Dentist wrong about medical card covering filling the same tooth again?

Paddy791

I got told by a dentist that this wasn't covered. I had a filling done on the medical card about a year and half ago and part of the tooth broke recently and it needs to be done again. she Said Its not covered because its the same tooth. Someone else told me that she was wrong and I'm entitled to it?

davo10

Paddy791 wrote: »

I got told by a dentist that this wasn't covered. I had a filling done on the medical card about a year and half ago and part of the tooth broke recently and it needs to be done again. she Said Its not covered because its the same tooth. Someone else told me that she was wrong and I'm entitled to it?

Your dentist is correct, there is a 5 year bar on claiming a fee for a filling on the same tooth twice.

Paddy791

davo10 wrote: »

Your dentist is correct, there is a 5 year bar on claiming a fee for a filling on the same tooth twice.

Thanks.

She was sneaky about the way she asked me. I should have said it wasn't done on the medical card before. I don't have the money and I'm in quite some pain.

Could I have it extracted for free?

lollsangel

Paddy791 wrote: »

Thanks.

Could I have it extracted for free?

I was told by my dentist you can have as many extracted as u want in 1 year but can only have 1 filling ....go figure

Paddy791

lollsangel wrote: »

I was told by my dentist you can have as many extracted as u want in 1 year but can only have 1 filling ....go figure

I think you can have two fillings. Only one in the same tooth though.

I've got 6 fillings in total, some were done on the med card and some weren't. I could easily have said that one wasn't done on the medical card but she was really sneaky about the way she asked me. I guess she gets more money if it's paid in cash which is fair enough. It's kind of a battle between you and the dentist in a way when you have a med card. They generally dont seem to like dealing with med card patients.

btkm8unsl0w5r4

Paddy791 wrote: »

Thanks.

She was sneaky about the way she asked me. I should have said it wasn't done on the medical card before. I don't have the money and I'm in quite some pain.

Could I have it extracted for free?

Well then the dentist would not have been paid for her work, not sneaky....theft. Its only the dishonest patients that dentists dont like dealing with.

davo10

Paddy791 wrote: »

I think you can have two fillings. Only one in the same tooth though.

I've got 6 fillings in total, some were done on the med card and some weren't. I could easily have said that one wasn't done on the medical card but she was really sneaky about the way she asked me. I guess she gets more money if it's paid in cash which is fair enough. It's kind of a battle between you and the dentist in a way when you have a med card. They generally dont seem to like dealing with med card patients.

I think you are directing your ire at the wrong person. If the payment form is sent off for a tooth already filled within the last 5 years, it gets returned by the HSE unpaid so the dentist gets nothing. You can't blame her for checking, she was sneaky because if she wasn't you would not have told her and she would have got no payment at all. Dentists like treating all patients, they just don't like dealing with the HSE.

Paddy791

davo10 wrote: »

I think you are directing your ire at the wrong person. If the payment form is sent off for a tooth already filled within the last 5 years, it gets returned by the HSE unpaid so the dentist gets nothing. You can't blame her for checking, she was sneaky because if she wasn't you would not have told her and she would have got no payment at all. Dentists like treating all patients, they just don't like dealing with the HSE.

Don't get me wrong, I would probably have done the same in her position. Well, I can't say I would now because I'm looking at it as a patient but maybe after a couple of years of working as a dentist id be less empathetic and see it from the business side.

Her interests are getting paid and making money. She is not a charity dentist. Mine are not having a lot of pain and anxiety over my tooth. There was a conflict of interests and there was only going to be one winner and it was her. I've been in agony most of the day as a result and will get little sleep if any and probably end up losing the tooth.

But if I had to do it again I'd lie and say it was a different tooth. Sorry but I'd rather not go through anguish. I don't hold a grudge to the dentist at all either. It's just an unfortunate situation that the HSE puts us in.

Maybe my story will help others in a similar position.

davo10

Paddy791 wrote: »

Don't get me wrong, I would probably have done the same in her position. Well, I can't say I would now because I'm looking at it as a patient but maybe after a couple of years of working as a dentist id be less empathetic and see it from the business side.

Her interests are getting paid and making money. She is not a charity dentist. Mine are not having a lot of pain and anxiety over my tooth. There was a conflict of interests and there was only going to be one winner and it was her. I've been in agony most of the day as a result and will get little sleep if any and probably end up losing the tooth.

But if I had to do it again I'd lie and say it was a different tooth. Sorry but I'd rather not go through anguish. I don't hold a grudge to the dentist at all either. It's just an unfortunate situation that the HSE puts us in.

Maybe my story will help others in a similar position.

Paddy you have a couple of options, you could go directly to your local HSE dental clinic and access free treatment there, I believe most do an emergency clinic early in the morning. You could consider having the tooth extracted or borrow the money to have it fixed. It is a terrible position to be in but it unfortunately is a result of the HSE's utter lack of common sense when it comes to providing treatment to those with Med cards.

Paddy791

davo10 wrote: »

Paddy you have a couple of options, you could go directly to your local HSE dental clinic and access free treatment there, I believe most do an emergency clinic early in the morning. You could consider having the tooth extracted or borrow the money to have it fixed. It is a terrible position to be in but it unfortunately is a result of the HSE's utter lack of common sense when it comes to providing treatment to those with Med cards.

When you say local HSE clinic, do you mean a dentist who does medical card treatments? Or are there special HSE clinics?

I thought my only option now was to have it extracted? I'm not going to be able to come up with the money to have the filling. I'll definitely need to get something done tomorrow. If I havent had an overdosed on Solpadeine by the morning!

davo10

Paddy791 wrote: »

When you say local HSE clinic, do you mean a dentist who does medical card treatments? Or are there special HSE clinics?

I thought my only option now was to have it extracted? I'm not going to be able to come up with the money to have the filling. I'll definitely need to get something done tomorrow. If I havent had an overdosed on Solpadeine by the morning!

The local HSE health office/centre. Contact the office which issued your medical card and ask where their dental centre is. This is a clinic staffed by dentists employed by the HSE. They provide treatment to children under 16 but also do emergency treatments on adults with Med cards.

ballsymchugh

Paddy791 wrote: »

Thanks.

She was sneaky about the way she asked me. I should have said it wasn't done on the medical card before. I don't have the money and I'm in quite some pain.

Could I have it extracted for free?

dentists can check straight away on an online portal if treatment will be covered anyway.

if you're in agony and losing sleep, then it's probably gone beyond the stage of only a filling.

desbrook

There is a very simple and practical reason that fillings are a only covered on a five yearly basis - fraud prevention. Extractions are different obviously as you can only extract a tooth once !

davo10

desbrook wrote: »

There is a very simple and practical reason that fillings are a only covered on a five yearly basis - fraud prevention. Extractions are different obviously as you can only extract a tooth once !

Interesting perspective, I'm not in the medical card scheme but I wonder how "fraud prevention" comes into the equation. I would have thought it had more to do with the HSE not wanting to pay for repeated treatment on teeth which require more substantive treatments like crowns or which have a hopeless prognosis.

What would you do if you had a medical card, you had a filling and three years later another piece of the tooth broke? The more heavily filled a tooth is, the more likely it is to fracture, the more often it needs to be filled. If there is no cost to the patient when a fracture/cavity occurs, the more likely they are to request repeated refilling even though the prognosis worsens.