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Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsMy kiddo had his wisdom teeth extracted today. Healthcare in America.
I took my 17 year old son into an oral surgeon today to have 3 third molars extracted. I'd been preparing for this...meaning saving money for the procedure for months...we don't have dental insurance. The bill was $1700 with no discount for cash. I had the money set aside and we got it done.
While I was in the waiting room, an older man was waiting go back to have all of his remaining teeth extracted. I know this because the front desk person spoke to the man loud enough for me to hear even with my ear buds in my ears. She told the man he owed $7000 today and it must be paid prior to the procedure. He asked about his insurance and she told him it would pay $1500 (typical dental annual maximum benefit...actually better than typical)of the $8500 bill. He said he didn't have the money. I mean, who has seven grand lying around?
I was embarrassed for the man and angry that this conversation took place at the front desk for all to hear. It is NOT how to treat people...and this man was clearly upset and told the front desk person he had infection and pain. He also said he did not have a ride home as was required by the office for any surgical procedure. It was a mess.
A second person came to the front desk and told the man the procedure would have to be postponed and could he come back next week (another week with dental infection and pain) and meet with her to discuss something she called "compassionate care financing". He agreed to do this.
Then the surgeon emerged from the OR area and called the second woman back to talk with her privately. She came back up front and told the man they would do his surgery today if he could arrange a ride home which he did after making a couple of phone calls.
The whole thing made me sick and sad. I'm just glad the man got care today. How he will pay back $7000 I have no idea.
CurtEastPoint
(18,646 posts)they are not in your body?
My Dad used to go on about docs etc and say, 'It's a goddamned racket.' I used to say, 'Oh, Daddy.' and now I SAY it's a goddamned racket.
MontanaMama
(23,319 posts)I pay $2000 a month for health insurance for my family of three. No dental or vision included, of course. It makes me so angry.
yellowdogintexas
(22,256 posts)some plans cover dental work for medical reasons.
If your plan will allow the charge, the provider has to file there first, then send the claim results to the dental plan.
Check the Exclusions and Limitations section of your policy as well as Policies & Procedures.
Call the medical plan and ask if there are circumstances under which dental care is covered. Wisdom tooth extraction may possibly be covered as surgery. Plans vary considerably.
Sometimes there is an exception regarding dental care which will allow it if it is the result of illness or injury.
My medical plan covered my daughter's wisdom teeth, then the dental processed the remainder.
CurtEastPoint
(18,646 posts)gotchas, etc. make this just insane for everyone.
republianmushroom
(13,597 posts)America's healthcare is embarrassing . To say the least.
paleotn
(17,920 posts)Takket
(21,573 posts)eyes and teeth are crucial parts of your body, and yet they don't seem to be important because they aren't even covered by "normal" medical insurance? why is that???
MontanaMama
(23,319 posts)its all about money. Dental insurance isnt really insurance its more of a stipend. I was an insurance biller for a dental practice for 21 years before going to work at our family business. Dental plans have an annual maximum benefit that theyll pay in any year once thats gone, your dental bills are paid out of pocket until the next year. Most plans offer around $1000 to maybe $1500 in benefit per year. If you need a single crown, theyll pay around 50% of the dentists fee up to a maximum of X. So, if the crown is $1200, theyll pay $600 and you owe the rest. Its a freaking racket.
BigmanPigman
(51,607 posts)and am continuing to learn about. My sister is now having the fun experience of learning the realities of dental and medical care before reaching 67 that I have had to deal with for over 12 years. Now she is learning about this BS healthcare system.
Out of sheer frustration I want to puke and punch someone at the same time for allowing this BS to continue in such an "advanced" country.
ShazzieB
(16,412 posts)I could write a book about what a joke dental insurance is, for anyone who needs anything more than the occasional small filling. If you have perfectly healthy teeth and just need to maintain them with regular checkups and cleanings, it's great, because those things are covered completely. But if you need any REAL dental work done, watch out, because the insurance will pay only half, and only that UP TO the annual max, which is always pitifully low, in my experience.
