Yesterday, I got a bill in the mail from the dentist. $495 for an oral appliance, and my insurance won’t cover any of it. Why on earth do I have dental insurance, if it won’t cover any of this stupid piece of plastic? Let’s get a little background on what happened….
The Big Guy has jaw issues (to go along with his knee, hip, and eye issues, but that is a story for another time, lol). His jaw popped continually, he couldn’t open his mouth all of the way, and he was in constant pain. He then went to the dentist, like anyone would have done, hoping that they would have a solution. and what do you know? They did. Yeah, of course they did…
The Big Guy, being the money-conscious guy that he is, talked with the lady in charge of billing about the cost of the oral appliance, and she assured him that our dental insurance would take care of it. He asked a couple of different times that appointment, and when everyone told him it would be covered, he made the appointment to be fitted for one.
The day of the appointment, The Big Guy got to the dentist, signed in, and double-checked to make sure that the appliance would be entirely covered by our dental insurance. The lady again assured him that there would be no expense to him.
Fast forward to yesterday, as I’m opening the mail. I see an envelope with a return address of our dentist’s office. I have a sinking feeling as I open it and then I see the $495.00 total at the bottom along with the little, super helpful sticker that says “Oral appliance is not a covered expense under your insurance.” Oh yeah. I was pissed. But I kept opening the mail and came across another lovely piece of information – the statement from our insurance company. I don’t know what the proper term for it is, but it was the statement you get when a claim is submitted stating what was paid by the insurance company and the amount that the provider may bill you for. In our case, dental insurance was billed for the entire $495, an expense that they do not cover. Go figure.
So now I’m livid, as this was an expense that we did not plan for, so logically, now that I have medical name for the oral appliance I pull out the dental insurance book and find out that – sure enough! – it is not a covered expense. however, I’m not done yet, and if I’m going to ream the dental office a new one, I have to be sure that my information is correct, so I call up the insurance company.
I have to say, I was kind of impressed. The wait on hold was less than 5 minutes, and my conversation with the person on the phone was less than 10 minutes, just verifying that was the insurance booklet said was correct. The verdict: the appliance was not covered.
Is the insurance’s fault? No, no it is not. They never changed what they covered. It was the dentist’s office that lied. Or was lazy and didn’t want to find out. Either way, I’m pissed.
Should I have called the insurance company directly? Probably?
Lesson learned: Go through the insurance company when finding out what the cost will be.
So now, while I should probably call the dentist’s office, I’m not going to. Instead, they are getting $20 a month until the stupid thing is paid off. Just. Because. I’m. Pissed.
Needless to say, we will not be going back to this dentist.
But now, we have come full circle to my point. I an considering dropping dental insurance. Dental insurance is worthless. At best, it is a discount plan. Our yearly cleanings are free, but anything above and beyond that is covered 50%, at most. Really, its rather atrocious. In fact, I think we might drop it, because as I look at it from a financial perspective, its just not worth it.
Think about it: Monthly Dental Insurance Premium: $27.47 per month, or $329.64 per year. We do get free yearly cleaning for all three of us which is approximately $127 (source) per person. Even factoring in Baby Girl, who is not yet old enough to go to the dentist, the benefit is only $381.00. Baby Girl won’t go to the dentist until she’s 6, and I hate going, so I won’t go, so is it really worth it? I suppose if we had a big expense, our premiums are so low that I would pay off, but I don’t know what to do.
What do you think? Is my dental insurance worth it? Do you have dental insurance?
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Wow – those dental insurance costs are really high. Ours are about 1/10th of that per person and cover 2 cleanings/year and usually 80% coverage on things like cavities, etc after a smallish deductible (maybe $50?). If we wanted braces or something like that it’d be mostly on our dime, but it’s worth it for us to keep it just for the semiannual cleanings.
Wow, I am really jealous that you have such good coverage! In your situation it certainly makes sense to keep the coverage then :-)
Yeh I have 3 kids plus myself and they’ve all been getting a cleaning two times a year since they were 3 years old. My annual payments are a whole lot less than what I’d pay for 12 cleanings for all of us a year. I also pay a little extra (still in that less than the price of cleanings total) to get 50% ortho coverage so it paid for half of both my boy’s braces. It think you just have to shop for a good plan. Good luck!
We’ve never had dental insurance, and have never opted to buy it. It doesn’t seem worth it to us at this point in our lives. We just pay for annual cleanings out-of-pocket and brush and floss regularly!
I think you’re right on the money here…it really just isn’t worth it, especially if we don’t use it.
You should take advantage of the dental insurance for your kids. It’s a really good way to set them on a good track of dental care for life. Fluoride treatments are covered for children and so are cavity prevention procedures like seelants that basically cap molars as they grow. I’ve been going to the dentist since I was a toddler and as an adult I’ve had absolutely no dental issues.
I’m thinking maybe we will just pay for cleanings out of pocket because you are exactly right – good dental health in childhood is absolutely essential to good dental health in adulthood!
