Dental Insurance and other ways to pay

[I Believe in Fairies]

We just moved and a tooth had to freak out. First it started to hurt, then it broke. I'm missing about 1/4 of a molar now. I went into Western Dental and they said I need eight fillings and a deep cleaning and a root canal and a crown. I have Medi-Cal and apparently they won't cover any non-metal work. I got a quote for the work and it's $1100!!!! I'd have to pay half up front, and I do *not* have that kind of money. The dental schools have stopped taking the insurance too!

I just don't know what to do. I keep hearing my Homeopatist in my head saying "What ever you do, don't get metal!". Ugh, I just don't know what to do.

Anyone have any advice?

Thanks,
Elizabeth McKeeman

[simonee]

I've been there. And I just had the tooth done that bothered me (they can insist to do whatever else first, but you are the customer and you get to decide what they do), and then I saved some money and got dental insurance, and now they're doing the rest.

There are insurances that don't cost too much, at least not if you only have them for a while. You'll end up in an HMO, and you have to get the somewhat fancier ones because then you don't have to wait 6 months. Mine is called Ameritas Excel 3000, they pay for composite (white plastic) fillings on all teeth except the deep molars, and on the molars the copayments are doable (about $60 a tooth). Root canals cost me $160, and crowns about the same. I think the site that got me there was called allhealthinsurance.com; it offers comparisons between different insurances. Or you can do a search on "insurance comparison" or something. I pay $35 a month (me and dh) for the insurance. So, if you started with the insurance, and then got the bad tooth fixed for $300 max (if that's the one that needs the root canal), you could always cancel the insurance again, wait till you had more money and then do the rest. I waited 5 years, to be exact (just don't let smilemomma read this).

Or do a search for dental discount plans ~ there are probably plenty of dentists in SF who accept them. (I wasn't so lucky here in SD, especially since I don't have a car and couldn't travel easily to those outlying dentists)

Anyhoo, it sux the big suxerooni. Good luck.

[Smilemomma]

Elizabeth, this always happens at the worst time, doesn't it? Teeth have a kind of calendar!

I second what simonee says about the insurance. Most plans that don't pay for metal will pay for other materials the same amount that they would have given you for the amalgam. (ie, amalgam = $60, composite = $100, insurance will pay $60 only, as if it were amalgam, and you'd be responsible for the $40).

Good luck to you!

[I Believe in Fairies]

what's that flicker at the end of the tunnel?

I talked to the Denti-Cal people today and I was only told part of the story at Western Dental. If I get a note from my doctor saying I can't have the metal then Denti-Cal will in fact cover non-metal fillings and crowns. I have an appointment with my doctor for the 23rd and I hope he will agree. I am going to get my mouth looked at by a dentistry school on Monday. We'll see what they have to say.

I'll keep you all updated : )

[AmandasMom]

Health insurance refuses to pay

*sigh*

After battling for months, my health insurance provider (United Healthcare) refuses to pay for the hospital/doctor/anathesiologist (spelled wrong) part of her dental procedure. We have asked, written, talked to, argued all no NO avail. They say that since she needs to go into the hospitall because of a dental procedure, that it isn't covered. We argue that she is 2 years old and she can't be awake for all the major work she needs to get done. They say too bad, we dont cover it. Our dental insurance won't pay for that part because they say Health insurance should pay for it.

So our daughter gets to have black teeth because of the stupid fuking insurance, and because we don't have the almost $3,000 it will cost us. I hate this country so much sometimes!!!!!

Her front 4 teeth are almost all black now. Luckily she is in NO pain. How long after they turn black can we hope that they just fall out? How does that work smilemomma? I feel like such a bad mom, but we have no choice

[shelbean91]

My daughter had 5 crowns and 1 filling the day after she turned 2. We also had the same problem with the dental saying they wouldn't cover the hospital because the medical should cover it and the medical saying the dental should cover it. We could not afford the $3000 either.

We went to about 3 ped dentists before we found one who would do the work in the office. It did end up taking 2 visits instead of 1, but dd did great. The dentist did what he called 'consious sedation'. They used some gas and another anesthetic (sp). DD wasn't completely under, but she was very out of it (almost like when someone is drunk- they are awake, but not always aware of what's going on).

They put her in a papoose so she couldn't wiggle too much. They were very gentle and stopped working whenever she started becoming agitated, so she could settle down. The most traumatic part of the visit and recovery was I had her wearing sandles and she must have been moving her foot back and forth because she had a blister the size of a dime on her heel.

