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VHI vs wisdom teeth extraction

  • 15-05-2013 11:28pm
    #1
    montybee
    Registered Users Posts: 13 ✭


    Hi there,

    Just wondering if anyone has info or advise re having wisdom teeth removed under VHI cover?

    At present I have no health insurance and low and behold my partially erupted wisdom teeth need to be removed as advised by my dentist.

    I visited my dentist with pain last week and an xray identified that my lower wisdom teeth will need to be surgically extracted. This is where my confusion stems.
    As I told dentist I have no insurance he informed me that he would refer me to hospital consultant via public list but waiting times are very long e.g years more than months.

    I dont plan on putting up with pain etc for this length of time so contacted VHI who quoted me X amount.
    However they told me that waiting times for 'pre-existing' condition is 5years but no waiting time for accidents/emergencies. So Im wondering really is my trip to dentist and referal letter to consultant now considered a pre-existing condition and if not how long of a waiting time will I have to endure before my VHI will cover the procedure.

    Any info would be greatly appreciated


Comments

  • #2
    Oral Surgeon
    Registered Users Posts: 3,240 ✭✭✭Oral Surgeon


    montybee wrote: »
    Hi there,

    Just wondering if anyone has info or advise re having wisdom teeth removed under VHI cover?

    At present I have no health insurance and low and behold my partially erupted wisdom teeth need to be removed as advised by my dentist.

    I visited my dentist with pain last week and an xray identified that my lower wisdom teeth will need to be surgically extracted. This is where my confusion stems.
    As I told dentist I have no insurance he informed me that he would refer me to hospital consultant via public list but waiting times are very long e.g years more than months.

    I dont plan on putting up with pain etc for this length of time so contacted VHI who quoted me X amount.
    However they told me that waiting times for 'pre-existing' condition is 5years but no waiting time for accidents/emergencies. So Im wondering really is my trip to dentist and referal letter to consultant now considered a pre-existing condition and if not how long of a waiting time will I have to endure before my VHI will cover the procedure.

    Any info would be greatly appreciated

    VHI like any insurance company have rules to stop people finding out that they need a procedure and then getting cover and then having the procedure and then leaving the insurance company.... they would be skint (or more skint than they are....)

    Generally, if you are new to health insurance, you have a 6 month wait before being covered for most procedures (provided the need for the procedure was only discovered during your period of cover), this is to prevent people form finding out that they need a procedure in January, getting cover at a cost of €1000 approx and then landing the VHI with a €2000 bill in Febuary.......

    Now that you have told the VHI of your need for wisdom tooth removal, it is a pre-existing condition so their rules of 5 years apply.

    If you are getting health insurance anyway then you may consider waiting the 5 years to have them removed but this is probably not a good idea...

    If you were just getting insurance for your wisdom teeth then it not mkes no financial sense. You will pay €5000 approx (actually €6000 as they will only cover you after 5 years...) to then have a procedure that would have cost hundreds under LA or IV sedation or €2000 approx under GA to have done now....

    Waiting for public treatment will take forever, dental hospitals will charge you too.... My advice, skip the vhi this year, go pay for your wisdom teeth and then take up VHI afterwards....


  • #3
    Rasmus
    Registered Users Posts: 2,075 ✭✭✭Rasmus


    montybee wrote: »
    Hi there,

    Just wondering if anyone has info or advise re having wisdom teeth removed under VHI cover?

    At present I have no health insurance and low and behold my partially erupted wisdom teeth need to be removed as advised by my dentist.

    I visited my dentist with pain last week and an xray identified that my lower wisdom teeth will need to be surgically extracted. This is where my confusion stems.
    As I told dentist I have no insurance he informed me that he would refer me to hospital consultant via public list but waiting times are very long e.g years more than months.

    I dont plan on putting up with pain etc for this length of time so contacted VHI who quoted me X amount.
    However they told me that waiting times for 'pre-existing' condition is 5years but no waiting time for accidents/emergencies. So Im wondering really is my trip to dentist and referal letter to consultant now considered a pre-existing condition and if not how long of a waiting time will I have to endure before my VHI will cover the procedure.

    Any info would be greatly appreciated

    Did you identify why you were getting pain? If your gums were infected because of the wisdom teeth, you could take antibiotics to clear that up, then wait for an appointment in the public hospital. Otherwise, pay upfront as there is no point getting insurance for extractions of even up to 4 teeth, which should be less than 2,000. A lot of dentists will entertain a payment plan. Another option is to apply for a medical card - if approved this may even come through before an appointment in the hospital, but you may only be able to get one tooth extracted, depending on how much of an emergency it is.


  • #4
    montybee
    Registered Users Posts: 13 ✭montybee


    Thanks Oral Surgeon for your advice. I understand insurance companies need to protect themselves from fraud,for want of a better word.
    Health insurance is something that I think is a necessity in this country and something Ive always planned on getting
    but I think my wisdom teeth arrived!!!

    What my real question is is who determins the existence of a "pre-existing condition" in my circumstance? Is it the dentist,even though VHI quote is without dental cover or the oral surgeon who I will be referred to by the time I have VHI cover??
    If its the oral surgeon then surely its not a pre-existing condition


  • #5
    btkm8unsl0w5r4
    Closed Accounts Posts: 9,538 ✭✭✭btkm8unsl0w5r4


    The condition is pre-existing cause you knew about it before you had the insurance. So if they ask you when was the first diagnosis (think that is on the form when the surgeon applies for payment?) you will have to lie to the surgeon, or the surgeon would have to lie for you. Either way you are party to insurance fraud. Now this might not be spotted at the time by the VHI. But say down the line, you have to make a major claim for a big operation costing 100,000 of euros, the VHI might investigate you claim history, and this "little lie" would invalidate your insurance even years later.

    So for the sake of 5-8 hundred euro now, you could jeopardies your health insurance for the rest of your life....

    If you end up hospitalised with a wisdom tooth infection that an emergency. Elective surgery is not an emergency.


  • #6
    cudsy1
    Registered Users Posts: 152 ✭✭cudsy1


    confirmed! thank you very much for your crystal clear advice Oral Surgeon (and Lea FC)

    mods - sorry for bumping old threads but they perfectly answered my questions


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