“The trouble with the rat race is that even if you win, you're still a rat." -- Lily Tomlin

Saturday, January 15, 2022

Oh, My Aching Tooth

     When I first went on Medicare I signed up for a dental insurance plan through AARP. It's called Delta Dental, and I'm sure some of you have it.

     I gave it up last year because the premium was going up, and it seemed like the coverage was very limited.

     Originally, my old dentist in New York gave me a discount because of the insurance. Then Delta Dental reimbursed the dentist for a portion of the bill, so I never had to pay more than $20 or $30 for a visit.

     When I moved to Pennsylvania the dentists in the Delta network all seemed like cut-rate operators. And I didn't want to end up in a Dollar Store for my dental work.

     A friend recommended a dentist who was supposed to be very good, but not in my plan. So that's where I went. It seemed like a thriving practice The office was modern, with all the latest technology. But I had to pay $200 to $300 for a regular visit, and Delta only reimbursed me a scant $40. That was bad enough. But then I needed to replace an old crown. The charge was $1600. Delta ended up paying about $200.

     I finally decided the insurance just wasn't worth it, especially since in addition to the deductible there was also a cap on the reimbursements. The maximum was $1000 a year. Anything beyond that, I was on my own.

     So I ditched my insurance. But maybe it wasn't such a great idea. Because a few months ago I had to have another crown replaced. Ouch. In more ways than one.

     I got the crown in, paid my $1600. But it wasn't right. I went back for an adjustment. Then another, and another.

     And yet another. This time the dentist brought in the endodondist to check to see if I needed a root canal. He banged on my tooth. He tried to freeze it. He took an x-ray. And he concluded I did not need a root canal.

     So why does my tooth still hurt? It doesn't hurt all the time, doesn't keep me awake at night. It only hurts when I try to chew on it. But isn't that kind of what a tooth is for?

     Now the dentist has recommended I get fitted for a night guard. He thinks I grind my teeth, and maybe that's causing the problem. Oh, and by the way, that's another $700.

     So I don't know. My friend still swears by this dentist. Linda at Thoughts from a Bag Lady in Waiting relates her story of traveling to Mexico to get her dental work done. She seemed pretty happy with the results. But she's from Arizona. I live a long way from Mexico.

     One of the items proposed in President Biden's so-called Build Back Better plan is to include dental work in Medicare. I think that would be a great idea. Don't you?

23 comments:

DJan said...

Yes, I do think we need some kind of plan to help us get better and less expensive dental care. My dentist's office offers an annual plan for $400 that covers two cleanings, x-rays once a year, and a 20% discount on major work. So far it seems like a good idea, since I haven't had much work done. I did have a tooth pulled last year, which was not fun, but the expense wasn't all that bad.

Anonymous said...

I have just been going through this myself. My wonderful dentist retired about 10 years ago and I've been wandering from practice to practice to try to find a permanent dentist. I began having some trouble with a bridge and suspected it would need work, so I undertook a thorough exploration of Medicare Advantage plans for my 2022 coverage. I had heard that everyone was having trouble finding a good dentist who took my 2021 insurance. I found that one of the big local insurers offers a $3,000 maximum on a broad list of dental procedures, while my previous insurer, who does offer coverage for routine exams and cavities, pays ZERO for bridges and crowns. I even called them to make sure I wasn't reading it wrong. Nope - no coverage for any extensive work. So I switched plans and made an appointment with a practice who has a good reputation. Met with them last week, so far, so good. When it comes time to sign up next year, it might be for you to go beyond the AARP insurance.
Nina

Miss Merry said...

My retired CPA friend who researched dental plans available in our area decided the same thing. You are better off paying for visits and dental work out of pocket than paying the premiums and deductibles and copays. But that is only for those who can afford it. I have other friends who are having save-able teeth pulled because they can't afford even routine dental care. Seniors do need to have dental and vision care included in basic Medicare.

JudyC said...

