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General Forum Topics > Health Insurance Forum > Dental ..Lifetime Cap Transferred between Insurance Carriers?
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Q: Dental ..Lifetime Cap Transferred between Insurance Carriers?
asked by: mpdsville1 on April 13th, 2009
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my employer is changing Dental Insurance Carriers. The new carrier
indicated that there is a lifetime limit on ortho treatment of
$1000, and that they will deduct from that $1000 any monies paid
towards ortho by my PRIOR dental insurance carrier.

I wont even ask if its ethical, but is it legal?

Also , They indicated that they would obtain a
claims summary from the old dental carrier to
validate payments made. I'm not authorizing
that and theres no authorization for this in
their forms. If they obtain a claims summary
from a different company, havent they just
violated HIPPA?
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errakus
replied on April 15th, 2009
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They may not be HIPAA compliant in the first place. Insurers can go and ask another insurer for authorizations I believe anyway, so that shouldn't matter. Ortho visits are usually for braces and whatnot. The rest of your regular dental claims should be paid just fine. IE: Root Canal, Cavity, Pull a tooth. I dont know exactly what plan your on but "Ortho" is specific to orthodontists not dentists.
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