I could write another book about how I lost all my teeth, because my molars were going down like dominoes, one after another, each needing a root canal AND a crown. (Some of the teeth this was happening to already HAD crowns on them, but a new one would have been needed.) My insurance was maxed out for the year after covering about half of the cost of ONE root canal, and the rest would have had to be paid put of pocket. At that rate, I could barely afford to fix one tooth a year, and they were going bad faster than that (and causing a LOT of pain each time).
I checked into the cost of dentures, found out partial dentures cost even more than full ones, then found a cut rate denture chain and had all my teeth removed and got dentures for less than the cost of getting 2 molars done with root canals and crowns.
The cost of dentistry (beyond basic maintence) is through the roof and ovr the moon expensive, but nobody ever talks about it, while people like me suffer. I admit to being just a little bit bitter about it.
Coventina
(27,120 posts)Mental health is.....HEALTH!
wnylib
(21,479 posts)surgery for wisdom teeth, and tooth fillings or root canals and crowns are so common place. Insurance companies would be paying out constantly for that kind of care, especially in a family of a few children.
It's counter productive, though. Paying for routine regular care would reduce the number of more expensive treatments when eyes or teeth get worse because of lack of regular care.
I was lucky regarding wisdom teeth. Never had any so nothing to extract. My dentist said that it is an evolutionary trend to not have 3rd molars.
RobinA
(9,893 posts)I have no knowledge of this really, but my take is that when medical insurance was first invented the carved out eyes and teeth (and hearing) because they are common and everybody would be making claims. Dental and vision insurance were invented to fill the gap. Most dental doesn't really cut it. It strikes me, but I'm no actuary, that it would be more cost effective to have elders who can see properly to avoid more costly problems. Like falls. Hearing, I don't know. Hearing aides are expensive, but not really in the medical world. Also, it's not debatable that keeping seniors seeing and hearing well goes a long way towards their wellbeing, which translates into health.
wnylib
(21,479 posts)I had dental insurance at my last job before retirement. The amount covered was so minimal that I stretched out my appointments and care in order to not go broke from out of pocket costs. But, I paid much more into the premiums than I ever got in treatment coverage.
phylny
(8,380 posts)dentists did not want their services to be covered under regular insurance.
Mr.Bill
(24,300 posts)but hey, let's build another aircraft carrier.
CurtEastPoint
(18,646 posts)Mr.Bill
(24,300 posts)concert ticket, right?
2naSalit
(86,636 posts)moniss
(4,249 posts)actually do that either.
brush
(53,784 posts)benefits non-wealthy people.
lynintenn
(646 posts)Starting in January 23 Tennessee medicaid started covering adult dental care.You have to find an office that accepts it. You can search it at Dentalquest.com
2naSalit
(86,636 posts)Here in Montana, our govgreg is trying, with full support of an R supermajority in the legislature, to end the extended Medicaid program in the state. As soon as that federal mandate expires, it's gone. And they also want to make it harder to qualify for all public assistance programs which are federal programs because the state has nothing to support its people in any way... unless you're a big time rancher, trophy home owner or a mining outfit. Nobody else matters.
The legislature just went into session, they do this for 90 days, once biannually so they are hot to trot on slashing and burning our state Constitution and most of our rights, those of us who are so unfortunate to not be billionaires that is.
MontanaMama
(23,319 posts)I actually have big time anxiety before opening the local paper in the morning because our legislature is in session and who knows what theyve burned down overnight.
2naSalit
(86,636 posts)I listen to the NPR reports, not gonna listen to that asswipe tonight for his "Things I've trashed and things I intend to trash" screech either. It will be bad enough to hear the summary later.
MontanaMama
(23,319 posts)I just don't have it in me. Thanks for the warning. I'm not even sure I can stomach the summary.