I have dental insurance… Ours we pay a 25.00 co pay every visit. Then it will pay 100% up to 1500 a year. That includes cleanings… So to say the least, the root canal I just had wiped out my insurance for a whole year…
Man, I’m jealous! If we had dental insurance like that, I would totally keep ours. Lucky you!
We are carrying dental insurance right now…with four kids in the house (probably headed towards braces) it’s a must. As tough as that experience was to swallow, dental insurance is still pretty cheap. I’d look at keeping it as long as the budget can afford it. Think how sick you feel if you drop it and then have a big expense.
So true and that is what is keeping me from dropping it…..it is such a dilemma!
We dropped ours at the beginning of the last year. It covered so little, it didn’t make sense. Ours is 100/month — and that could cover a lot of dental work!
Yeah, $100 could probably cover a cleaning!
I’ve thought about doing dental insurance every few years. At most every other year. We rarely use ours.
I had a meniscus torn in my right jaw in an auto accident. Absolutely excruciating pain day and night — I’ll spare the details! I have used a bite plate (bite splint) ever since the problem was (finally!) correctly diagnosed — I understand the pain of TMJ disorder AND the bill for the corrective appliance. I’d think really hard before cancelling dental insurance for that reason, though. Our insurance covers not only routine cleaning, but DH’s quarterly periodontal treatments and periodic scaling (something that came up out of the blue!), routine fillings and replacements, accidentally chipped teeth, removing the “10 year” molar that erupted long after my 21st birthday — and more. Insurance only covered half the cost of an implant crucial to maintaining my bite and preventing a recurrence of TMJ pain — but that was thousands of dollars so was very welcome. You may never have to deal with those issues, but ya never know —
I’m only keeping mine so that I can get my wisdom teeth taken out (next week). And only the top two. My dentist said I can keep the bottom. I think dental is such a rip off and I had to switch dentists recently too because they were trying to scam me! I’ll still have to pay 50% of the cost for the wisdom teeth but better than full price! Although, I suppose I probably already paid for them with my premium costs. Sigh. USA!
You might want to reconsider waiting until your daughter is 6. My parents did the same, and the only fillings I’ve had were in my baby teeth. :-( After that I got regular fluoride treatments, sealants on my molars, etc. and at 36 I’ve had no problems.
We’ve taken our daughter to the dentist starting at age 2 (the recommended start age) and while they haven’t really done much more than take a peek and verify that everything looks fine, it was reassuring. It was definitely not a full cleaning! It did, however, get us started on fluoride drops because our town doesn’t fluoridate the water and the pediatrician didn’t think to offer them (the prescription is still through the pedi, not the dentist).
All that said: I can see why you would drop it. We’re thinking of doing the same with our vision coverage: we paid for it this year but plan to drop it next year, maybe bring it back the following.
I’m debating the same thing – whether to drop mine since it doesn’t seem to pay much on what I need. That being said, remember that most dental insurance gives you only very limited coverage for the first year you have it, to discourage those who would sign up only when they have big expenses and then drop it once those are fixed. And you do have options – I suppose your best bet would be to find out what’s available in your area, since it varies from state to state. I’m assuming you’d need to go through an insurance agency in order to find and sign up for one.
I haven’t read all the other comments, so I’m not sure what everyone else has already said. And here’s my honest advice … KEEP YOUR DENTAL INSURANCE!!!!
$27 / month is super low if it covers you both.
My husband and I have not had dental insurance for 8 years, b/c we’ve been in graduate school / traveling / etc. Here’s the thing, without the insurance, especially as a money conscience person … we did not make those bi-yearly cleanings a priority. We paid extra towards debt. We put extra money into a Roth IRA. We put money into a 529. But, we did not think to (want to) pay to just go to the dentist.
What happens if you don’t go to the dentist?
Cavities … turning into deeper cavities … turning into root canals and crowns … which can cost anywhere between $3000-4500.
For one.
But what if there are three or four.
It can really add up and cause havoc in your mouth.
Seriously, I cannot recommend enough to just pay the $27 / month, keep getting your teeth cleaned. You are paying to prevent all the ridiculous and very expensive problems.
We are FINALLY beginning a job next month with dental insurance and we could not be more excited.
One more dental suggestion. Haha. Floss / Sonicare / ACT, everyday.
Pregnancy, babies, and nursing can be hard on your teeth, even if you’ve always had perfect ones. It’s super important to have consistent daily habits.
Here’s a kind of funny, but honest post I wrote about it a while back! :)
http://idonthaveacluebutimfindingout.blogspot.com/2012/12/lesson-57-grown-ups-go-to-dentist.html
Love this!
You’re definitely right about the good habits. They can set you up for success more than anything!