Tom, some years ago my dentist retired and I went to new one. Pretty soon she wanted to replace two adjacent upper crowns. After the replacement I had same trouble you are having. It hurt to bite on that side. She tried a few times to make adjustment then decided I needed a root canal. I changed dentists. My new dentist had me bite on that little paper that shows how the teeth meet. Then he barely touched the tooth directly below the new crown with his drill. He may have done it twice, I can't remember, but it was a tiny quick touch with the drill. It immediately felt better but still sort of sore. He said give it day or two and come back if it still hurts. I am guessing the nerve had to settle down a little after being abused, but that's just my guess. Anyway I have had no trouble or pain since then. I also have Delta but they have always paid very well... sometimes better than I expected. However I have had nothing but cleanings and x rays done in past 5 or so years. Maybe they have changed. Good luck on finding a solution.

ApacheDug said...

Tom, I'm sorry for your difficulties. I've had so much work done on mine, I feel like an old pro at this. First of all, I think most dental insurance are simply not worth it (at least for now). My dentist has something very similar to what DJan wrote about here, which I was going to do, until one of her hygienists told me about Denta-Card. I would google dentacard.com and see if your dentist (or one in your area) is on this network. It costs $85.00 a year and it's a pretty significant savings if your dentist accepts it (like mine). It's reduced many of my costs by half.

PS. I had a high-acrylic nightguard made in 2016, cost me $400.00. But they're indestructible and last a lifetime, most dentists happily adjust them if needed. Also, my dentist just told me 3 weeks ago that they have recently come down significantly in price, no one should pay more than $200 for one. I'm just telling you what she told me.. good luck sit.

Janette said...

In general the military gets the same “insurance” as Medicare. We, for the last twenty five years, have had ….. Delta dental. Build back better will probably offer the same. We find we really shop around for dentists when we move. We look for non invasive people- no whitening, crowns and bridges being last resorts. We plan on keeping our teeth for thirty more years :) We are in the discovery phase right now. Good luck to you.

Tom said...

Judy -- Thanks for sharing your experience. As far as how well Delta pays, it seems it all depends on whether the dentist is in network or not. Trouble is, the network is spotty. I had a good one in NY, but here in PA one is harder to find. Doug, I'm telling my dentist about your nightguard.

Linda Myers said...

Tom, you may well find that a flight from your home to Tucson, plus a car rental, plus all the dental care you need just across the border, will be less money than your local dentist. Plus, you'd get away from east coast winter weather for a few days!

Arkansas Patti said...

I have known others who swear by the Mexican dentists. Any insurance I ever had paid just a fraction of the costs so I dropped them.
Maybe a vacation to a border town is called for.

Tom said...

Linda -- The problem is: I might not come back!

Linda Myers said...

Patti, we have a sleeper sofa in Tucson you're welcome to use, and an extra car for your 1.5 hour trip to Nogales, Sonora, Mexico.

And Tom, that could happen. Many people where we live in the winter have homes elsewhere during the summer. It's turned out to be a great option for us.

Our Mexican dentist will bill our Delta Dental insurance for the amount a North American dentist would charge. Then we get the refund from the dentist.

For example, I needed an implant and a crown. I paid the Mexican dentist $1100 upfront for the implant and will pay $300 for the crown. The dentist billed my Delta Dental insurance for $2,500 and I'm getting a check for $713. Works for me!

Rian said...

Tom, I respect everyone's opinion here, but would not go across the border to have any work done (have heard some horror stories - one recently). But YES to some dental (and possibly hearing aid) coverage being added to Medicare! That would be great! We are in the process of looking for a new dentist that is in our Cigna insurance network. The dentist we have is very good, but not in our network and very expensive.

tahoegirl.blog said...

I agree that it's terrible to have to deal with this issue of dentists at this point in our lives. Why can't medicare cover dental and vision? We have Delta Dental of California and I'm not sure it's worth the premium. But at least our dental pratice we go to is in network and I think that makes a big difference. BTW, my husband is having a tooth pulled tomorrow. :(

Gail, northern California said...

I agree; but would go a step further to include vision and hearing aids under Medicare.

Have to go in for teeth cleaning next month. Will cost $265. (Northern California).

River said...