So...I wrote yet another letter regarding the cost of health insurance in MT to Jon Tester. I wrote to him through the website and also via one of his interns at the Missoula office. It has been more than two months...no response or acknowledgment of the letter. I called to follow up and was told my letters were "in the system" but it might be that no one responds. Wow. Not at all what I expected to be told on the phone.
2naSalit
(86,636 posts)I wonder if Tester is doing okay. It has to be disheartening to be the only Dem in the state holding federal office. I wonder if a staffing issue is what you encountered.
MontanaMama
(23,319 posts)I didn't lose my shit on anyone because under-staffing was my fear. Nobody has that coming.
I cannot and will not turn our shithead governor on any of my devices. He's abhorrent.
usonian
(9,810 posts)I forget which one (Yes, I'm part of the dreaded older group on DU! )
Forgot to take my memory pills today.
Hope22
(1,840 posts)We witnessed this at outpatient eye surgery. Not about the finances but the transportation. The woman at the desk said where is your driver? He said he was going to have a local and would drive himself home. She looked at him and went into his medical history saying loud enough for all to hear that a month ago he couldnt handle the local and they had to put him out. She told him it was evident that he would have to be sedated this time as well. No ride, no one to monitor his 24 post op either. They didnt do his surgery. My friend who was getting his eye done that day felt so sorry for the man. He told me that he almost asked if I would take him for the night! 😳 That might be a volunteer job but I certainly would not have been comfortable with a stranger and no medical history or background. Im glad your guy got his surgery. They will take the $1500 and see what other sources they can find.
Hortensis
(58,785 posts)Getting old here, used to have a dentist and PCP. Now in the past year we're becoming far more informed about how a lot of offices operate.
Since they did end up giving the man the care he requested, maybe I'd just complain about this playing out where it did.
Btw, I believe most county health departments provide referrals to subsidized dental services. They specialize in basic solutions, including removing teeth, at very low price.
MontanaMama
(23,319 posts)about this just making sure my kiddo is in the clear before I do. I wish it didnt have to be that way but the way this man was treated I dont want that woman anywhere near my kid.
Hortensis
(58,785 posts)at a doctor's office was when I called and inquired if they charged for Covid vaccination. They did, a substantial fee, and the clerk didn't tell me I could get it free elsewhere, which I knew and considered a betrayal of their patients. Not all are insured, after all. Your post reminded me of that.
brush
(53,784 posts)Were your son's bothering him?
MontanaMama
(23,319 posts)wisdom teeth and there just isnt enough room for them to fully erupt in a way where he could keep them clean over the long term. Both his dentist and orthodontist recommended getting them removed.
Rhiannon12866
(205,451 posts)It became infected and I had to go on an antibiotic beforehand. It was incredibly painful, I couldn't talk, eat or sleep - so it's good that your son is avoiding what I went through. I also remember that years ago my brother had his wisdom teeth removed, probably for the same reason as your son, and he had to spend the night in the hospital. And it's also important that he follows the dentist's instructions, keeping gauze on the wound, nothing solid, hot or carbonated to eat or drink in the beginning - and avoid straws. And keep ice on the jaw and ibuprofen for dental pain. That's the post-op instructions that I was given.
And I certainly agree with you about that poor man. I hope that they gave him sufficient post-op instructions, too.
MontanaMama
(23,319 posts)Your wisdom tooth just came in??? That must have been so traumatic.
Rhiannon12866
(205,451 posts)Niagara
(7,620 posts)Last edited Wed Jan 25, 2023, 10:06 PM - Edit history (1)
The 3 wisdom teeth were impacted causing him jaw pain, problems with opening his mouth and was effecting his other teeth.
They shot him with an injection and the procedure took less then 23 minutes.
Emile
(22,773 posts)MontanaMama
(23,319 posts)thats barely worth the premium we would have to pay. Dental insurance is ridiculous.
