But it looks as if my dentist (or my dental insurance company) assumes I am.
I am learning the very very hard way that for the most part, dental insurance is a joke. I will be paying anywhere from $3,000 to $5,000+ out-of-pocket over the next however long for dental work. That includes 3 crowns, 1 root canal, 2 fillings, gum graft surgery, gum surgery around my back lower molars, and removal of 2 wisdom teeth. Crowns are supposedly covered at 50% by my insurance, but somehow it ends up that only about 25% of a $950 crown gets covered (so if you are doing the math, that is over $2,000 out of pocket right there for 3 crowns). My root canal was supposed to be covered at 80%, however that is only 80% of what the insurance company deems appropriate, which is of course lower than what is actually charged, so I paid 20%, plus the difference between what my insurance thinks is a fair price and what the price actually was. Insurance will only pay $1,500 a year for any and all dental work, and there is not an out-of-pocket maximum. I had thought for a while that if an oral surgeon (MD) did my wisdom teeth and maybe my gum surgery that maybe it would be considered medical, but I think I just found out that isn't the case. I read that anything relating to gums, teeth, and the jawbones not related to an accident will not be covered by medical insurance. Awesome.
The funny thing is I never had a single cavity until just 7 years ago. You'd think I have slept with sugar sitting in my mouth for the last year for the amount of stuff that is all of a sudden going wrong. The needed crowns are all for teeth that have previously had fillings. I'm not sure how that happens, but I guess I am proving that it can easily happen. Apparently after a while some people are just predisposed to this stuff and I will have to be on prescription toothpaste and mouthwash for the rest of my life. My question is if this much happened in a year, what is to come in the next few years, or decades? Would it be cheaper to just get dentures at the ripe old age of 28?
I shelled out $500 Monday for part of my first crown, $300 yesterday for the root canal, will shell out at least $200 more next week, then over $1,000 the first week of February for round 2. After that there is still round 3, two gum surgeries, and wisdom teeth. The gum surgery and wisdom teeth will both mostly likely require sedation - i.e. $$$$$$$$$$$$$$$$. GEES.
$5,000. Seriously. I could think of soooooooooooo many ways to better spend that money. It could be used towards a down payment for a new car or house, for a trip to climb Mt. Kilamanjaro, for a new road bike (or 3), for 9 ironman race entry fees, for a new mountain bike (since my $350 one I bought 7 years ago will now take nearly $400 to fix...another fun part of my week...obviously I'm going to go without that repair), for several trips to see friends, family, or new places, to help other people who are less fortunate, etc. You get the idea. $5,000 for teeth was no where in my budget for this year (actually not for the next 10 years to be honest).
I feel guilty or not right when I look at all the AWESOME Christmas presents I received from my friends and family. I think it would have been more financially appropriate for me to have the money for my teeth instead of these material things, but then again I couldn't have exactly asked everyone to give me tooth money instead of gifts (but that does not mean I won't be asking for tooth money for my birthday...start saving now, you all have 1.5 months). I also spent quite a bit of money on presents for other people - but that is usual and something I enjoy doing. I don't think it would have been totally right for me to say "well, you aren't getting a present this year because I have to fix my teeth." I guess I'm experiencing a touch of what some people have to go through every day - weighing every penny they spend and deciding between needs and wants, and even having to choose certain needs over others. We will hopefully get some sort of bonus in February, but working in the real estate industry has not been exactly profitable over the past few years. If anything, I may have to sell some of my stock come February, but I really am not excited about that either - that is meant to be there for the long haul, not to be taken out every time I need something.
Jon complained when I was saving for my bike last fall that he'd never seen my refrigerator that empty. I think it is about to be pretty darn empty again. I do realize I am still very fortunate that I have insurance at all, that I have a job, that I have a roof over my head, etc. I have the ability to pay for all of this, but it just it not what I had planned for, and is not exactly fun.
I'm really hoping 2010 starts better than 2009 has ended. I have had more shots of lidocaine in the past week than most people have in several years. I'm sick of needles, especially in places like my mouth and toes. Also my poor Grandmother fell before Christmas and had a huge hole in her shin and fell again yesterday morning, on Mom's birthday, and was taken to the hospital. She has a bad cut on her face this time around and they think the thing on her shin may be infected. Mom got to drive back to Waco from Beaumont yesterday (about the most boring 5 hour drive there is) for the third time in about as many weeks (after just getting back from there Sunday) to help her out. And my toes are gross. Really gross. Still oozing and hurting more now than they have before.
Overall, 2009 was absolutely awesome, its just that these last few days of the year haven't been so great.
