Whither Dental Insurance?

Good Grief Charlie Brown! I had oral surgery today – but that isn’t the news. The procedure is fairly common and with anesthesia – painless. I couldn’t face sitting with my mouth open for an hour while a surgeon performed micro-surgery on my uncooperative, failed-root-canal-tooth. Anesthesia didn’t change the mouth open part (and people who know me will probably say I never shut it anyhow). But I didn’t have to know what was going on or hear it. If dental surgery can ever be considered “comfortable” – this was it.

Until I had to pay for it.

I have some dental insurance in my plan. It pays only, however, for preventive measures – like teeth cleaning and necessary xrays before getting a tooth filled. It doesn’t pay for the filling. Or the crown. Or the oral surgery.

So as I was sitting in the recovery room holding ice to my gauze-stuffed cheek – the moment of truth arrived. My credit card (or more accurately my husband’s because I couldn’t get mine out with just one available hand; the other, you’ll remember, was holding the ice pak) was taken and the receipt returned.

$2100. And that didn’t included the $350 or so for the initial consultation and the panoramic xray needed to be sure my remaining 2 wisdom teeth - never to be touched without major jaw surgery – weren’t affected. The nice lady at Guardian said oh yes –that panoramic xray would have been eligible for the 75% reimbursement. Except that the plan only allows for one set of full-mouth xrays every 5 years. And I had a set back in ’09. Every 5 years???? Whose mouth stays the same for 5 years?????

Back to the $2100. It could have been $400 less if I had opted to stay awake and totally panicked for the surgery. I figured I could live without a few things for myself at Macy’s when I start my Christmas shopping. I needed that IV drip!!!

What do people do who need emergency dental procedures – and who aren’t as lucky as I am? Who simply don’t have that money? Maybe pay it off over 2 years? I didn’t see anything in the surgeon’s office about installment plans.

Why isn’t dentistry in general simply included with our regular health insurance plans? After all – you can get pretty sick and cost the health care system a pretty big chuck of change from a tooth or gum infection. In fact a bad tooth left untreated can do more than make you sick. It can kill you. Not having your teeth – or for that matter your eyes – tied into your regular health insurance makes absolutely no sense at all.

Until you talk to your dentist.

I asked mine and his answer was that the various dental associations –which ostensibly represent their members – don’t want the hassle of dealing with a broken insurance system. One that will cost each dentist additional time and money. Dentists would have to hire full time insurance clerks – the way physicians do. One of the reason group practices are so common. So the dentists deal with maybe one half-baked dental insurer --- which most of their patients don’t use even if they are lucky enough to have separate dental insurance. And they charge the rates they wish to charge without all the red tape medical doctors must deal with --- not the least of which involves Medicare and Medicaid.

So -- no pressure from dentists and oral surgeons to be included in the health insurance system. Or maybe pressure applied by their lobbyists in the other direction. As in “don’t you dare, Congressman so and so, to include us in that new health insurance law”.

As a result, I paid $2100 out of my own pocket today. And considered myself among the lucky ones.