I broke my front tooth. You know of the the two that is directly in front. It broke vertically almost straight in half. OK my dentist is going to cap it but he tells me the insurance won’t cover it, because it’s cosmetic. I spent all of Friday on the phone with the dental insurance, and they assure me the dentist can simply buff out the crack and contain it.
I’m gonna get the cap, of course, but I really see why people hate dental insurance. Half a missing front tooth is cosmetic indeed. OK yeah maybe it is, I thank God, I can pay the $750 for the cap. I feel for those who can’t.
Anyone else have, what they feel are weird or ridiculous dental insurance stories? Oddly enough with all this talk of healthcare, no one seem to ever mention dental.
My dental is capped at $1,500 a year. I was reading it, I love the fact it won’t pay for a bridge. You have to get a partial.
I had a childhood injury to my front tooth that was fixed with a bad fill that started to discolor in my late 30s. I replaced it with a porcelain veneer 5 years ago. Right before Christmas, the veneer started cracking on the side. I knew I was switching to my husband’s better dental insurance on Jan 1, so I scheduled the appointment for January and crossed my fingers the entire veneer wouldn’t crack in half and I’d ruin all the Christmas photos with my hillbilly smile.
Got a temporary crown on Thursday - instead of 1200.00, it cost 700.00. Normally, dental insurance isn’t a big deal for me, I’ve never had a cavity and the most basic plans cover twice a year cleanings. Glad to have good insurance this year!!!
I should clarify I mean they said, they could buff it out at where it cracked. I still would have a gap in my teeth the size of half a tooth, which is missing
I don’t think there’s anything weird or ridiculous about my dental insurance stories. But I’ve got a lot. I went over the front end of a bicycle 45 years ago and have spent thousands over the years keeping various types of ‘teeth’ in my head. Dental insurance has never covered any of the prostheses. It did cover the costs of anathesia/novacaine, xrays, root canals, and consultations, sometimes. If dental insurance policies regularly covered cosmetic work, the price of the premiums would be exhorbinant. To get away from yearly fee caps and partial coverage, I’ve maintained two dental insurance policies for about 10 years now. But most of the time I had no, or minimal, dental insurance.
I asked on this board once why we have this Medical<------->Dental insurance system, and the answer was pretty interesting. Turns out Medical insurance was begun by hospitals trying to ensure a revenue stream during slow months. For a small monthly fee, they’d keep you on their rolls and when you needed medical care, you’d get it for free. That way they got some money all the time, and you didn’t have to come up with a large sum of money when you were ill. Of course, these hospitals didn’t have dentists, so dental was never covered. When insurance went third-party, the divide persisted out of habit, or something.
I think it’s stupid. I’ve got so many patients with missing teeth. They can’t afford dentures, or even to have the rotting teeth in their mouth pulled out. They have constant infections, which can damage the heart. They tend to be obese or very underweight, because they can’t chew their food well. They either eat high calorie, poor nutrient food like Big Macs and fries because they’re so soft, or they don’t eat enough food because it’s exhausting or impossible to chew, and pureed food just isn’t appetizing. They tend to have the troubles you’d expect finding a sexual partner, and are at higher risk for abuse by caregivers than people with a full set of teeth. I see a lot of diverticulitis and bowel perforations with this population too. While I don’t know if that’s been linked to poor dental health in actual studies, in my mind the link seems to make sense - if they can’t chew their food well, food particles may be getting trapped in their intestines and causing problems.
So yeah, dental health absolutely affects overall health, and specific disease processes, for the worse. I see no reason in this day and age not to include dental care in health insurance.
Ouch! I filed my taxes yesterday so I can go to the dentist. I have a tooth that needs a crown (and hopefully not a root canal) that’s been giving me problems the last week- aching, sinus, everything. When my car broke down, I had to use my ‘dentist fund’ to cover it. So very soon after 2/8 (my estimated deposit date!), I get to shell out between $1200-2400 to fix it. I very much wish I had insurance, but I could imagine the frustration if I did and something like what you have would be called ‘cosmetic’!
I just got a letter from My vision insurance. They are rejecting paying for the exam because I wear contacts and it’s an “exam/lens fitting”. They will pay for the contacts(well 75%) no problem. The will pay for an “exam” along with getting contacts, 100 %, no problem. But they will not pay one damn cent for an “exam/lens fitting” that comes with the contacts. Only 65 bucks so I’m not sure it’s worth the aggravation of appealing, but WTF?
