Tuesday, February 28, 2012

Why Do We Even HAVE Dental Insurance?

I swear, we have the worst dental insurance in the world.  It barely pays anything on standard stuff (cleanings, x-rays, etc).  Hence....the reason that we almost always owe the dentist something.  Both the kids' dentist and our dentist have been terrific in letting us pay as we go, and have NEVER said anything about the balance.  We just pay something every month, and it slowly chips away....until the next visit when it goes back up.

G-man has terrible teeth, so he goes 3x a year for a cleaning.  I have great teeth, so I go once a year (I figure it balances out....sort of giving him my second cleaning).  Since our insurance only pays $16 a cleaning, I am trying to save money.

Well, I have had a tooth that has been bothering me for several weeks.  VERY sensitive.  I was hoping it wasn't a cavity (I have NEVER had a cavity....see, I have great teeth).  But as the discomfort grew, I decided I better have it checked out.

Several mini tests and an x-ray later.....I have a cracked tooth.  If I had to guess, it happened about a month ago when Bossy was having a tantrum and hit is head into my jaw.

I need a root canal and a crown.  And possibly a "build-up" but they can't determine that until they are ready to do the crown.  Our insurance covers NOTHING.  NOTHING.  The wonderful office staff (we have been going to this office for almost 9 years, and have gotten to know them), checked our insurance, and just had this forelorned look on their face when they gave me the quote.

Root Canal - $891
Crown - $985 (with a $200 deposit due that day for lab expenses)
Build up - $200


I think I stopped breathing.  For someone who has only ever had a cleaning...to drop over two grand on ONE tooth.  Good grief. Unfortunately, this isn't something that can wait.  I need to be on antibiotics for the start of an infection, and unless I have it done, the infection will come back and could get worse.

The office staff said they will continue to work with us on the balance, and as long as we keep doing what we have always done, we will never get a call from them. 

Here is the thing....we have a Flexible Spending Plan.  Our FSA will cover it.  Of course, that is over half of the $4,000 we elected for the year, so our FSA will run out that much sooner.  The only small silver lining....at $5,000 we hit our out-of-pocket max, and the rest of the year we don't have a co-pay for anything.  Based on our regular usage...that would be sometime late summer.  So from Sept-Dec, we wouldn't have any medical co-pays.

But still....$2000......UGH.  They will still submit the claim to our insurance on the chance they will pay something.  We looked at our plan book last night, and it wasn't even listed.  Cleaning, X-rays, fillings.  That was it.

In a Dental recap.....Sassy broke her tooth July 2011.  G-man had an abscess in Fall 2011.  Now Mysti has this Feb 2012.  Less than a year, and 3/4 of our family has had dental issues.  And we already know that Bossy needs braces....

Can I just scream????

ETA:  I called around, and this is the going price for this work.  I called my dentist and asked if we paid cash, could they do a discount.  They said they could do 15%.  So when I have the root canal done next week, I will take the money from EF to pay for the work.  Once we get the FSA reimbursement, it will go back into the EF.  This will save us $134 on the root canal.  It is better than nothing.


  1. Wow that's a lot of money. I'm sorry that really stinks

  2. Given that your dental plan pays for so little, have you calculated whether you'd be better off just dropping the coverage and putting the premiums aside for out of pocket dental expenses? I'm surprised your coverage is so poor as you said your husband is a federal employee and those jobs have a reputation for excellent benefits...sorry about this. I had a cracked tooth about two years ago and I agree that it has to be dealt with right away.

  3. @Consuelo - the dental plan is rolled into our medical plan. We don't have the option to drop it. Our medical insurance is excellent...I guess they just didn't negotiate better for the dental.

  4. I have not solution but to say "that sucks"! Will your dentist consider lowering the fee? When we didn't have a plan for the last six years, my dentist charged just $200 to pop out two impacted wisdom teeth, including the drugs, the x-rays & the extraction. Would have been close to $1,000. Another option maybe: do you have a university or college nearby that has a dentistry program? In Canada, they offer discounted rates & the students are in their final year & well supervised. Check that out too.

    Hope you feel better soon.

