NewsProblem Solvers


Teen Loses Teeth in Accident; Insurance Claims Denied

Posted at 7:49 PM, May 02, 2014
and last updated 2014-05-02 20:06:58-04

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.

Follow Darren Cunningham on Facebook