A few years ago I asked why they only pay 75% of the contacts rather than the 100% if they are “medically necessary”. I can’t legally drive with unimproved eyes so doesn’t that make them “medically necessary”. No he said, “medically necessary” contacts means you can’t wear glasses, and the only time in 15 years he had seen contacts given necessary status was a dude born without ears and a deformed skull, and would have needed some kind of custom rig to wear glasses.
My insurance does not cover an anesthesia beyond novocaine. Never mind that novocaine does not WORK well for me… fortunately we can afford the out-of-pocket for nitrous, and for IV sedation when needed… interestingly, the IV sedation does get reduced to the “in-network” price so I save some money, but still…
When I had my wisdom teeth out, I was out of college and working on my own, but still covered under my parents’ insurance for that year. So I submitted the cost: 260.00 for the extraction and 30.00 for IV sedation.
They denied the 260.00 entirely. They covered the 30.00. Yep, they’d have paid for me to be sedated for no reason whatsoever.
There was a 25.00 deductible and they paid 80% of the rest. Yes, I got a four dollar reimbursement.
Dental insurance is insane. I hate selling it because of all the odd restrictions and limits. It’s gotten to where I don’t even mention dental unless someone asks me about it.
I almost had another stroke a couple weeks ago. Certainly felt like it tho I didn’t tell that to the doctor who, over the phone and who knew something was up, was urging me to go to the ER. The only way it would have been covered is if it had been bad enough that they had to come for me (the paramedics.)
We have universal healthcare in Canada, but it doesn’t cover teeth or eyes. You know, I can understand that - my teeth and eyes aren’t part of my body, so there really isn’t any reason for general healthcare to cover those body parts. :rolleyes:
I do have dental insurance through my husband’s company, but it’s still kind of ridiculous - it will cover an extraction (I think), but not fully cover a crown or a root canal. So, just yank 'em all instead of fixing them, eh? Good plan. It doesn’t cover sedation dentistry at all, so whenever I need something big done, it ends up costing us around a grand WITH the insurance. Sheesh.
I am guessing perhaps this is why I hear some, usually older, people call it “hospitalization” rather than “health insurance”.
My job offers dental insurance but doesn’t subsidize it all, so it hardly seems worth getting it. It costs some $300+ a year and coverage is limited to $1500. I have had one filling in the last decade with no problems reported on the horizon, so I think that $1200 I would save is worth the gamble.
Oddly, my vision coverage actually pays for itself. That costs a hair over $200/year for my wife and me and includes a $130 credit for contact lenses per person.
My teeth have cracks in them but are otherwise healthy. Back when I had dental insurance my dentist recommended an onlay (basically a half-cap) to fit over the top of the tooth and keep it from cracking further. The insurance refused the $800 price for a gold onlay but would pay the $1200 to have the perfectly good tooth ground down to have a full porcelain cap (which would not last as long on a molar) placed.I paid for the onlay and keeping 80% of my original tooth.
A few miscellaneous comments:
[ul]
[li] I doubt that insurance companies’ profit margins are too huge. Thus those who think insurance should cover more are implicitly asking that their premiums be raised! (Or, for those with employer-provided insurance, asking that their salaries be lowered.)[/li][li] In America, lack of insurance is a big problem. It would be nice if those who do have insurance but spend energy complaining how bad their insurance is, would instead spend that energy seeking single-payer UHC. That this doesn’t happen is an example of the unfortunate divide in today’s America between haves and have-nots.[/li][li] The cost of major dental work in America, or even the non-covered portion of that cost for those with insurance, may be about the same or even less than the cost in a foreign country plus the cost of travel to that country! The idea won’t work for many of course, but, rather than paying American prices, the need for major dental work can be viewed as an opportunity to get, in effect, a free vacation! (Do make careful inquiries to ensure you find a competent foreign dentist.)[/li][/ul]
So very soon after 2/8 (my estimated deposit date!), I get to shell out between $1200-2400 to fix it. I very much wish I had insurance, but I could imagine the frustration if I did and something like what you have would be called ‘cosmetic’!