I have the PPO through my wife's employer. According to the summary of bennifts and numerous other pages, we are entitled to recieving $1000 for orthodontic services. My daughter (10 years old) needs phase one treatment requiring a RPE, Bi-Helix, and upper/lower braces then eventually a retainer. Dentist say the insurance will not cover it, although i'm reading on my benefits plan that orthodontic treatment will cover up to $1000. The billing code they are using is D8060.
I need to know why Humana will not cover this treatment. OR is there a mistake between the dentist office and/or the insurance company. The coverage documents doesn't really specified what ortho treatments it covers.