posted
Okay, I realize that actually having dental coverage puts me in a group that some here may aspire to join. But this has me really steamed and I need to vent.
I switched to Aura's insurance last year to save money. Now, being divorced, I'm not on her insurance anymore, so I switched back to the coverage offered by my MUCH smaller company. We get okay deals from our insurer, but not all that good.
We are in the majority in that our dental insurance has a waiting period before coverage of "major" things (like cavities, crowns and root canals). This is where they really get you. You pay for coverage, but can't really use it for a year. Unlike medical coverage, it doesn't matter that you've been continuously insured in the past. You have to wait the 90 days, 180 days... or, in my case a FULL YEAR before you are covered.
Now, the sick thing is that I'm paying the same premium as everyone else but they ARE covered because they had this same insurance last year and I didn't.
So, of course, I cracked a molar. I've got an appointment to get it fixed. I talked to the dentist's office and they said I can have a cheaper crown put in. They didn't offer this when they thought the insurance was paying, but now that I'm paying, they came up with a stainless steel crown and one visit instead of two.
That's nice.
So, in a way, I sort of see the insurance company's point. I wasn't paying THEM last year and now I wanted them to cover my darn cracked tooth. But on the other hand, I DID have insurance and it's just the luck of the draw that I cracked the tooth in January (after switching to the new coverage) rather than in December (when the prior coverage would've handled it).
So, I'm going to have a cheapo steel crown. It may not last more than 2 years, but that's okay because then my insurance will kick in and they can cover the replacement.
Then I'll get porcelain and they can pay for it.
Ugh.
Anyway, I know it's not as bad as being uninsured, but I really hate paying and not being covered.
We need national health care and dental care.
This penalty for being employed by a small company just sucks.
Posts: 22497 | Registered: Sep 2000
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posted
Actually though, they may not cover the replacement crown two years from now either, assuming that they operate the same way my current dental insurance company does. My wife had a crown crack, and had to have it replaced. The insurance company said that it wouldn't pay for replacement crowns that were younger than 7 years old.
Posts: 16059 | Registered: Aug 2000
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posted
You are seriously suggesting insurance froud? Or is there a missing word? Either way, it's cool with me.
Your insurance covers crowns? Mine will only pay for half. And nothing for braces and 80% for fillings, but they do pay 100% (after the deductible, of course) of routine cleanings, 2 a year.
Posts: 171 | Registered: Jun 2001
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posted
Well Bob, all of this really bites. I'd say that making you pay for insurance, but not actually providing it for an entire year could be thought of as the crowning indignity in this whole affair.
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Personally, Bob, I think you deserve...oh, I don't know, a trophy, or a plaque or something for your patience in dealing with this situation.
Hopefully in the near future congress will enact some legislation that will help us get to the root of this problem--and something that can help us bridge the gap between the insured and the uninsured as well.
Posts: 16059 | Registered: Aug 2000
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posted
Yeah! I'd hate to think that I'll have to enter into indentured servitude just to have a decent set of choppers.
Posts: 22497 | Registered: Sep 2000
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posted
Bob, have you considered something like Ameriplan?
It isn't dental insurance, it's more like huge group discounts. Like check-ups /cleanings for $40.00, etc. And it's only $20.00 a month to cover everyone in your household, including non-family members, and you are covered right away. You'd need to chech which dentists in your area take it, but it started in Texas so it should be widespread there.
It turned out to be a deal for me, because I needed a crown where an old filling was cracking. It was still expensive, but only about half so much as it would have been.
Posts: 9293 | Registered: Aug 2000
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I just bristle up at the thought of these insurance companies. Why, I could grind them to a paste! Posts: 1466 | Registered: Jan 2003
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You know, I'm fairly confident that if we just put our heads together, we can at least make a dentin this problem.
Posts: 16059 | Registered: Aug 2000
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posted
I had an annoyance with my Dental Insurance yesterday and now I'm not sure what I want to do about it.