RipVanWinkle
(228 posts)I'm an ex-healthcare auditor. Over a 15-year period, I audited Medicare, Medicaid, and VA hospitals.
You are 100% correct. Our "healthcare system" places profit way above patient care. Many of the audits I participated in resulted in a lot of money recouped.
This may be an exaggeration, but it's not far from the truth: the "healthcare system" is a scam.
Joinfortmill
(14,427 posts)questionseverything
(9,655 posts)The staff are only enforcing his rules and only the dentist can decide when an exception is made
MontanaMama
(23,319 posts)I was an insurance biller and treatment coordinator for a dentist for 21 years. I was the person to deliver the bad news about insurance and treatment costs to patients. It is difficult for a lot of dentists/doctors to deliver care and talk about money so they hire to their weakness in that regard. I will say that when there was financial hardship, I had no issue talking to the dentist privately to see what we could do to make sure someone received care. I would never talk money with a patient at the front desk. I felt it was disrespectful to do so. You never know what someone's situation is and what is happening in their private life. A lot of people struggle. Hell, I struggle. It took me 6 months to save the $1700 for my son's procedure...and I've got it better than a lot of folks.
questionseverything
(9,655 posts)The youngest is fourteen and needs braces
She has medicaid but her teeth arent bad enough to be covered so we are looking at five grand out of pocket
Then a week ago hubby cut off the tip of his finger at work so theres another seven grand out of pocket
We went from fairly secure to a mess in less than a month
Sorry just felt the need to vent about my personal healthcare in America mess!
🥲
MontanaMama
(23,319 posts)That's the reason for this thread. So many of us are in this position. I'm so sorry you are going through this. I wish I could hug you.
questionseverything
(9,655 posts)I hope it gets better for all of us
MontanaMama
(23,319 posts)When it does, I'll be virtually dancing in the streets with you, your husband and the three beloved grandkids you are raising. Universe bless you.
KentuckyWoman
(6,679 posts)From being destitute. Add that cost to being out of work due to illness a fairly short time and suddenly everything you spend a lifetime sweating for is gone.
questionseverything
(9,655 posts)moonscape
(4,673 posts)and pleas. But, if we connect with them one-on-one, they often will bend their own prices/rules, at least my experience. I recently had 2 implants and yeow $$$$.
BlueWaveNeverEnd
(7,939 posts)MontanaMama
(23,319 posts)Dental infections are dangerous.
in2herbs
(2,945 posts)important than heart health.
Oh, I forgot --- gun rights are more important!!! grrrrrrrrrrrr
MontanaMama
(23,319 posts)If someone can't eat well they won't be able to stay healthy. Why is this not understood? Even with most dental plans bills like this are out of most people's ability to pay without a loan or costly financing.
I'm really sorry this happened to you.
spinbaby
(15,090 posts)Im in the middle of it now, sitting in a nursing home, aka rehab, for week four of recovery from a shattered ankle. I have no clue how much it will wind up costing me. No one seems to be coordinating anything and my medication errors have been epic. Oh, and the nursing home has a covid outbreak, which at least has the overworked staff masking correctly.
MontanaMama
(23,319 posts)I'm glad you are paying attention because it sounds like there is indeed no coordination. I'm sorry. I hope you aren't in rehab for the long haul.
Warpy
(111,267 posts)I spent 26 years without access to health insurance before Medicare kicked in. Docs were my greatest ally once I got past the dragons at the front desk.
Glad your son got the wisdom teeth out, those things are nasty when they don't come in right and they don't come in right for most of us. I think Mother Nature was out of her mind when she installed the damned things.
Traildogbob
(8,746 posts)They say the will lay 50 percent of major but that is 50 percent of what they allow. Had a root canal a few moths ago, $1,700 up front. When insurance finally contacted me 4 months later they paid $375. That was 50 percent of what the allow for a root canal. God bless America.
MontanaMama
(23,319 posts)Youve got it right! Their allowables have not kept up with costs. Between that and unrealistic annual maximums dental insurance is a scam.
