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Old 09-17-2012, 09:35 AM
 
Location: Colorado Plateau
1,133 posts, read 3,169,371 times
Reputation: 1226

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My company is switching to a new insurance plan so I am exploring whether it might be worth it to me to take the dental ins for the gum graft work I have planned. I've had a consultation with the periodontist and the quote for 4 teeth (over two areas) is $2100.

So far the info I've seen on the dental plan (Cigna) is that they cover procedures like that 50%, which is pretty standard. $1200 max per year. But I'd have to get it preapproved, which could take the ins co 3-4 weeks to do. Not sure on the success rate of approval of procedures like this. Periodonist does not offer any discounts for self-pay (I asked).

I have the money to pay for this, so I'm not totally averse to paying for it all myself. So I'm trying to decide if the hassle of dealing with the ins co is worth it to save maybe a few hundred bucks.

My dentist, where I got a cleaning/exam a couple months ago, would like to do a root canal (my first!) and new crown on one of my teeth maybe next year. $1400 for that. The tooth is not bothersome, but I have a large filling in it that he's concerned about.

For what I've put into my teeth in my lifetime, braces at 18 (in 1987) I payed for myself ($3000) and two bridges after that ($1000 each), I've gotten good deals so even if I pay out of pocket for all of this I've still gotten off pretty good, I think.
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Old 09-17-2012, 03:01 PM
 
Location: Colorado Plateau
1,133 posts, read 3,169,371 times
Reputation: 1226
Update: I just found out that the dental plan is $60/mo. More than I want to pay. Especially since the HI plan just went up by $50/mo.

I'm going to look into a FSA that my company offers to see if that offers any help.
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Old 05-22-2018, 08:38 AM
 
442 posts, read 564,145 times
Reputation: 926
Quote:
Originally Posted by eofelis View Post
My company is switching to a new insurance plan so I am exploring whether it might be worth it to me to take the dental ins for the gum graft work I have planned. I've had a consultation with the periodontist and the quote for 4 teeth (over two areas) is $2100.

So far the info I've seen on the dental plan (Cigna) is that they cover procedures like that 50%, which is pretty standard. $1200 max per year. But I'd have to get it preapproved, which could take the ins co 3-4 weeks to do......

I have the money to pay for this, so I'm not totally averse to paying for it all myself. So I'm trying to decide if the hassle of dealing with the ins co is worth it to save maybe a few hundred bucks.

My dentist, where I got a cleaning/exam a couple months ago, would like to do a root canal (my first!) and new crown on one of my teeth maybe next year. $1400 for that. The tooth is not bothersome, but I have a large filling in it that he's concerned about.
I'm curious about this dentist who: "would like to do a root canal and new crown on one of my teeth", for a "tooth that is not bothersome". I've never had a preemptive root canal--isn't that usually done when a tooth is broken, or has such a bad cavity that it's become infected?-- (the 2 root canals that I've had).

I'm also struggling with whether or not to get dental insurance--probably Delta Dental. This would be me paying individually. Their plans are from $40 to $104 per month. I definitely need one crown, maybe two, & have another tooth with fillings that fell out. There are waiting periods before I could have that done. As I understand it, one of the advantages is that if I go to an "in-network" dentist--they have to charge less to patients with that ins.

I'm also in New England--about an hour from Boston--& I've learned from this forum that dentist prices here can be almost 2x what they are in other areas (& I've called a lot of dentists around here to get prices on work I need). I recently spent about $2200, all in, for a root canal, & then a "core". Both the endodontist, & the dentist, seemed terrific, great office staffs, I've been to a lot of dentists & I felt like I was in good hands. The crown would be $1370.

I really like that dentist. Calling around to 4-5 other dentists, they were all around the same price for a crown. To be honest, I can afford it. The only dental ins. that dentist that did the core takes is Delta Dental Premium at $104/month, & a 6 month wait for crowns, & a $2000 yearly cap. Oh, & the 6 month wait would put me into......January, in NH, to be trying to go to the dentist, in maybe a blizzard.

