Teen Loses Teeth in Accident; Insurance Claims Denied

ROCKFORD, Mich. (May 2, 2014) — Annah Hillary, 17, lost five of her teeth in a horrific longboarding accident in May 2013.

Her medical and dental insurance claims for dental implants were denied. Her family was told the dental implants she needs are considered “cosmetic.”

Hillary and her boyfriend were having fun, longboarding when she lost control.

“I was going down a really large hill, and my knees started to wobble,” she said.

She fell off her board and hit her face on the ground. Her boyfriend called 911.

“I knocked my teeth out, and I broke my jaw, and it was really nasty,” Hillary explained.

“That’s how big my face swelled up,” she showed me a number of pictures.

A four day hospital stay turned into another 6 weeks with her jaw wired shut.

“Just the smell of people eating food would drive me crazy, and I was literally starving. All that I could eat for six weeks was either blended food or smoothies,” Hillary said.

She lost 35 pounds, but that was only the beginning for the 17-year-old Rockford High School Senior.

Hillary said what remained of her five badly damaged teeth had to be pulled out. She said the implant process to restore her smile would break the bank.

“My quote, just for the post, not even the teeth part, was $8,441,” she read from her documents.

Hillary said bone grafting is also needed “because my bones have started receding.” The grafting was quoted for another $3,302 and “none of that is covered” by insurance.

Her mother Kendra Hillary said, “My husband has worked for the same company for 21 years.”

Kendra Hillary explained, “We have health insurance. We have dental insurance. We pay our monthly premiums. You expect when something like this happens to be covered for your insurance.”

Just when they need it most, they said Blue Care Network (medical) and Aetna Dental denied their coverage.

“Medical will say it’s dental. Dental will say it’s medical. Medical will say it’s cosmetic,” Hillary said.

Appeals were denied and a patient advocate couldn’t help.

Kendra Hillary recalled the advocate’s words. “She’s like, ‘I feel your pain, but it’s not a covered benefit.’”

It’s something they have heard over and over.

Friends held a car wash last summer, and a Sparta dentist came up with a temporary fix at no charge but she needs more work. Annah Hillary has started a Gofundme page to raise money. It can be found by clicking here.

She’s still on her longboard, but she avoids steep hills.

“That’s the other side. It’s really pretty,” Hillary showed me her board.

A pretty smile is all she wants. She`s tired of being the target of cruel jokes.

“I was prom dress shopping, and these girls will take a pictures of me in the store and laughing and pointing,” she recalled.

“The kids at the daycare I work at, they all call me “miss funny face,’” she said.

“I just wish that I could have my insurance company fix my teeth and fix my smile and help me look and feel like a normal 17-year-old girl again to limit people from staring at me and pointing and laughing,” Hillary said.

She isn’t just concerned about her look, but she is concerned about proper function.

FOX 17 reached out to the Blue Care Network. Spokesperson Helen Stojic said in an email, “Dental implants are not covered by most medical insurance.”

FOX 17 also spoke with a representative with Aetna Dental. Spokesperson Rohan Hutchins said the company will investigate this.

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  • mikehansen23warper

    I suppose our eyes and limbs are "Cosmetic" as well. Teeth are teeth, ,dental, plain and simple. I suppose the bastards will use the excuse "An act of god" like a house insurance company did to a 90 year old lady on disability did when a brutal winter (78) caved her roof in. Someone go knock their teeth out and see how they like it!

  • MIchkat

    How about your homeowners insurance? If her friend was hurt your homeowners would have covered it-I would check with them.

  • guest

    insurance is all about the money, however much money they can get away with out spending and the more profit they show the better the people at the top are. They do not care if you can walk, talk, eat or smile nice, it is only if they can get your premium and come up with any reason to pay out as little as possible.
    I wish you luck in your endeavor to get them to pay and hope they do.

  • Elbanna

    Its Blue care Network they don't want to pay anything!!!!! Not even if you need it for your disability pay from work!

  • dogsnot

    "We aspire to be clear and simple, to help you make the right choices, to offer valuable coverage, and help you get quality health care for you and those you love.",,,unless you have the misfortune of actually needing coverage for a claim against us, then you have to retain legal counsel and fight our judgement, tooth and nail…….

  • heftyhoss

    This girl lost 38 lbs? wow! sometimes i think to myself "this is really the only way im ever gonna loose that much weight". i know its wrong but to a fat guy this kind of accident may be a blessing in disguise.

  • CommonSense

    Blue Care Network and Blue Cross and Blue Shield of Michigan do their best to drag their feet on complex high cost claims. They will drag their feet on this for years, hoping the family eventually will just give up. That way, the money stays in their pockets. If people want to change this, the elimination of the insurance lobbyist both in Lansing and in Washington DC needs to come to an end. The health insurance industry doesn't want this to occur. Health insurance as a whole is corrupt, this includes BCN & BCBS of MI and their corrupt union. And to think they exist as a non-profit, laughable!

  • futuristicthinker

    When I was going through the grueling week of State mandated class time to get my Real Estate licence, the class instructor started ripping on the insurance companies. I'll never forget what he was claiming. He said that the upper 90th percentile of secondary mortgages in this country are underwritten by insurance company profits. I have never substantiated this claim, but stories like this royally piss me of because of it! Someday greed is going to be accounted for. I actually feel sorry for the price that will have to be paid. Jesus said you can't worship God and money!

  • heymikepap

    If it was my daughter id have that fixed immediatly. Regardless of cost or whos paying for it. I would sell my car and ride the bus if i had to

  • Guest

    Implants are expensive, but they are a luxury, not a right. Treatment options for missing teeth could include bridges, as well as partial dentures. At the age of 17, her bone should not resorb as quickly as someone whom is 80 years old, if she has to wait a few years for implants, it should not effect the procedure much. Also, many dentists/oral surgeons aren't even willing to place dental implants in someone younger than 18 because of growth.

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  • guest

    The same thing happened to my daughter. She was in a 4wheeler accident while at a friends house. she lost 6 teeth, we fought with the insurance company for 3yrs, and of course they won. Good luck I am still trying to find a way to pay for all the treatment she will need in the future.