Health insurance doesn’t cover dental work, as if our mouth was not a part of our body. This madness started over 100 years ago. Few have dental insurance and that rarely covers much anyway. You have to self pay and that hurts! So dental visits and problems can get put off. Neglect can continue until expensive crowns, partial dentures, dentures, and implants are needed. Not surprisingly, many older low income Americans can’t afford it and have little or no teeth at all.
Medicare and health insurances end out paying for illnesses downstream in the body from gum infections and poor nutrition from poor chewing. Although this makes no sense, we have to deal with what craziness there is.
I was one who put off dental work. It cost me. I learned a lot. What I learned can help you save a lot of money. Here goes:
You need to know as much about dentists as you can.
You can get referrals from family and friends. If you need extensive work and their dentist only did a few fillings, this isn‘t much help. It could also be expensive if you don’t price shop.
You can and should price shop.
There are doctor and dentist rating web sites, but I found them disappointing. There is too little input. It’s easy to get a contractor’s rating on something like Angies‘s list, but not for a dentist or doctor. Improvement in this area is needed. You can try dentist rating web sites. Whatever you learn can help.
On the internet, you can use a search engine like Google to look up a dentist’s dental school, how long he or she has been practicing, credentials and specialized training.
There is a wide variation in the prices for services among dentists. I priced Crowns in my area from a low of $640 to a high of $1400 and even higher. There is a wide difference in the types of crowns. The cheaper crowns are usually adequate. Of course there are higher quality crowns with better durability and longer average lifetime.
You should get the ADA numbers for each item and procedure from each dentist so you can compare estimates accurately. You can get ADA numbers from the American Dental Association web site and from the dentists. Get these in writing and ask about written warantees.
You should be aware that “silver” fillings are really about half mercury. This element is highly poisonous. It would be playing it safe to get the amalgam fillings even if it costs more.
Here are your options for the lowest cost for dental care:
1. There are dental discount chains that have many offices. They hire dentists who work for a salary.
2. Dental Insurance may be ok for routine preventive care if you have it at all, but not so for the big ticket items. Even the best dental insurances have limited coverage of less than $2,000 per year. They don’t cover preexisting conditions. If you have a substantial bill, you will pay for most of it yourself. Someone has to pay for the dental insurance premiums too. You are lucky if your employer pays for them.
3. There is some hoopla about dental tourism. You have to need a lot of work to consider this. The cost of going to a country like Costa Rica can cost thousands of dollars for visits that can extend for weeks to over a month. There can also be needed return trips.
If you can enjoy the trip as a vacation, then your costs don’t have to be considered part of your dental bill and you may save money. If you really don’t want to go to another country then there may be no savings from this after deducting the airfare and motels.
With this option, you have the same problems rating dentists and price variation. Not every country has the same standards as we do here. You must check out your health insurance or Medicare coverage in a foreign country.
Problems that can crop up later with the dentist can be complicated living so far away. If you make reservations and have to cancel, you could take losses.
My own limited experience with dental tourism was finding a lot of web sites that were no longer functioning. When I did find functioning ones, I found the dental charges were about the same for the low end of the scale that I could find locally. So there was no incentive at all.
4. There are dental plans, not insurance. They give you a list of dentists who agreed to a list of prices for dental services. You can join for about $100 a year and work with one of these dentists or a chain that is participating.
My experience with a plan was not perfect, but good. On the Web site, I found a price of $440 per ADA 2750 crown. No plan dentist honored that price . In the fine print from the plan it said that “lab fees” were extra. This raised the crown from $440 to $648 and higher. That’s the bad news. The good news is the $648 was still the best price for that crown in my area
Other items like a “tooth build up” for crowns were in line with those posted for the plan. This is another add on that happens with or without a plan.
Here are two real learning experiences I had with plans and plan dentists.
With one dentist, I was shown a printout estimate for one option for extensive work for $23,000. Then the dental assistant noticed the plan discount had not been applied. A computer recomputation came to $17,000! The plan cut $6,000 off that bill!
Before I knew about plans I got an estimate from a plan dentist. His price per ADA 2750 crown was not too high at $700. After I joined a plan. I mentioned my plan membership to his assistants and got $105 taken off to $595 per crown estimate. There were other price cuts from the plan.
Strange but true, some dentists have plan brochures in the waiting room, but charge higher prices than the plan. It’s up to you to find and join the plan and get the plan prices!
5. If you live in a high cost of living area with high dental prices, you might try shopping around within the U.S. for domestic dental tourism. If your area is a high cost of living area like California or Long Island/New York City, do a national search for specific areas known for lower costs of living .
The dental plans offer prices by zip code on their web sites. I found a $400 spread for ADA 2750 crowns between high cost of living areas like California and Long Island/ New York City and lower cost of living areas like Florida. It didn’t help me much since I already live in Florida.
6. Some dental schools offer discounts for work done by trainee dentists.
7. I needed extensive dental work and got five opinions and estimates. This was very stressful as there were substantial differences of opinion along with price. At one extreme a dentist said to have all my teeth removed and have dentures. On the other extreme was as little as three teeth removed and nine crowns with a bridge. In the middle was a partial denture and a number of crowns. Since three were on the end for only about 3 teeth removed, I took that as an average of opinions. I think the dentist who wanted to pull all my teeth was nuts. Time will tell who was right.
So you should get a number of opinions and estimates. I economized on that by going to some dentists who offered free consultations and paid for others.
If we ever get our act together for American healthcare, dental care will be included. For the foreseeable future, you are on your own.
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