Kansas Not telling Dr.Office we have insurance

[Jocker]

Jurisdiction

Kansas

A family member won't have coverage next year due to ACA cuts. In 2025, she has ACA insurance with dental coverage, however she already used all her preventive dental benefits this year. There is a (new) dentist that we haven't been to, who is advertizing New patient special for 59 dollars. There are reasons why I'd like this family member to see this new dentist at the very end of 2025. When I was making an appointment, they asked if we are claiming any insurance, I said NO
However, I just checked her 2025 insurance network and this new dentist appears to be in network with them. Do I have an obligation to tell them she has insurance where the dentist is in network? Would I violate anything not telling them? Do you recommend that we tell them about the insurance but no remaining preventive benefit? There is no option to wait till the beginning of 2026. Thank you!

 

[Zigner]

You don't have to tell them you have insurance.

 

[Jocker]

You don't have to tell them you have insurance.

thank you but why do I have a feeling I am doing something bad/wrong?

 

[adjusterjack]

I've seen those deals. The $59 doesn't cover much: exam, maybe Xrays, cleaning.

But if any work needs to be done, it will be at some outrageous price rather than the price they would charge for insurance.

Read the fine print of that $59 offer.

 

[zddoodah]

A family member

So...your spouse? Third cousin twice removed? Might not matter, but why be vague?

I was making an appointment

Why were you making an appointment for someone else?

Do I have an obligation to tell them she has insurance where the dentist is in network? Would I violate anything not telling them?

No.

Do you recommend that we tell them about the insurance but no remaining preventive benefit?

My only recommendation is that, if the patient is an adult, you stay out of it. If you must be involved, don't lie.

 

[Jocker]

So...your spouse? Third cousin twice removed? Might not matter, but why be vague?




Why were you making an appointment for someone else?




No.




My only recommendation is that, if the patient is an adult, you stay out of it. If you must be involved, don't lie.

For my child who is technically "an adult" but I am still responsible: financially, and for giving needed push to get things like this done. This said child spends very little time in close proximity to me, so I have to act fast.