The dental insurance still didn't cover the anesthia, but it cost us $300 out of pocket instead of $3000. Also, the dentist didn't charge us for the anesthia the second time, only the first, since originally we had thought he could get her done all at once.

[Smilemomma]

Whoa, whoa! I'm sorry that you're in such a bind, but it doesn't involve the country. Your insurance only covers what you pay for it to cover; if you did not sign up for a particular coverage, you don't get it.

I'm sorry that they're not covering what you'd like them to cover, but the person to be angry at is whoever decides your coverage (your employer? Your husband's employer? They bought the plan.) Do they have other plans that you could choose that DO cover more, even if it cost you a bit more each month?

You could also call the insurance commissioner in your state. Sometimes just *threatening* to call the insurance commissioner gets things rolling. There are also options outside of this like credit cards, a bank loan, relatives, etc. Does the health department in your state do this kind of thing? Medicaid or MediKids? Florida has a KidCare program that helps in situations like this.

I sure hope things work out for you! I know it seems like you don't have a choice, but you do. Keep trying, sweetie, it will happen!

(As for the teeth, they don't usually fall out. They rot off to the gumline, but the roots remain in the gum and bone. I'm sorry. )

:better

[AmandasMom]

I'm sorry that they're not covering what you'd like them to cover, but the person to be angry at is whoever decides your coverage (your employer? Your husband's employer? They bought the plan.) Do they have other plans that you could choose that DO cover more, even if it cost you a bit more each month?

Vanderbilt has 4 health insurance plans (Blue Cross, United Healthcare (which we have), and 2 plans that use only Vanderbilt doctors) to chose from, and none of them cover anything related to dental unless its an emergency. And Vandy only offers 1 dental plan. This Novemeber we get to chose new coverages if we want, I may start looking for a new dental plan. Most people at Vandy buy private dental plans because the one Vandy offers sucks so bad.

Both myself and the dentist office have written and called over and over again to get them to cover it. But they don't care, even when you point out the only other option is sedation/strapped down and I will never ever strap her down unless she is in pain, and even then I would rather hold her to restrain her.

This is all terribly stressful to me. Not only did I have HUGE nightmares about putting her under, now I've had to fight to be able to do it, and I've lost. I keep thinking about how when I was sick in London and in Sydney, all I did was walk into hospital/dr office and they saw me. No one asked how I was going to pay, no one asked "which insurance do you have". If I were in any western place but here my daughter would not be running around with black teeth. I should consider myself lucky, my husband has a good job with insurance, while most people no insurance.

[lilyka]

If you have checked all you options and feel that this is the course you need to take then by all means have it done. To hell with the insurance company. Insurance just doesn't cover everything. Some things just have to be paid for. oUr hospital bill for dd #1 was $25,000 and we had no insurance. We could have taken quite a bit off if we bottlefed (because she could do that : ) but somethings are just worth paying for. Six years later we are still plugging away at that bill but no one has come calling yet. Talk to billing at the hospital and make a payment plan. Most peole are willing to work with you if you are upfront and make payments on time. There will probably be fees but just suck it up and pay them if they are being helpful. If they require payment upfront get a credit card and make faithful monthly payments. Minnimum payments on a $3000 balance on a credit card are usually only around $30. Not too terrible really. Just think about how much this is going to cost you if you let it get any worse. It can effect her permanant teeth too from what I understand (somone correct me if I am wrong).

good luck.

[shelbean91]

Trying to make payments might be ok, but when it came up for us, the hospital wouldn't even schedule the visit until it was paid in full. If I hadn't been able to find someone willing to do the work in the office, I would have had to have her front 4 teeth pulled because that's much cheaper than having baby root canals and crowns.

I also read that preemies can have bad baby teeth, but the permanent teeth end up being fine. That made me feel better in our case since I was told it looked like classic 'baby bottle mouth'.

[Gendenwitha]

Dental alternatives

I have several mercury fillings. I also have some cavities, and my wisdom teeth need to be taken out. I have horrible toothaches--not from the cavities, but from UNDERNEATH two of the fillings I already have. The fillings are about 15yrs old more or less.

I'm scared of the dentist, and have heard that composite fillings only last five years, and REALLY don't want to go to the dentist every five years for a bunch of new fillings. Is this true? Or are there other options? Do they still do gold fillings or is there something wrong with them too?

