| Date Submitted: | August 21, 2010 |
| Insurance Provider: | MetLife in New York |
| Coverage: | 1 out of 10 |
| Claims: | 1 out of 10 |
| Customer Service: | 1 out of 10 |
| Cost: | 1 out of 10 |
| Recommend: | No |
| Review: | It's a fight for every claim I've had MetLife for five years and only needed benefits for cleaning and xrays for the first four years. In my fifth year, as my old childhood fillings are failing and separating from my teeth (leaving them dangerously prone to cracking) I needed filling removal and a crown and root canal. MetLife denied the claim for the crown saying there was not enough proof the tooth was compromised enough for a crown. (Say what? Uncompromised teeth don't normally need root canals.) In my sixth year, same thing. Needed another crown and root canal. Same denial of claim. Then came the kicker: only coverage for 1 crown every 60 months! Lousy $2000 a year benefit pays for virtually nothing. A root canal is over $1000 and a crown is over $1000! Even with my $2000 maximum, I only got back $800 last year from MetLife after paying out almost $3000. This year looks to be the same. My friend has Aetna and has needed the same work as I have. Hers has been fully covered even out of network. I'm going to inquire of my company to see if they can get something better than MetLife. I've had to take money from my 401K to pay for my dental care. |
| Submitted by: | Dental Patient 43 year-old :: Female Reviewer :: Suffolk County, New York |
1 comments for this review
| Comment by: John Doe From: Boston,MA November 12th, 2010 |
"Then came the kicker: only coverage for 1 crown every 60 months" Well your rating is only further proving the true lack of knowledge you have of any sort of dental plan. Its not one crown every 60 months, its a crown is only eligible to be replaced after 60 months. You can get as many crowns as your maximum allows as long as they are more than 60 months old.` You can get a plan through a different insurance the same basic concept applies anywhere, dont believe me, sign up for Aetna and see if they cover your fillings without any medical reason other than "there old". I think what you dont understand is your employer creates your benefits, they are the ones who say yes make sure our employees claims are reviewed, no only cover this so many times a year. Why you ask, because it costs them less to insure you... So before you flip out on a customer service rep next time you call maybe you can do alittle research before you jump to your ignorant conclusions. |
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