Member Savings Story | Abbey, 38
When Abbey noticed a lingering irritation near her back teeth, she knew she probably needed to have her wisdom teeth out. Abbey wanted to make sure she knew all her costs up front. She contacted HooPayz to help her understand her coverage. After a HooPayz advisor confirmed her dental insurance covered 80% of the oral surgery costs, Abbey felt more comfortable going forward with the procedure.
Abbey’s oral surgeon discovered she needed 3 out of 4 of her wisdom teeth taken out and recommended a full sedation for this surgery due to Abbey’s age and the age of her teeth. Wisdom teeth extraction surgery for someone at the of 38 is a complicated and risky procedure due to the length of time the roots have been in the gum. Plus, in Abbey’s case, one of her wisdom teeth was very close to a major facial nerve.
Abbey was ready to go for her surgery until she was told that her out-of-pocket balance due was $1395, which was more than she had expected. She asked her surgeon’s office why it was so high and was told that her insurance did not cover the general anesthesia that her surgeon recommended. She was shocked. How could they possibly not cover the anesthesia when it was clear that the surgery was complicated and risky? She knew she needed to have wisdom teeth removed but was confused and disappointed about the cost. Abbey decided to call HooPayz again.
Her HooPayz Advisor let her know that there was a chance it would be covered. All Abbey had to do was ask her surgeon’s office to send over a full profile and explanation of her case and her insurance would review it. When Abbey put this request in with her surgeon’s office, they insisted there was no chance of having the anesthesia covered, But, Abbey insisted they send the information anyway.
Abbey went ahead with the surgery and paid her full out-of-pocket balance hoping to get reimbursed. A few weeks went by and as her surgery wounds started to heal, she received an Explanation Of Benefits from her insurance. Abbey’s insurance did go ahead and cover her anesthesia costs! She called HooPayz again to confirm and her advisor said she should receive a very big reimbursement check.