I received a statement from my dentist for my last visit (in December), saying that I owed $42 (apparently for my x-rays). Now, for the last several years my insurance has paid for yearly x-rays and it had been more than a year since my last set. I called my dentist's office to ask them about the charges. They called the insurance company and then called me back. The insurance company apparently had changed their coverage so that they now only pay for x-rays every 3 years. I don't really mind paying my dentist, because it isn't that much money and I love my dentist. The confusing/annoying thing is that I was never notified that my coverage had changed.
Should I call my dental insurance company and request a new statement of coverage from them?
Posts: 5879 | Registered: Apr 2001
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posted
ludosti...yes, you should get a new statement of coverage. You could be missing all kinds of stuff.
Posts: 22497 | Registered: Sep 2000
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posted
I had a similar experience a couple of years ago, but when I went into the dentist for my appointment, the receptionist (who was also the dentist's wife) told me that she'd gotten pre-approval for the porcelain crown and all was well. I paid my 50% up front (and THAT was painful enough), but when I came in for the 2nd appointment and crown fitting, she read the letter from the insurance company again, and what do you know, I wasn't covered (because I'd been covered for less than a year). She suggested I take out a loan from Beneficial (at ONLY 18%) to cover the difference. I told her "I don't think so" and started paying $10 - $15 a month. They sent my account to a collection agency, where I am still paying $10 a month. I could afford more, but I'm too angry about the whole thing still.
posted
Bob, as an alternative to paying a couple of hundred bucks for a metal crown, you might try shopping around online. I've found you a site that might just have what you're looking for:
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And if the insurance company balked at paying for something else down the line, you'd be equipped to really chew them out.
Posts: 16059 | Registered: Aug 2000
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posted
[cracks fingers] step back. Here I come [/cracks fingers]
I almost missed this thread, and all of its Puns.
When I first read of Bob's poor insurance my jaw dropped. It hit the floor. If I were Bob I'd chew out the insurance company, fight them tooth and nail for my compensation. I'd bite them where it counts, in the wallet.
I'd get my teeth into whoever came up with that silly rule and really drill them for the reasons why. I'd make them open wide and cough up the dough for this procedure.
Or I'd be stealthy and sneak in a Molar spy of some kind to root out some way to braces my bank book against this expense.
Posts: 11895 | Registered: Apr 2002
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posted
Insurance companies apply the waiting periods because of people who would get on the dental plan just to take care of major dentistry and then drop it as soon as they get the problem fixed. Some employers offer plans that have reduced or no waiting periods but it costs more.
Posts: 134 | Registered: Jul 2003
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posted
I'd been trying to figure out how to get a "molar" related pun in there Dan, but I couldn't come up with one. That was great! I'm pretty much tooth puned out though, I'm afraid. I've been running through every dental term I can think of, and at this point I'm drawing a blank.
Okay, that one was weak. I've heard a friend of mine who is a dentist refer to generic crowns as blanks, but I have no idea if it's an official term or not.
Posts: 16059 | Registered: Aug 2000
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posted
Some of you seem much too attached to your teeth. You don't really need all the ones in the back, so unless it's one of the teeth that you can see when you smile, have it pulled. Sheesh. Instead of paying $600-800 for a root canal and $600-1300 for a crown, you can pay $65-120 to get the darn thing pulled.
Posts: 171 | Registered: Jun 2001
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1) If you pull a tooth, the ones on either side of it start to move slightly toward the gap. It's a domino effect and soon the entire Middle East is engulfed in bloody warfare.
2) Although I live in the South, I am intensely proud of the fact that I have a full set of teeth (minus wisdom teeth, alas). I could probably get away with not having teeth around here, but I guess I haven't assimilated quite that thoroughly yet.
3) I am an amateur whistler of some renown. I'm worried that my tone would be thrown off by a hollow spot along the tooth line. I just can't take that chance.
Posts: 22497 | Registered: Sep 2000
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