Read Judy C's comment and she speaks true. If any filling or crown is left just a tiny bit "high" it will cause the trouble you are feeling. Ask your dentist do do what her dentist did and get that adjusted, then you should be fine. I've been through the same thing.
Here in Australia, our Medicare, available to everyone from birth still does NOT cover dental, which is a crying shame.

Fred said...

While we would all like to see dental insurance added to Medicare, I don't see that happening anytime soon. Build Back Better appears to be DOA. The Democrats will be hard pressed to pass anything in 2022. If we lose the House or Senate Biden becomes a lame duck President. Then we get to see 2 years of total stalemate. If we do someday get dental insurance, it will be very modest. Think along the lines of $1000 to $1500 per year max.
I keep Dental insurance to at least get the dentist to honor the negotiated prices. Due to a health issue, it looks like I will always require extensive dental work. Some years ago, before I was 65, I asked the billing clerk at my dentist if they offered lower prices to seniors in exchange for cash payment. She laughed and said no and told me it looks like the seniors would subsidize everyone else. I never went back to that dentist.

Anonymous said...

I think the point is that Medicare specifically excludes most things that seniors need most: hearing aids, dental work, etc. That is not coincidental. Our elected officials, many of whom are seniors themselves, are privy to premium health insurance, including those things that they deliberately exclude for us. The question for me is: why do they continue to get elected????? Is it because they use distracting things that have no bearing on our lives to divide us and keep them in power? Think abortion/critical race theory (which isn't even a real thing)/the "woke left mob" (again, not a real thing and is reminiscent of "Volvo driving, latte drinking east coast liberals" of yore)/voter fraud (again, not a real thing). What IS a real thing is providing health insurance at its most basic level to those of us who worked hard for decades to keep this country running at its peak. And now in our "golden years" the younger generation has decided that the work we did is an impossible standard to live up to. And our elected officials have sold us down the river to the power of the lobbyists. Sorry for the rant.

Olga said...

I don't have dental insurance since when I retired the cost was more than I would have spent on two cleanings a year and the occasional x-rays. However, when I went to a new dentist in Florida, they gave me a consultation after free x-rays and then presented me with a $12,000 plan for dental work -- entirely cosmetic. I told them that I had lived my life with these teeth and since I wasn't considering a film career, I wasn't interested in their plan. So now I am noncompliant and can't even go there to get my teeth cleaned. That office also offered Botox injections.
I have also considered insurance a soulless, money-grubbing industry but now I think dentistry is joining them.

Tabor said...

I do not have advice for insurance as ours only covers 2 cleanings, one x-ray every year, and then some deductions on a very few expensive treatments. But I do think you may need to shop around for another dentist.

Jennifer (UnfoldAndBegin) said...

Not to be a pessimist but a nightguard isn't going to fix the pain that happens when you're chewing. If you're grinding your teeth at night, you'd have pain all the time. And you can buy a nightguard in a drugstore for much less than they will charge you if you want to check it out first before dropping a lot more cash--my own dentist told me to get a drugstore nightguard when I mentioned I was grinding my teeth.

Rebecca Olkowski said...

Honestly, I don't know why anyone would be against dental, hearing, and vision care in Build Back Better, especially for seniors no matter what party they are affiliated with.

I have also found some dentists to be money hungry and they will tell you that you have cavities or need a root canal when you do not. It's sickening. I had to change dentists because of that. Luckily, I sent my X-rays to my sister in law who is a dentist in another part of the state where I live and she told me I didn't need the work.

Arlene said...

Try Plackers Grind No More, available from Amazon.
I was shocked when my dentist showed me a picture of how ground down my teeth are. I had a night guard made by my former dentist ($500 in 2014), but it wasn't comfortable and I quit wearing it. The Plackers are a softer plastic, several to a pack for a few dollars. They are much more comfortable and, although sold as disposable, I use them for a long, long time, just cleaning every morning.
I also dropped Delta Dental--just not worth the money.
Arlene

Wisewebwoman said...

As seniors, we had free dental out here but it was all taken away as it was massively abused by all including the dentists. The plan was open to that. We proposed in our activist work that a card be issued with a prearranged amount to assist the impoverished seniors but it never happened. Teeth are such an important part of good health that dental should be included in any health care plan.

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