I am learning the very very hard way that for the most part, dental insurance is a joke. I will be paying anywhere from $3,000 to $5,000+ out-of-pocket over the next however long for dental work. That includes 3 crowns, 1 root canal, 2 fillings, gum graft surgery, gum surgery around my back lower molars, and removal of 2 wisdom teeth. Crowns are supposedly covered at 50% by my insurance, but somehow it ends up that only about 25% of a $950 crown gets covered (so if you are doing the math, that is over $2,000 out of pocket right there for 3 crowns). My root canal was supposed to be covered at 80%, however that is only 80% of what the insurance company deems appropriate, which is of course lower than what is actually charged, so I paid 20%, plus the difference between what my insurance thinks is a fair price and what the price actually was. Insurance will only pay $1,500 a year for any and all dental work, and there is not an out-of-pocket maximum. I had thought for a while that if an oral surgeon (MD) did my wisdom teeth and maybe my gum surgery that maybe it would be considered medical, but I think I just found out that isn't the case. I read that anything relating to gums, teeth, and the jawbones not related to an accident will not be covered by medical insurance. Awesome.
The funny thing is I never had a single cavity until just 7 years ago. You'd think I have slept with sugar sitting in my mouth for the last year for the amount of stuff that is all of a sudden going wrong. The needed crowns are all for teeth that have previously had fillings. I'm not sure how that happens, but I guess I am proving that it can easily happen. Apparently after a while some people are just predisposed to this stuff and I will have to be on prescription toothpaste and mouthwash for the rest of my life. My question is if this much happened in a year, what is to come in the next few years, or decades? Would it be cheaper to just get dentures at the ripe old age of 28?
I shelled out $500 Monday for part of my first crown, $300 yesterday for the root canal, will shell out at least $200 more next week, then over $1,000 the first week of February for round 2. After that there is still round 3, two gum surgeries, and wisdom teeth. The gum surgery and wisdom teeth will both mostly likely require sedation - i.e. $$$$$$$$$$$$$$$$. GEES.
$5,000. Seriously. I could think of soooooooooooo many ways to better spend that money. It could be used towards a down payment for a new car or house, for a trip to climb Mt. Kilamanjaro, for a new road bike (or 3), for 9 ironman race entry fees, for a new mountain bike (since my $350 one I bought 7 years ago will now take nearly $400 to fix...another fun part of my week...obviously I'm going to go without that repair), for several trips to see friends, family, or new places, to help other people who are less fortunate, etc. You get the idea. $5,000 for teeth was no where in my budget for this year (actually not for the next 10 years to be honest).
I feel guilty or not right when I look at all the AWESOME Christmas presents I received from my friends and family. I think it would have been more financially appropriate for me to have the money for my teeth instead of these material things, but then again I couldn't have exactly asked everyone to give me tooth money instead of gifts (but that does not mean I won't be asking for tooth money for my birthday...start saving now, you all have 1.5 months). I also spent quite a bit of money on presents for other people - but that is usual and something I enjoy doing. I don't think it would have been totally right for me to say "well, you aren't getting a present this year because I have to fix my teeth." I guess I'm experiencing a touch of what some people have to go through every day - weighing every penny they spend and deciding between needs and wants, and even having to choose certain needs over others. We will hopefully get some sort of bonus in February, but working in the real estate industry has not been exactly profitable over the past few years. If anything, I may have to sell some of my stock come February, but I really am not excited about that either - that is meant to be there for the long haul, not to be taken out every time I need something.
Jon complained when I was saving for my bike last fall that he'd never seen my refrigerator that empty. I think it is about to be pretty darn empty again. I do realize I am still very fortunate that I have insurance at all, that I have a job, that I have a roof over my head, etc. I have the ability to pay for all of this, but it just it not what I had planned for, and is not exactly fun.
I'm really hoping 2010 starts better than 2009 has ended. I have had more shots of lidocaine in the past week than most people have in several years. I'm sick of needles, especially in places like my mouth and toes. Also my poor Grandmother fell before Christmas and had a huge hole in her shin and fell again yesterday morning, on Mom's birthday, and was taken to the hospital. She has a bad cut on her face this time around and they think the thing on her shin may be infected. Mom got to drive back to Waco from Beaumont yesterday (about the most boring 5 hour drive there is) for the third time in about as many weeks (after just getting back from there Sunday) to help her out. And my toes are gross. Really gross. Still oozing and hurting more now than they have before.
Overall, 2009 was absolutely awesome, its just that these last few days of the year haven't been so great.
Comments
That just stinks!
try having your oral surgeon resubmitting using different codes (or you can submit directly to your medical insurance for reumbursement)...What I mean is this. I recently shelled out alot of money to visit a specialist about my jaw. He provided me with a receipt using major medical codes instead of the dental codes. Even though my medical insurance also includes the no dental except accident clause, they paid the 60% (since it was out of network).
good thinags and fast times on 2010
hope you are able to come out