The last dentist I had said to "call the ADA, silver fillings aren't dangerous", and for some of my cavities they are the only kind I can get. Then dropped me as a patient because I refused to sign the paper agreeing to all they wanted done (none of which addressed my toothaches.)

They also said I'd have to have my wisdom teeth taken out with a local anesteshia, one or two at a time. (Did I mention I"m scared of the dentist? Besides I've had friends with general & local removals and the general had a lot better recovery.)

I live between Olympia & Tacoma, and we're on a managed care plan that only covers mercury fillings. Dh is a state employee, and open enrollment starts in November. Does anyone have suggestions as to what insurance plan to get? Right now we have two options for dentists on our plan in town (one of which just dropped me) and it takes MONTHS to get an appointment.

[menudo]

Deteriorating filling, possible infection, no $$, no insurance...

HELP! I will be 27 yo this Thursday but still have some baby teeth (it's genetic). They have cavities in them. These have been filled but was finally told by the last dentist that the reason the fillings keep falling out is where the cavities are and that they are baby teeth, etc. This made sense. So the last fill was several years ago (the white fillings, how safe is that?) but the fillings began deteriorating soon after. Well, now I can see the rot on both teeth (same teeth opposite sides of mouth!) and on one tooth the filling is actually sliding up and down, I have to push it back up! I feel/see infection setting in and wanna go to a Dentist BUT I have no dental insurance and we are more than broke (a $25 payment at a clinic is not currently possible!!) What can I do?!?! I am going to call my MD tomorrow (I have health insurance thru the state, they don't offer adult dental) b/c I was told he may be able to refer me to a Dentist as an emergency and it may be covered, but my HMO sucks so I am not counting on it! HELP! What can I do, particularly for the infection? I am still nursing my DS, who has a cold. I am knew to natural medicine and what I should watch out for at the Dentist so I need some advice asap!

THANKS!!

[menudo]

SmileMama? Anyone? I am in pain! The infection is on both sides now, still not too bad but I need to do something soo. I got a job today but no insurance, I can't work if I am in pain. There is no way I can afford dental care now. My insurance is saying they will not pay even with a referral. I told them hospitalization due to infection costs more. They didn't care.

[Xenogenesis]

The dentist we use lets us write post dated cheques even if they are dated many weeks from the appointment (but usually within the month) with no down payment and the subsequent cheques being dated approximately one month apart. Can you phone them and ask? I hope you find an answer.

[Smilemomma]

bebesho2, check out this thread :

http://mothering.com/discussions/sho...threadid=22583

not because I think you have a similar problem, but because I go into the various means of obtaining dental care at low or no cost, at least in my state. There should be similar programs in your area.

Good luck, please post back and let us know how it goes!

[Xenogenesis]

Don't they also do free/half price dental work at a university or college that offers a dental study program?

[Smilemomma]

That's a good point, laila!

If there's a dental school in your area, they will do everything from full, comprehensive care to just an emergency visit. It's not free, but it is at a much reduced price.

Prepare to spend at least 3-4 hours there, but it will be taken care of. As far as quality, everything that is done is checked by several instructors along the way.

[anythingelse]

I had 2 crowns done and put no money down. The dentist was very cool about it and they don't charge any interest. I will probably pay him $20.00 a month till I need new ones
I used to babysit for the dentist that pulled a wisdom tooth for free. I hope you can find a dental school near you, keep calling on the phone and tell them your story. We have a free dental clinic near my house that is associated with a large food pantry and clothes closet.
Another thing to do if you belong to a church is to call the secretary and ask if there are any dentists registered. We use our parish directory to find people that have a business or trade when we are in need of help and have found those people to be willing to wait to be paid or trade a service.
I wish you the best!!!

[Jane]

Don't forget to look at your local community colleges. One has a dental assistant school, and they do reduced cost dental work as well. The students have to practice assisting during all kinds of procedures.

[menudo]

I am familair with schools but I cannot afford the reduced price (times are that rough). I'll call my DD's school parish, although it is Catholic and unfortunatley Catholic churches are not known for having the 'community" other churches have, I wish they did. I have called them before and they are clueless!!

BTW, I bought a store brand of Scope and it is doing wonders on keeping the pain down!!! Brushing is rough but that mouth wash is killer-literally. I will borrow the $$ if I have too, as my Father saw my teeth and is paranoid..