  5. I can literally feel your pain as I have an impacted wisdom tooth that pushed in to the molar and now BOTH need to come out and the molar replaced with an implant. To remove all 5 teeth (I also need my other 3 wisdom teeth out since they are all coming in sideways) is $4,000.00. Implant $4,000.00. My insurance would cover the extractions but the only oral surgeon I found who accepts my insurance is so low rent I don't trust them (seriuosly has anyone else called their dentist office to ask a question and get yelled at & hung up on?). I rather pay for someone with a) experience and b) professionlism.
    But dental problems do suck and for us always seem to appear at the absolute worse time...usually after an expensive emergency!!! Good Luck! My surgery is Friday :-(

  6. I have a tooth with a crown on it that I think needs a root canal. I am putting it off, even though we have the "good" insurance.

    Can you ask them to just pull the tooth? I mean, we really do have a lot of teeth and if all the other ones are good, could you make do without one? It's way cheaper than what they want to do and far less painful.

    My oldest son has an enamel defect and needs crowns on every single one of his teeth. The insurance covers 80% of two each year and we are paying for a third one to try to get this thing moving before he has to go off of our insurance, but at three teeth a year, he's never going to get all of them fixed. And the enamel is literally eaten away on all of his teeth. I don't know how he chews. Our dentist just raised his prices on crowns to over $1100. Luckily, they are like your dentist and know I am good for it over time. We're still paying on last year's and he's already started this year.

    I hate paying for things that aren't any fun. Dental visits, doctor visits, car repairs. I feel like we work to make money just to hand it to people who aren't really making us any happier. If I'm going to spend $3,000 (on teeth), I'd much rather spend it on a trip to the Carribean for me and my husband!

    I feel your pain. I really do.


  7. Wow it really does sound like you have bad dental insurance. Have you looked into switching? If it is through work, can you get a supplemental insurance on your own? That being said - I had a double root canal and 1 new crown a few years ago and had to pay a lot more than you - it was double if I remember correclty. It is painful to pay those high bills, but having a toothache is even more painful. Good luck!

  8. Dentistry is the new growing billionaire population. As all health systems grow through your mouth is is very important that you take care of your teeth, however the prices they charge are ridiculous and the government will intervene in about 20 years. Because our health the care system is so bad and insurance has doctors so tied up it will not allow the Dentists to do the same. There for we pay and they run uncontrolled. I think those prices are very high. Check around.

  9. If it makes you feel any better(ok, prolly won't lol), the majority of dental plans pay very little for anything they consider cosmetic....and a crown is considered cosmetic in their book. The most we've ever seen insurance plans pay is 50% on a crown.

    Consider having the tooth pulled instead....depending on which one it is. I had a tooth that cracked and ended up needing root canal and crown. In the end the root canal physically couldn't be completed(due to the tooth's own issues)so the crown couldn't be done. The dentist did something else(that cost very little)which kept the tooth going for about 2 more years before that failed. The only choice was to pull it at that point.
    I've had a couple of crowns and this tooth they couldn't crown and the not crown-able tooth cost much less in the long run even with the oral surgery.....and I don't miss the tooth much. It's way in the back, doesn't affect my eating and isn't visible to anyone.

    Dental work is expen$ive no matter what your coverage is. Good luck.

  10. I'm so sorry - I know how terrible it is to have that kind of pain in your mouth, and knowing that it's going to cost you a lot to fix. :-(

  11. Oooooh I feel your pain. When I cracked a tooth my insurance said getting the crown was cosmetic and only covered half. I paid almost $1000 out of pocket and that is WITH great insurance here in Canada. The exposed nerve was horrible pain. I'm sorry but a crown doesn't seem like a cosmetic procedure when you cover a broken tooth!
    Hang in there! I hope it goes well for you!

  12. Yikes! I had a crown last year and it ate up every single bit of my FSA. And I'm having issues with that one now too. Not fun. Not fun at all.

  13. That is scary. I havent really gone to a dentist in a very long time (think > 5 years), and I'd be terrified of the costs. I know that at some point I'll need my two lower wisdom teeth pulled, but for now, I'm just playing the waiting game.

    I hope you feel better soon.

  14. dental seems to be the worse. My insurance covers two cleanings a year and that's about it. It will cover percentages of other procedures but it's really sad how much it cost for what it pays out.

  15. I just had a huge bill and it was awful!! I agree, why do we even have insurance?