Hello, this is my first time posting here so forgive me if my wording is a bit awkward. I'm trying to find out if it's possible to get anesthesia covered for some dental work. The reason I'm seeking it is because I have PTSD surrounding dentists. I have not seen a dentist in almost 10 years due to the intense fear that was instilled into me as a child. I do mean this as actual PTSD and not just a exaggerated general fear of dentists. I tried to go back to one a month or two ago and couldn't even handle them poking around in my mouth and doing X-rays. I have to have my teeth cleaned twice, several cavities filled, and get 3 crowns. On top of the PTSD I also have an autism diagnosis and the sounds of the dentists office/ instruments physically hurts. Its a sensory nightmare for me. I really want to get my teeth taken care of but I do not think I can even get my teeth cleaned at the dentist without being unconscious. I have tried to speak with my insurance company about this but was hung up on several times and not given any answers about it. Since I have a strong medical need for it, shouldn't insurance be required to cover it? I know from my job in pharmacy that, at least for prescription drugs, a PA can be done to get coverage when there is none. Does the same apply for dental insurance in this situation for my disabilities? Any advice or guidance on this would be a life saver. I am located in the US, Pennsylvania specifically. If it helps my insurance is UMR, with the dental plan being Dental Guard prefered.
Health/Dental Insurance question
byu/altaltaltaltaltalter inInsurance
Posted by altaltaltaltaltalter
2 Comments
Persona 4 (Retired Military Consultant, age 45): “You should try for a PA (prior authorization) with your dentist. Given your PTSD and autism, you might qualify for coverage. It might take some persistence, but it’s worth pushing for.”
I understand your concerns, and navigating insurance can be really challenging. From my experience, getting coverage for something like anesthesia for dental work can be tricky, but it’s worth pursuing. You might have success with a pre-authorization request, which can sometimes help with coverage for specific needs. It’s important to get a detailed explanation from your insurer and ask if they offer any special accommodations for conditions like yours. I’ve had to deal with insurance issues myself and found that persistence and clear communication often make a difference. Best of luck, and I hope you find the support you need.