What does "up to age 14" mean to you?

[lynn]

Does it mean day after the 14th birthday or through 14th year to day before 15th birthday. Our dental isurance pays 100% of a service "up to age 14" and the lady my dental business office told me we should get ds in before he turned 15 next week so this service would be covered at 100%. I recieve a statement from my insurance saying coverage denied due to age limitation. :glare: Of course I will pay because we do sign a statement stating that we will pay if insurance does not pay, etc.

[Daisy]

I would understand up TO age 14 to mean once they turned 14, they were no longer covered. Up THROUGH age 14 would lead me to believe it was until they turned 15.

 

Lousy, lousy situation.

 

Can you talk to the lady at the dental office? Maybe they'll negotiate the amount since it was partly due to an error on their end?

 

My hubby would probably just pay the bill and not want to deal with it.

[KS_]

I would understand up TO age 14 to mean once they turned 14, they were no longer covered. Up THROUGH age 14 would lead me to believe it was until they turned 15.

 

 

 

I agree - that's what I would understand it to mean, also.

[SproutMamaK]

I would understand up TO age 14 to mean once they turned 14, they were no longer covered. Up THROUGH age 14 would lead me to believe it was until they turned 15.

 

Sucks, but :iagree:

[JFSinIL]

I agree with KH

[Audrey]

I would understand up TO age 14 to mean once they turned 14, they were no longer covered. Up THROUGH age 14 would lead me to believe it was until they turned 15.

 

 

 

This is how I would interpret it, too. However, the way the OP describes it, it seems to me that the lady in the dental office led her to believe it would be covered. At the very least, that would confuse a person.

 

Sorry this happened. :sad:

[Daisy]

This is how I would interpret it, too. However, the way the OP describes it, it seems to me that the lady in the dental office led her to believe it would be covered. At the very least, that would confuse a person.

 

Sorry this happened. :sad:

 

Agreed. I think it is worth at least talking to the lady about it. If nothing else, she'll be more careful next time.

[ereks mom]

"Up to age 14" to me would mean until the day before their birthday turning 14.

 

"Up through age 14" would mean until the day before their 15th birthday.

 

:iagree:

[eaglei]

I would understand up TO age 14 to mean once they turned 14, they were no longer covered. Up THROUGH age 14 would lead me to believe it was until they turned 15.

 

:iagree:

[AuntieM]

To me it means call up and ask what they mean!

 

Grammatically it sounds like "right up until the moment you turn 14 but not one parsec afterward." But in practice I think it may be open to interpretation.

[NanceXToo]

To me it would have meant as long as he was 14 or under, they'd cover him. But what all the other posters are saying makes sense to me, now, too. I guess they should have been clearer in their wording and said "age 13 and under" or "until their 14th birthday" or some such.

[phathui5]

It means until their 14th birthday, to me.

[kiana]

I'd assume it ended when they turned 14, but I'd check.

 

I would see if the dentist's office can work out a low-cost payment plan for you. Mine's very good about that.

[littlebug42]

I would ask the dental insurance to pay anyway because you were told they would. I had a similar circumstance with our medical insurance a few years ago. I questioned whether or not it would be covered to take our daughter to a different state for medical treatment and surgery. I called the insurance company to question it and I was told that it would be covered. Well, after surgery etc was completed, insurance denied it. I called them on it since we were told differently. Because the CS rep wrote in our record that we called for approval and received it, insurance paid the bill with the condition that any future treatment would certainly not be covered there because now we definitely knew better. I would ask again and appeal if necessary.

[Jean in Newcastle]

Was it the dental insurance customer service that told you it would be covered, or the dentist's office? If it was the dental insurance itself, you can request that they pull the tapes of the calls on the day that you called so that it can be proved that they told you that it was covered. If it was the dentist's office then you might be out of luck but you could appeal to the dentist or office manager and ask for a discount since they gave you false information.

[Audrey]

I would ask the dental insurance to pay anyway because you were told they would. I had a similar circumstance with our medical insurance a few years ago. I questioned whether or not it would be covered to take our daughter to a different state for medical treatment and surgery. I called the insurance company to question it and I was told that it would be covered. Well, after surgery etc was completed, insurance denied it. I called them on it since we were told differently. Because the CS rep wrote in our record that we called for approval and received it, insurance paid the bill with the condition that any future treatment would certainly not be covered there because now we definitely knew better. I would ask again and appeal if necessary.

 

 

Except in the OP's case the person who told her it would be covered was not from the insurance company. It was just a worker in the dental office -- who, frankly, should be more careful about what she says regarding what insurance may or may not pay for!

[silliness7]

I would double check with your insurance company. They do make errors. Up to age 14 means til you are not 14 anymore, imo. Clearly I'm in the minority here so I googled the phrase "up to age 14" and read a handful of articles and scientific studies. The other words in these reports made it clear that they were all using the phrase "up to age 14" to mean until you are not 14 anymore. 14 year olds were included in the group but 15 year olds were not.

 

There were even some dental plans that came up when I googled saying various procedures were covered up to age 13, up to age 16, etc.

It seems extraordinarily disingenuous to slap these numbers on a policy, burn them into your visual memory and then suggest that you subtract a 1 to get the "real" age these procedures are covered.

 

I would assume someone made a mistake and I would call.

[happi duck]

I think up to age 14 includes while you are 14.

 

In general this is often not clear...I wish there was a clearer common usage...maybe 14 and under or up to and including age 14.

 

Hope it works out in your favor!

[Carrie12345]

It feels like yet another English language oddity.

For some reason, I would assume that "up to 14" means to the day before the 14th birthday. However, I read 0-14 as "Zero TO 14" (without the "up"), and that means until the day before the 15th birthday.

 

"Up" changes it for me, and I'm not sure why. :confused:

[AHASRADA]

I agree that it could be interpreted either way. My first reaction, though, was to assume it meant till the day before the 14th birthday. "Under 14" or "Under 15" would be clearer.

 

Since the dental office worker told you otherwise, I would go to the office and act all perplexed that it wasn't covered ;). Put the ball in their court. You never know, they might reduce the bill or some such since it was their mistake.

 

You could also take it up with the insurance company, again pleading ignorance, saying there must be some mistake, because ds was indeed 14 when the procedure was done. Maybe he really was covered, but turned 15 before the bill went through and the computer spit it out because he was too old then. If they try to explain that 14 year olds aren't covered, read back their policy to them word for word, and tell them that it seems clear to you he should be covered. A long shot, but worth a try.

 

My insurance covers kids "under 10". I have always assumed my 10 year old is not covered, but now I will look into it, just to be sure :tongue_smilie:.

 

Sorry this happened.