay their final installment. It’s true that I was not covered by Cigna between January – March 2020, but I WAS covered by Cigna for the entire duration of my Invisalign treatment.
Now my dentist is telling me that I am responsible for paying the balance that Cigna won’t pay. I am so upset that Cigna is pulling this shit, and trying to find a loophole to get out of paying for treatment that occurred while I was fully insured by them. And at this point, this matter is more than a year in the past so Cigna is definitely pulling the “this occurred over a year ago so we’re not responsible” shit.
Is Cigna actually not obligated to pay this final portion? And am I right to refuse to pay for it because my dentist failed to even notify me about this balance issue for over a year?? Any advice would be so helpful, I’m so mad and feel like I got duped by multiple businesses (insurance and my dentist)
submitted by /u/stitchbitch27
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This is long, but I am in a tough situation and have no idea what to do about it. So in February 2019, I started Invisalign with a Cigna PPO plan (employer sponsored) that paid for about half of my treatment (I can’t remember exactly the coverage amount – would need to dig around to find that). I completed treatment in October 2019 and paid off my portion in November 2019 (I made monthly payments during treatment). Apparently, Cigna was only paying my dentist THEIR portion every 3 months — not monthly like I was paying. As such, their final payment was supposed to be sent to my dentist in March 2020. Unfortunately, my employer forced us to switch insurance starting January 1st, 2020. I had no choice but to switch to an Anthem Dental PPO. When this happened, it didn’t even cross my mind to consider how this would affect the insurance payments towards my Invisalign. In my mind, insurance just paid my dentist the balance in one payment – or at least in monthly installments, like me. On February 28th, 2020, I left that job and my Cigna Dental PPO plan ended on March 1st, 2020. I didn’t have health insurance coverage again until about June 2020. Then, I went to ANOTHER new job and got NEW coverage (Guardian) starting September 1st 2020. I am currently still with Guardian dental PPO, employer sponsored. SO. Throughout 2020, I didn’t visit my dentist due to Covid. I finally went to my dentist on March 22, 2021 for a routine cleaning. During that visit in March, my dentist did not tell me ANYTHING about an Invisalign balance or insurance issue, until NOW… because my dog chewed my Invisalign retainer and I need to replace it. So I called my dentist to replace my retainer, and only now – August 2021 – is my dentist telling me I have a remaining balance because Cigna did not finish paying for their portion of Invisalign. I asked why Cigna wouldn’t pay it, and the dentist told me it’s because I wasn’t covered by them during the time when they were supposed to pay their final installment. It’s true that I was not covered by Cigna between January – March 2020, but I WAS covered by Cigna for the entire duration of my Invisalign treatment. Now my dentist is telling me that I am responsible for paying the balance that Cigna won’t pay. I am so upset that Cigna is pulling this shit, and trying to find a loophole to get out of paying for treatment that occurred while I was fully insured by them. And at this point, this matter is more than a year in the past so Cigna is definitely pulling the “this occurred over a year ago so we’re not responsible” shit. Is Cigna actually not obligated to pay this final portion? And am I right to refuse to pay for it because my dentist failed to even notify me about this balance issue for over a year?? Any advice would be so helpful, I’m so mad and feel like I got duped by multiple businesses (insurance and my dentist)
submitted by /u/stitchbitch27 [link] [comments]Read Morer/HealthInsurance