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is this insurance fraud?

Posted by on Aug. 13, 2014 at 8:18 AM
  • 11 Replies
I have 2 daughters with autism and they get Medicaid plus my husband's insurance. When we see a dr in our county my husband's insurance is primary and medicaid is 2nd but that covers everything.
I need them both to see a dentist and I found a great one that excepts their medicaid but not my husband's insurance. They will even gas mask them if need be.
I called the dentist and they called me back telling me they don't expect my husband's insurance so I just told them thanks anyway for trying to help. There is no one else in county excepts the medicaid because it's straight medicaid and in the state of Missouri only children get dental under medicaid.
I feel like I should call back and see if they will take the girls with just the medicaid. I also thought if they don't my husband could drop them off his dental at least until Jan and then they'd just have medicaid which would cover them.
I just don't want to commit insurance fraud.
by on Aug. 13, 2014 at 8:18 AM
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Replies (1-10):
Anonymous
by Anonymous 2 on Aug. 13, 2014 at 8:27 AM
Why would he need to drop the insurance on them? Why can't they just use the Medicaid?
booksrme
by Member on Aug. 13, 2014 at 8:32 AM
This.

Quoting Anonymous:

just go to the dentist and use the Medicaid without your dh ins, if anything not covered by the Medicaid you will have to pay out of pocket then submit them to dh dental ins, they will probably pay you back.

mamaBerg85
by on Aug. 13, 2014 at 9:22 AM
Ok that's a good plan. I just don't deal with insurance a lot so I didn't really know.

Quoting booksrme: This.

Quoting Anonymous:

just go to the dentist and use the Medicaid without your dh ins, if anything not covered by the Medicaid you will have to pay out of pocket then submit them to dh dental ins, they will probably pay you back.

mamaBerg85
by on Aug. 13, 2014 at 9:29 AM
It was a thought because I don't know the first thing about insurance and the lady I spoke to at the dentist didn't tell me there was any way around my issues but I think she was just a Secretary not the billing person so she might not have really known.

Quoting Anonymous: Why would he need to drop the insurance on them? Why can't they just use the Medicaid?
Anonymous
by Anonymous 3 on Aug. 13, 2014 at 9:32 AM

they can use the medicaid insurance since you dh's doesn't cover dental. and no it's not fraud. i just wish that wouldn't drop some things that are needed once they turn 18 in mo. 

Anonymous
by Anonymous 4 on Aug. 13, 2014 at 9:35 AM

Medicaid wouldpay first in this case and then submit the dental bills as out of network to your husbands provider.

lulumomof2
by Gold Member on Aug. 13, 2014 at 9:35 AM

No I don't believe it is ins fraud, as long as your dh's insurance is the primary insurance.

bluebunnybabe
by kid crack dealer on Aug. 13, 2014 at 9:48 AM
1 mom liked this
They can just use the Medicaid since they don't take your private insurance. No fraud involved.
mamaBerg85
by on Aug. 13, 2014 at 11:13 AM
Me too. When they are 18 they will still be disabled adults who can't work full-time jobs they provide benefits. I'm being realistic. I want them to work and live productive independent lives but who knows a lot can change in 7 yrs so maybe things will be fine for them by then.

Quoting Anonymous:

they can use the medicaid insurance since you dh's doesn't cover dental. and no it's not fraud. i just wish that wouldn't drop some things that are needed once they turn 18 in mo. 

Anonymous
by Anonymous 3 on Aug. 13, 2014 at 11:25 AM

we just paid to have the inserts for her shoes to help her walk, they don't cover that either. i love how people think that everything is covered.

Quoting mamaBerg85: Me too. When they are 18 they will still be disabled adults who can't work full-time jobs they provide benefits. I'm being realistic. I want them to work and live productive independent lives but who knows a lot can change in 7 yrs so maybe things will be fine for them by then.
Quoting Anonymous:

they can use the medicaid insurance since you dh's doesn't cover dental. and no it's not fraud. i just wish that wouldn't drop some things that are needed once they turn 18 in mo. 


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