I Guess They Showed ME!

Remember way back to July 12, when I complained about Guardian dental insurance shorting me $17 on the #1 son's fluoride treatment? If not, you can read about it here. The point was, they kept giving me the runaround, declaring that 15 years old is not a child, but an adult, so he got an adult fluoride treatment, on which they only pay $12 and not the $27 that the dentist billed them. Problem was, they only paid $10, which put a little doubt in my mind, since also they had paid the full amount every year, twice a year, for both boys. And they paid $25 for The Pony, who is 12 years old.

So after multiple calls, with promises to respond in 24 hours, I finally got an answer left on my answering machine (yes, some people still have those ancient artifacts), even though it took 10 days. The message stated that a child fluoride treatment is paid at the full rate, but that any patient 12 years old or older is not a child by their standards, so even if the dentist bills it as a child fluoride treatment, it is an adult treatment, covered at $12. You can see where I'm going with this, can't you?

The message said that in their lengthy fact-finding mission, they found that The Pony should not have been paid at $25, but at $12, because he is not a child, either. Oh, and not to be surprised if the dentist bills me for that extra $13.

Yep. That would be $30 that I'm responsible for to the dentist: the $17 on #1, and the $13 on The Pony. But the pharmacy Even Stevened me that $30 yesterday in their error. I'm just like Jerry Seinfeld finding that twenty-dollar bill in his jacket pocket after wadding up a twenty-dollar bill and tossing it out his apartment window to show Elaine that he was Even Steven.

This whole situation is messed up. I didn't think that an insurance company could demand money back from the dentist once it was issued. Good luck with that, Guardian. But it wouldn't surprise me if the dentist came up with some way to scam that $13 from both me and Guardian.

I'm not even going to call Guardian back and ask why they paid the full fluoride amount for #1 twice a year during the years he was 12, 13, and 14.

No good can come of that.