Pronouncing Dentistry Procedures As Medically Necessary: How Its Done

In dentistry, most procedures are more restorative than medically necessary. There are also procedures that are cosmetic instead of medically necessary. If you have to prove in a court of law that certain dental procedures for your children are medically necessary, then here is what you need to do.

Determine What Is Cosmetic, What Is Necessary and What Is Restorative

Restorative dental procedures are usually covered by most dental insurance plans, including Medicaid and Medi-Cal (Medicaid for California residents). These procedures are not usually the ones that divorced parents worry about, since they will both have to split the remaining cost and the expense is typically small. Cosmetic means just that--it makes your kids' teeth pretty. Medically necessary means that, without the procedures, your children could have long-term negative effects on their teeth, their oral health, their ability to chew, breathe at night and/or even speak correctly. Your dentist knows the difference, which is why you should talk to him/her first.

Talk to Your Dentist

Most dentists understand the conflicts that divorced parents have with regards to their children's medical and dental health and the bills. If you talk to your dentist and explain why you need documentation of your children's oral health, he or she will probably be willing to help. That usually comes in the form of a document or letter on office letterhead that states what procedures are needed, why they are needed, and how soon these procedures need to be completed before they will no longer be beneficial to your children's oral and dental health.

Bring Your Dentist's Letter, Children's X-rays, and Recommendations for Treatment Before a Judge

If you still cannot get your ex-spouse to pay for the children's dental procedures, bring the dentist's letter, the children's x-rays and the recommendations for treatment before a family court judge. Despite the expense, judges still expect parents to address the needs of their children, and dental procedures are no exception. With all of the documentation you have from your children's dentist right in front of you, most judges would be hesitant not to side with you. That said, working with your dentist going forward, you should show the dentist what the judge ruled, and then whatever share of the expenses that your ex-spouse owes your dentist can pursue him/her for that (although, on some occasions, you may be advised to pay in full yourself and pursue your ex's share in small claims court).