Maybe it's a wash? And I should just pay out of pocket? There's a risk that this recent molar with the root canal, & then the "core", is more prone to breakage w/o the crown. It's all making me a little crazy right now. And like I said, that dentist, & his office, they have great reviews on Yelp, & even the 2 people people answering the phone seem very knowledgeable & nice. Besides telling me how crazy these prices sound to people in cheaper parts of the country, does anyone have any sage advice?

cheers, Woody
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Old 05-22-2018, 09:00 AM
 
531 posts, read 274,091 times
Reputation: 822
Quote:
Originally Posted by WoodyWW View Post
As I understand it, one of the advantages is that if I go to an "in-network" dentist--they have to charge less to patients with that ins.
Be sure to check your insurance plan about which specific procedure codes are considered to be "covered", and then check your state insurance laws. In recent years, many states have passed laws that allow dentists to charge their private fees - even if they are "in-network" with your insurance - if the procedure is not a covered benefit.
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Old 05-22-2018, 11:54 PM
 
Location: la la land
26,935 posts, read 11,259,968 times
Reputation: 19187
Quote:
Originally Posted by WoodyWW View Post
I'm curious about this dentist who: "would like to do a root canal and new crown on one of my teeth", for a "tooth that is not bothersome". I've never had a preemptive root canal--isn't that usually done when a tooth is broken, or has such a bad cavity that it's become infected?-- (the 2 root canals that I've had).

I'm also struggling with whether or not to get dental insurance--probably Delta Dental. This would be me paying individually. Their plans are from $40 to $104 per month. I definitely need one crown, maybe two, & have another tooth with fillings that fell out. There are waiting periods before I could have that done. As I understand it, one of the advantages is that if I go to an "in-network" dentist--they have to charge less to patients with that ins.

I'm also in New England--about an hour from Boston--& I've learned from this forum that dentist prices here can be almost 2x what they are in other areas (& I've called a lot of dentists around here to get prices on work I need). I recently spent about $2200, all in, for a root canal, & then a "core". Both the endodontist, & the dentist, seemed terrific, great office staffs, I've been to a lot of dentists & I felt like I was in good hands. The crown would be $1370.

I really like that dentist. Calling around to 4-5 other dentists, they were all around the same price for a crown. To be honest, I can afford it. The only dental ins. that dentist that did the core takes is Delta Dental Premium at $104/month, & a 6 month wait for crowns, & a $2000 yearly cap. Oh, & the 6 month wait would put me into......January, in NH, to be trying to go to the dentist, in maybe a blizzard.

Maybe it's a wash? And I should just pay out of pocket? There's a risk that this recent molar with the root canal, & then the "core", is more prone to breakage w/o the crown. It's all making me a little crazy right now. And like I said, that dentist, & his office, they have great reviews on Yelp, & even the 2 people people answering the phone seem very knowledgeable & nice. Besides telling me how crazy these prices sound to people in cheaper parts of the country, does anyone have any sage advice?

cheers, Woody
Check with your dentist and see if they will take Denali & Spirit. I asked my dentist and he wasn't familiar with them but he had his office assistant get the info and he signed on as a preferred provider. The insurance isn't cheap but if you have a need a lot of work you can get a policy from each of them, major work is covered from the effective date of the policy. The first year Spirit pays 25% and Denali pays 30% for a total of 55%. I had a lot of work done and cancelled one of the plans when I was done but kept the other, it now pays 50% and in January it will pay 65%
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Old 05-23-2018, 06:35 AM
 
