Why are TEETH and their associated problems, NOT covered by Medical Insurance??
How did teeth get to be so “extra special” ?
If I had a tongue problem or a throat problem most medical insurance would cover it.
Who started this shit? and Why?
Huh? They are covered under some insurance plans. Same things with the eyes. You can buy dental insurance too. If you have a dental Emergency you can see a dentist under medical insurance if the doctor at the ER room says its neccesary (we did once).
I think it’s because a doctor can’t treat your teeth, and dentistry still has a bit of a stigma attached to it. The whole “people who can’t make it in medical school either become dentists or chiropractors” silliness. And a lot of people see it as a cosmentic thing instead of a health issue, you can still walk and talk and go to work with a sore tooth, ya know?
Insurance agencies REALLY need to get over this attiude. If you have bad teeth and there is lots of bacteria in there, you are swallowing all of that bacteria all day long for years! Yuck! and in the long run it can take years off your life. (I’m not sure where I read that, put I can see how it would be true)
We’ve been covered by several “Major” insurance plans
and dental was ALWAYS considered a separate insurance.
Take it or leave it…
Bad tooth? Excruciating pain? Unless you paid out the nose for dental insurance, you were on your own.
What I wanted to know was why are teeth EXCLUDED in basic medical insurance.
How do they explain/reason this?
And per the other post…
Why CANT a medical doctor examine teeth for heavens sake?
He can look up your ass and down your throat, but heaven forbid he notice or suspect a bad tooth.
There’s really only so many things that can go wrong with a tooth…
From what I understand, bad teeth CAN cause physical health problems. Bacteria from the mouth/gums etc can find their way into the bloodstream. And the last I heard, gum disease has been associated with several serious heart conditions. So wouldn’t it benefit the SCUMBAG health insurance companies to include this? And offer “preventive”
dental checkups along with physical checkups?
Somebody please explain this to me, because I really dont get it.
Well, I’m a doc, and I never was trained to look at teeth. I can generally recognize gum lesions or severe gum infections, and I sure can tell a bad tooth when I see it, but I don’t know what the hell to do about it, other than give 'em some penicillin and painkillers, and tell 'em to have their dentist fix it! I’m not taking up the noble art of drilling and filling. I’ve already gotta know how to restart a heart, deliver a baby, sew up a person, disimpact someone, treat an asthma attack, deal with a suicidal person, a drunk person, a hemorrhaging person. So don’t tell me I gotta do teeth, too!
Dear Doc Mercotan,
I realize you have other things more important to do than fix teeth and it is appreciated…
I did not suggest medical doctors start "filling and “drilling”. But as you stated you can recognize infected gums etc., indicating it is a “medical condition” and the treatment you suggested, penicillin etc, is probably the exact same thing a “Dentist” would do, at least temporarily…
Dentist are fine in their capacity, some of them actually know what they are doing, but I am still asking…
WHY? Are teeth so damned special that they are not included in regular health insurance?
I thought surely by now some healthcare insurance represenative would have some kind of an explanation. I’ll just assume they are not bright enough to have located
this board…
The reason that dental care is not covered by major medical insurance, including your HMO policy, is that dental problems (caries, periapical abscesses, malocclusion, impacted wisdom teeth, etc) are extremely common, and restorative dentistry is expensive. So expensive that if most insurance covered treatment, the premiums would probably have to double to cover the expenses.
Most dental problems are not life-threatening, but some are. Dental abscess used to be a significant cause of mortality due to septicemia and extension of the infection (especially in maxillary teeth) to the sinuses and brain.
However there is no question that dental problems can be extremely painful. The patient with a painful “hot” tooth has two options: 1)extraction, at about $30-$70, or; 2)root canal and crown at $500+. The pain will make anyone who cannot afford option #2, no matter how much he is attached to his teeth, opt for extraction.
The answer, my friends, all comes down to $.
Nobody except Neurodoc came anywhere close to answering the OP. The reason dental care is excluded has almost nothing to do with the differences between medicine and dentistry.
To understand why dental care is not part of most medical insurance plans you have to understand the concept of medical insurance, which few people seem to understand anymore, now that medical insurance is used as a means of financing medical care.
Years ago (I don’t know how many, maybe 50 or 100), people started to buy health insurance to protect themselves against catastrophic expenses due to unexpected, serious illness or injury. This only became necessary when medicine developed to the point where you could run up a really big bill with operations, drugs, and skilled nursing care, etc. (Before this, when medicine had very little to offer, there was little need for insurance since medicine had nothing expensive to sell.)
People bought insurance to protect themselves against huge, unexpected costs. People didn’t buy insurance to cover predictable or minor expenses such dental care which was, until fairly recently, quite cheap. (What did it cost to have a tooth extracted?)