I think it’s worth keeping. Our plan is definitely not as horrible as yours, but doesn’t always cover some things either. But I’m lucky enough to have a dentist office that checks every single time. They are awesome. Side note, as soon as your daughter has teeth coming in, she should be going in for regular checkups. Plus, just to give you an example of why its good to have, especially for children, when I was 3, i fell. Because hey, I’m 3 and that’s what 3 year olds do. But during that fall, I chipped a tooth. I remember, even decades later, the pain I was in. I had to have a crown put over the tooth until it fell out and I got my permanent one. But had my mom not had insurance, I know that bill would have been outrageous. Another example, in case that isn’t a selling point. Just this past year, out of no where, I went from no cavity to a root canal. Not entirely surprising since I genetically don’t have the greatest enamel, but before they knew what was happening, I was in absolutely horrendous pain. Waking me up during the middle of the night, making it impossible to really chew. My dental insurance covered almost all of it and I barely had any out of pocket.
Just from experience, you never know when something will happen. And if your daughter or you or your husband ends up with a cavity, say goodbye to a good chunk of your savings.
Oh yes, I just paid $340 out of pocket last week for my new night guard for the TMJ- which I will NEVER understand why insurance doesn’t cover… it’s not a cosmetic problem! I knew it would be out of pocket though, I got my first splint about 6 years ago and that was $1000! Luckily they had a new material they were using which made it cheaper, on me, but my dental office made sure I knew it was out of pocket. I was ok with the expense because the excruciating headaches my nighttime clenching was causing was out of control.
We are lucky to have incredible insurance through my husbands job. We don’t have a copay and at this point, since we’ve been on the plan for a while, they pay anywhere from 90% to 100% of care. Devices and ortho are additional, for hubby’s braces they paid $1000, we paid $4000. I have friends who have dropped their insurance, and I totally get why, but I would be concerned as well that it would encourage you to NOT get regular cleanings. If you aren’t paying for it already, and that cleaning comes up if $127 is tight, it’d be too easy to skip it- which can cause major issues and financial hardships down the road. Good Luck with what you decide!
That’s awesome coverage! I would definitely keep it if I were you!
As a registered dental hygienist, this article makes me sad. Yes, the dental office that you went to was negligent, but that doesn’t mean that you should jump to the conclusion that dental insurance is worthless, and even encourage people to drop preventative care that they need.
Also, you should go to the dentist every 6 months, not once a year. That is how you prevent costly fillings, crowns and root canals. They will be more than $400 something dollars.
We’re definitely not going to skip dental care, we’re just going to be paying in cash, rather than through insurance. Many people believe that without insurance you have no access to health care, but that is not the case. Unfortunately, our dental insurance only covered one preventative visit per year, so it was even more of a waste of money.
You may have already heard of it but just in case – oil wicking… If you have generally good dental hygiene at home and healthy teeth regular oil wicking can give you the extra edge to help keep you from needing the dentist in the first place. Personally I use coconut oil that I get in a huge tub at Costco that is good quality for $26 and it lasts about a year for my husband and I. What you do is first thing in the morning before anything (eating/drinking/brushing your teeth) scoop about 2teaspoons of the solid oil into your mouth and start to swishing. Swish the oil around in your mouth pulling it through your teeth and gums for at least two minutes (often times I will do it during my morning shower which is 10 minutes), what this does is pulls the bacteria that has built up and made a home in your mouth and between your teeth out and captures it in the oil. Now spit! It is recommended to spit the oil into a garbage can with a liner and garbage in it already because the nasty stuff it wicks from your mouth is so bad it is actually corrosive and can eat away at your porcelain sink over time. Think about what that is doing to your teeth.
Consider this: I had incredibly sensitive teeth that my dentist at the time attributed to thin tooth enamel I was born with and probably worsened by eating acidic things, the solution switch to $6 a tube special sensitive teeth toothpaste, avoid hot things, avoid cold things, and if that doesn’t work pack on a gel pain reliever. After a month of oil wicking daily I am back to the cheap $1 toothpaste and I have not dealt with sensitivity since. If you are not convinced yet I have one more personal experience to share… after dropping the ball on my coconut oil routine for a long time (almost a year) I started having pain again this time it was localized and felt like a bad cavity with the help of my husband and a dental mirror I could even see a dimple in my upper left molar. I did not have dental insurance and desperately needed to avoid the bill that would come with a trip to the dentist, so I started up the oil wicking routine. Being diligent daily and taking the couple minutes every morning to oil wick in one month my pain was gone! Even though there is still a dimple in that tooth the bacteria that had been living in there where my toothbrush could not get to it was now gone and no longer causing any tooth decay.
I think if you are going to drop your dental insurance, like my husband and I have, then it is important to step up your tooth decay prevention and this is a healthy affordable way to do it.
i would definitely keep the insurance. After losing my job last year, along with my dental insurance, I was added to my husbands insurance. I had to have a crown and filling replaced. Luckily my husband’s insurance covered it. I still had to pay 50 percent, but that was better than 100 percent. I also have TMJ and can tell you the night guard is definitely worth the cost.