Alternate benefit/appeal
My dental insurance carrier knocked me down to an alternate benefit. Any strategies for potentially appealing?
I have an inlay (it's well over the five-year mark for replacement, so that's not a concern), but some of the tooth it's on has broken off. My dentist wants to replace the inlay with a new one that would would fill in the chipped area.
But in response to the prior authorization request, my insurance carrier (MetLife)knocked it down to an alternate benefit — amalgam filling. So it ends up being about $250 less in the reimbursement.
Does anyone have any advice on how I can convince MetLife to relent? My sense from the documentation is that insurance companies frequently avoid normal reimbursement inlays/onlays because they believe fillings are just as effective. Realistically, I'm not going to downgrade from my current inlay, but I'd like to get the higher reimbursement if possible.
submitted by /u/Square-Emu3861
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