Question regarding retroactive dental coverage

I am currently under my family’s health insurance plan and was unaware of the full range of my coverage. When I called my insurance company for clarification, I received some conflicting information between my managed care organization, Empire Blue Cross Blue Shield HealthPlus and its affiliated dental insurance company, Liberty Dental.

I was previously on medicaid and recently upgraded to another plan under Empire Blue Cross Blue Shield, the Essential Plan Standard, which does not cover dental insurance. I spoke with someone at Empire, who transferred me over to Liberty (dental insurance company) and they told me that I was covered for basic dental insurance benefits. Liberty is a new company that Empire partnered with as of May 1, 2018 so their system is a little backdated and not completely accurate.

I went to see my dentist recently and got the standard x-rays and cleaning/scaling. The receptionists presumably contacted Liberty Dental, who probably granted the office the approval as per the presumed coverage under my previous medicaid insurance. Again, Liberty’s systems are not up-to-date so they inaccurately provided approvals for my coverage.

Since my plan does not provide dental coverage as of May 1, 2018, I predict that I will be getting a bill soon for $200.00 for the cost of the x-rays and cleanings. It turns out that I also need some fillings replaced, so it’s better for me to upgrade to the next tiered plan (basically from Insurance 1.0 to Insurance 2.0), which will include both dental and vision insurance.

My question is do insurance companies generally provide retroactive dental coverage? In this particular case, NY State of Health Marketplace is the institution that is managing the dental insurance. I made an honest mistake in originally getting dental services without coverage and would like to upgrade given my numerous dental problems that require fixing. I am asking this question here because my father is currently unavailable to speak with an agent over the phone.

Please advise, thank you.

submitted by /u/philipsreddituser
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