BlueCheeseAgain
(1,654 posts)Even most countries with universal healthcare have limited coverage of dental care.
CarlYasutomo
(53 posts)I've never had an issue with insurance coverage of root canals and other procedures. Never had to worry about it here.
vapor2
(1,248 posts)Evolve Dammit
(16,736 posts)teeth (all their teeth??) removed, and how does that benefit the patient? He probably had no "preventive care" coverage/ insurance is my guess (routine check-ups, cleanings, etc.) and his teeth/mouth were an infected mess. Tragic and totally avoidable with routine check-ups and cleanings. We are a shit-hole country. It is disgusting.
area51
(11,909 posts)Evolve Dammit
(16,736 posts)cayugafalls
(5,641 posts)And this Dr was a good one.
Compassion and concern. Sending an elderly patient home with an active infection is life threatening.
I am sure that doc can absorb the funds if push comes to shove.
Now about that bill you got, it f'ing sucks.
Healthcare should be a right.
Puppyjive
(502 posts)I've been nothing but a cash cow for dentists. I have over $22, 000 on my teeth because they would not pull the very back teeth. They keep making me get crowns and root canals for teeth that I would rather have pulled. If i can ever retire, i wouldn't mind starting a charity to help people with their dental care. Dentists make me sick. Literally.
DENVERPOPS
(8,835 posts)to do a single thing about health care or medications, Dental, Eyes, hearing.
It is enough for them to battle the constant barrage of shit the Republicans are trying to do to all medical. Just look at what the Republicans want to do to eliminate Medicare, Medicaid, food stamps, etc.......the republicans all want to take us back to a third world country, except for themselves...........
The worst is that Medicare doesn't cover Dental, Eyes, Hearing...............
Niagara
(7,620 posts)Years ago, a mother came in with a young toddler and the toddler had her glasses for 2 weeks and broke the frames.
They wouldn't replace them for free. At that time, they actually did make unbreakable glasses for young children.
It was apparent that the mother was stressed out about having to pay for another set of glasses.
pansypoo53219
(20,978 posts)ride home after something. he visited usa in 2016 + got sick from the plane trip. he had to inform them from our house his last week in milwaukee. dk paid for his med bills in NYC. his lost vacation time, paid us for the phone call. i have been there twice. it is so much NICER there.
Yavin4
(35,441 posts)NickB79
(19,246 posts)It documents the hell people without health insurance have to go through trying to get medical care in a hospital ER.
There was a young man in his mid-20's that came in with testicular cancer. He had been scheduled to have surgery the day before, but the hospital he was originally booked at realized he had no insurance. Just like that, his surgery is canceled.
So he and his girlfriend go to the ER to figure out how to get one of his balls cut off to save his life. My God, as if being told you need to have THAT cut off, now you have to deal with no health care?
Samrob
(4,298 posts)C0RI0LANUS
(510 posts)His funeral will be cheaper than mending his teeth.
The average cost of a funeral in Montana is $4,789 based on surveys. Research shows that prices can range from $3,725 to $6,120 (perfectgoodbyes.com).
And below see what a suffering man did to get free medical care. He put himself in prison:
https://www.theguardian.com/world/2011/jun/21/verone-one-dollar-robbery-healthcare
Our country can do better!
AZLD4Candidate
(5,696 posts)as a paid benefit.
cstanleytech
(26,293 posts)they really try to push for you to use financing and if you hesiitate they jerk you around and say they will claim they have to check your insurance again and will call you back and then they never call.
Now why do they do this? Well from what I have read (assuming I understood it correctly as I could be mistaken) is the reason they push for you to use financing is because the financing companies (which you pay interest of if I am not mistaken) pays them up front the full amount.
Then after that you are left with a big bill that you have to also pay interest on and meanwhile Aspen walks away with smile on its lips for hooking another sucker.