1,340 posts, read 1,311,079 times
Reputation: 1873
Quote:
Originally Posted by WoodyWW View Post
I'm curious about this dentist who: "would like to do a root canal and new crown on one of my teeth", for a "tooth that is not bothersome". I've never had a preemptive root canal--isn't that usually done when a tooth is broken, or has such a bad cavity that it's become infected?-- (the 2 root canals that I've had).
Similarly, you should not treat your high blood pressure until you've had your first heart attack. It's just the drug companies trying to milk money from you to treat "high" blood pressure when it doesn't even hurt.
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Old 05-24-2018, 02:31 PM
 
442 posts, read 564,145 times
Reputation: 926
Quote:
Originally Posted by toofache32 View Post
Similarly, you should not treat your high blood pressure until you've had your first heart attack. It's just the drug companies trying to milk money from you to treat "high" blood pressure when it doesn't even hurt.
That's a ridiculous comparison. High BP is treated with medications (& lifestyle, etc.). A root canal is a semi-major medical procedure. Do YOU know if that poster needs a "preemptive" root canal? I don't, & I've never heard of that. I just questioned it, there are some dentists that will try to "sell you" on anything........
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Old 05-24-2018, 02:40 PM
 
Location: la la land
26,935 posts, read 11,259,968 times
Reputation: 19187
Quote:
Originally Posted by WoodyWW View Post
That's a ridiculous comparison. High BP is treated with medications (& lifestyle, etc.). A root canal is a semi-major medical procedure. Do YOU know if that poster needs a "preemptive" root canal? I don't, & I've never heard of that. I just questioned it, there are some dentists that will try to "sell you" on anything........
A root canal is NOT a semi-major medical procedure! And it's preemptive if it keeps you from losing the tooth because an abscess went untreated for too long.

Yes, there are some crappy dentists out there but there are also some excellent ones. Do some due diligence, read reviews and ask your friends and family members who their dentist is and you won't have to deal with bad dentists.
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Old 05-24-2018, 06:16 PM
 
1,340 posts, read 1,311,079 times
Reputation: 1873
Quote:
Originally Posted by WoodyWW View Post
That's a ridiculous comparison. High BP is treated with medications (& lifestyle, etc.). A root canal is a semi-major medical procedure. Do YOU know if that poster needs a "preemptive" root canal? I don't, & I've never heard of that. I just questioned it, there are some dentists that will try to "sell you" on anything........

I don't know anything about this poster's tooth. But there is no such thing as a "pre-emptive" root canal. There are many cases where a periapical radiolucency is developing without pain because it grows so slowly. This is an infection destroying the bone. This is not pre-emptive. The pathology is already there, it just doesn't hurt yet. Kinda like high blood pressure doesn't hurt until you have your first heart attack. It's actually a great comparison.
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Old 06-18-2018, 08:09 AM
 
38 posts, read 15,968 times
Reputation: 22
One problem with individual dental insurance, especially those with bad dental genes and/or habits, is the insurance companies are very smart to people knowing they have a dental problem, they sign up for the dental insurance just before their dental appointment, and hoping insurance will pay. To deal with this, the companies either have waiting periods of 6 to 18 months for other than preventive benefits or reduced benefits for calendar year 1 of coverage. The waiting period can sometimes be waived if you had continuous dental coverage for 12 months before.

In researching individual dental insurance recently, two plans generally available nationwide, with $2000 annual caps to consider, with large networks of dentists and specialists. Both of these companies are focused on dental and not major medical, so they are not challenged like companies also offering health medical insurance.

1. Ameritas https://www.securitylife.com/persona...hkVision=False Then click on View Details for Advantage Plus Network (2nd one listed). This one has lower percentage coverage initially, but increases after the first year.

2. Delta Dental Premium plan https://www.deltadentalcoversme.com/s/ AND https://www2.deltadentalcoversme.com...%20001.000.pdf (note PDF is for Virginia, go to 1st URL to get PDF of policy for your state if different. More expensive, but three exams and cleanings a year included. Waiting period for some procedures, but waived if had 12 months of continuous dental coverage with another carrier (see page 11 of PDF).
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