4 Aug, 2021 → by ClaimboUser394781
Full Upper Denture Replacement

1

I broke my denture completely in half and was told on 12/272020 by DentaQuest that I did not have coverage for a denture replacement. I called both DentaQuest and Wellcare about the miss information pointing out my policy stated that I did have full coverage. After numerous phone calls back and forth to both DentaQuest and Wellcare. I went ahead and had a denture made out of network and paid in full out of pocket $725.00 on 1/12/2021. On 1/15/2021 DentaQuest finally called to tell me that I did have coverage and since I went out of network I would have to fill out a reimbursement form and that it would take up to 6 months for payment. I filled out the reimbursement form and sent it to Wellcare which they received in 2/2021. Wellcare sent me a letter in 4/2021 stating that the reimbursement form was forwarded to Dentaquest. I waited till 6/2021 since that is I was told by Dentaquest in 1/2021 that it would take at least 6 months for my reimbursement. Dentaquest stated that they never received the form from Wellcare. After numerous phone calls again in 6/2021 and 7/2021 I was told by both Dentaquest and Wellcare that since I went out of network the claim was denied. I would not have gone out of network if they would have told the truth to begin with about my coverage. I am asking for full reimbursement since they are the one that misinformed me about the policy. Dentaquest also stated that they do not reimburse any out of network but Wellcare states that they do. As of 7/2021 Wellcare is now stating that it is up to Dentaquest and has sent me another reimbursement form to fill out. It seems as if both companies do not want to honor what the policy states. I must assume that I am not the only policy holder that has problems with both of these companies.
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