MontanaMama
(23,319 posts)It was the oral - facial surgical practice around the corner on Reserve St.
While I was waiting for my son, I noticed lots of brochures for financing options. When I worked at a dental office, we offered Care Credit to patients. I was straight up with patients about it
always. Care Credit offered no interest on short term financing but if you go minute past when the payment is due, they hit you with retroactive interest and fees. Its nothing to mess with if you dont clearly understand the terms. I try to avoid financing whenever possible.
ETA: You are correct that when a patient uses financing options, the practice gets paid in full.
The Jungle 1
(4,552 posts)I read once that one of the few good things we did for Native Americans was pull their teeth.
OMGWTF
(3,957 posts)go to Mexico for dental work that is far cheaper than in the US.
lambchopp59
(2,809 posts)Same here. I've had major work done there at 1/4 the cost of procedures in duh good ol' USA AFTER insurance paid the trickle they did.
I wish I could find one down there with the Nitrous Oxide though.
OMGWTF
(3,957 posts)go to Mexico for dental work that is far cheaper than in the US.
Emile
(22,773 posts)20 years ago. I was surprised the first couple blocks were drug stores all advertising boner pills and dental offices.
Nac Mac Feegle
(971 posts)Earlier this year, my son needed some extensive dental work and has no insurance. I was able to take him to Algodones, Mexico and get what his Dentist wanted to charge over $20,000 for done for just over $2500. And get a crown for myself done for $275 that would have been $1,400 after insurance here.
The facility there was much newer than the one locally, too.
DownriverDem
(6,228 posts)paid $1000 per year. I dropped it and am now going to get dental through BCBS of Michigan PPO Medicare Advantage. It will pay $1500. Thanks to folks voting for the repubs, we will continue to not have reasonable dental coverage.
MontanaMama
(23,319 posts)If you dont mind sharing that information.
Ms. Toad
(34,074 posts)Delta dental runs about $30 per person per month. It generally covers two visits a year, x-rays once a year, (without charge) then a portion of actual care, capped at $1000-$1500.
But you have to find a dentist in network, or the payments are capped at the usual, customary, and reasonable rate (and discounts are based on that price).
MontanaMama
(23,319 posts)All of the dentists pretty much agree to not participate in plans due to low reimbursement rates. I was an insurance biller and treatment coordinator for a dental practice for 21 years. The network contracts that providers had to agree to to become an in-network dentist weren't reasonable at all. The fees that Delta in particular stated as usual and customary were anything but. What they were willing to cover for a conventional crown didn't even cover the lab fees to make the crown. It was very difficult to explain to patients why their dentist wasn't in network. As a patient myself, it is incredibly frustrating.
Ms. Toad
(34,074 posts)Both my daughter and spouse have participating providers. I have residual trauma from a participating provider who touched 3 teeth and destroyed 4, so I have been reluctant to move to a dentist desperate enough to accept the UCR.
So I'm not getting a lot of benefit from my plan, but since my spouse can only get insurance through me, I'm mostly wasting my money to get her covered.
I'm probably going to switch, if I can get up the emotional energy to do so.
MontanaMama
(23,319 posts)You refer to "emotional energy" in switching providers...you sure have that right. It's a big deal to put your trust in someone who's working in your mouth. New dentists will usually sign on to in-network agreements because they're trying to build a patient base. After they're established they tend to drop out of the network. I'm not saying new dentists are bad at all...but you get my drift. I wish you the best whatever you decide to do.
LudwigPastorius
(9,150 posts)That was $6,500.
The remaining work of fabricating and fitting a full arch restoration cost an additional $23,500.
I had to take out a loan and finally paid it off last year.
My teeth are the reason I'm currently driving a 20 year old car.
MontanaMama
(23,319 posts)Implants are the standard of care for missing teeth. I'm happy you were able to pay off your loan to get that care. In the wealthiest country in the world, we shouldn't have to make choices like this and I'm sorry you had to do it.