This makes sense. Insurance is to protect you from unexpected catastrophic expenses, not to reduce your overall expenses. Think of car insurance. Your policy covers your expenses if your Miata is flattened by some drunk in an Explorer or if you drive it into a telephone pole. Your insurance does not pay for gas (although you need it) or oil changes (which are good for the car) or even for brake work (which could help you avoid driving into a telephone pole). The reason is that all these are foreseeable expenses and it’s cheaper to plan for these than to insure against them.
anenquiringmind asks: “So wouldn’t it benefit the SCUMBAG health insurance companies to include this? And offer “preventive” dental checkups along with physical checkups? I would answer anenquiringmind’s question with another question: How about your car insurance company? wouldn’t it benefit the SCUMBAG car insurance companies to include tire insurance? And offer “preventive” tire checkups.” After all, why should you have to pay $80 to get your tire replaced fixed if you run over a piece of construction equipment on the road? And wouldn’t preventive tire inspections save money for SCUMBAG car insurance companies by preventing people from driving around on bald tires thereby preventing accidents?
I’ve never had an insurance plan with dental in it, unless I was willing to pay an exorbitant additional fee. Nor have I ever had eyeglass insurance. Yet, if anything happens to either teeth or eyes, one can be completely disabled.
Today, dentists will not treat you without assured payment and you can kiss corrective lenses good-bye without the same. Very few will let you pay on time. You can die from an abscessed tooth and it has been proven that bad teeth will not only affect your heart, but your immune system, your mental health and your diet. Most emergency rooms will not pull an infected tooth unless you are close to dying right then from blood poisoning, gangrene or a septicemia. They’ll give you a shot of antibiotics and pain killer and a prescription for antibiotics and scoot you on your way, telling you to go to your dentist. You can go to public health, and get it pulled for something like $50, but they’re not going to try to rebuild it, nor are they likely to be all that concerned with your pain and if you don’t have the $50, it doesn’t get pulled.
No one will help you with needing glasses.
I think insurance companies feel that people will go see dentists and eye doctors more often than absolutely necessary because the doctors urge them to. Many dentists, some say because they did too good of a job educating people on caring for their teeth, will no longer pull a bad tooth for $50, but repair it for $450. A simple $30 filling can cost up to $100 and they can add in cleaning, scraping, braces (we never had adult braces 20 years ago) and other things that the insurance companies feel are not necessary.
Eye doctors don’t make much money on an examination, but they make a killing on lenses and frames. A friend of mine who used to work in one of these walk in eyeglass places told me that they bought things like those $200 frames for $40 or $50 dollars, then sold them to the public at the inflated prices. The guys who grind the lenses do not get paid much money above the normal range, but they place will charge you like $100 for lenses their crew made for $25. Coatings are extra, and they do not tell you that all coatings eventually wipe and wash off. Even the mirroring people like.
So, perhaps the insurance companies figure most of the charges are too inflated to cover. Medicare and Medicaid do not cover dental or optical either.
WELCOME TO AMERICA!!
Uh, this isn’t Ellis Island. It isn’t The BBQ Pit, either. So either keep this stuff to yourself or rant in the appropriate forum.
" Most emergency rooms will not pull an infected tooth
unless"
Where do you get this information? We went to one here & they referred us right away to a dentist on call & it was all covered by regular medical insurance. I’d like you to post a site for your quote…
but was it done in the ER, or did you just get referred at the ER?
Thank you, neurodoc.
I think we’re just beginning to understand the role between oral health and general health. I’ll add to the findings others have cited the fact that they think there may be a higher risk of premature birth among pregnant moms with gum diseases.
I think it’s an insult to dentists to suggest that doctors could easily assume a dentist’s role, or that gum disease can be fixed up by a scrip of penicillin. FWIW, my doctor DOES look in my mouth as part of my regular exam, and he said something to me when he could see I’d been neglecting my teeth. But it’s a dentist I needed to see. It’s not like dentists only go to school for a coupla months.
I’m sure my dental insurance is like others: completely separate from our health insurance. You can choose what level of coverage you have. The cheapest pays 100% on preventative care (two cleanings a year, xrays as needed) which is not peanuts. It’s a pretty good deal. But if you need something like a crown, they pay, say, $2 while you pay $248. That bites, but oh well. My health insurance goes to great lengths to describe what parts of my mouth are NOT covered, and what sorts of emergency oral procedures are covered. It ain’t much.
As for medicare, etc, maybe the dental lobby needs to get moving. Dental care among the poor is abysmal. The thing to remember with insurance is that most of us pay in the long run. If everyone’s dental got covered, we’d all be paying a lot more, as someone else noted. Or our employers would, which means something else has to give.
Everyone keeps saying that dental insurance is ridiculously expensive. Adding dental to my medical insurance only cost like $1.80 more a month! And its comprehensive, not just preventative (I had two $1400 procedures done and they paid $900 on each). Am I just lucky?