I just got back from a periodontist’s office and was quoted about $15,000 for necessary work. I will need an extraction, bone graft, another surgery to bring my gum level down, two implants, and two final crowns. On top of this I also need Invisalign as my teeth have shifted over the years and once you get implants, they cannot be moved.
I would be happy to pay for the orthodontia at around $5,000 (that is to be somewhat expected), but I am not exactly sure how to cover the other $15,000 in major dental work. Am I supposed to just suck it up and pay for this out of pocket? The periodontist says all funds are due at the time of the procedures. I can throw it all on a credit card, but their office does not offer payment plans. I called a few others in my area and this is apparently pretty standard.
I am self employed and figured I would just buy the best possible dental PPO insurance plan I could find. Little did I know they are all terrible. I can’t believe California dental plans still have $1,500 annual / lifetime maximums. These are the same maximum amounts these plans had 40 years ago when dental insurance was created! No increases for inflation? I am realizing that if you live in America, you are basically fucked here when you are in a situation like mine. It looks like if you need major work like myself, nice teeth are only available to the top 1-2% of wage earners which is tragic.
I would be happy to purchase ANY type of insurance to cover some of this, but once you subtract the premiums from the annual maximums, you are left with very little benefit overall. How is it possible that we allow the insurance industry to be run this way? I don’t get it. ANY advice is appreciated here. My periodontist says they are only in-network with Delta Dental and their plans for individuals like myself are severely lacking as mentioned above. Is there any sort of coverage I can get to cover this work or am I basically screwed here?
Yep. Dental insurance is a scam. Best you can do is get the work done in December/January, so you use the limits of both years. My dentist did this when I needed some major work and it helped.
This is why there is a very big dental tourism industry in Mexico and over seas as you can get the dental work for a very big discount right over the border in Mexico. And a lot of the dentist there study in the US then go back to practice.
Shop around. I needed lots of dental work maybe 10 years ago and found a “nice” dentist office and was quoted an insane amount. Then I went to a not so nice area a strip mall type of dentist and he was awesome! I maybe paid around 2k over about 6 months getting everything done.
I could have dental insurance, but it sucks. Pretty much all they cover is cleanings and cavities. A cleaning costs me $150 twice a year, or $300 a year. The cost of the insurance is $20 per pay period. $20 x 26 weeks is $520. Cheaper to just pay out of pocket and forego the insurance. Haven’t had any cavities in years.
Look at los algodones Mexico. Accross from Yuma az/Whitehaven vs. 600 dentists serving the tronational dental tourism market. Close to the university baja California dental school.
I did medical tourism to Costa Rica
Had a great experience
Look into a dentist in a different country. Even with a flight it will be a lot cheaper.
As sad as it sounds, I’ve heard stories of people that live in California going to Tijuana for dental work. The drive and/or stay plus the dental work there ends up costing a lot less than what you would pay in California.
The overwhelming majority of what is sold as dental and vision “insurance” in America isn’t insurance at all, merely a dental and/or vision discount product. Even healthy, non-cosmetically altered adult teeth –> luxury bones. And you’re correct in your observation that you’re rarely if ever more than 10-15% “better off” after you’ve paid the premiums given the reimbursement exclusions and limitations of the products. Necessary, orthodontia for children is really the only valid excuse these products have for their continued existence.
Whether you realize it or not, you’re actually in a better financing position for non-urgent/non-emergency health care with the vendor *not* running its own payment arrangement agreement scheme because health care vendors, neither medical, mental, nor dental, are regulated as credit-granting entities.
Look into health care-specific financiers like Care Credit and such. Any financing scheme regulated as credit-granting, whether that’s your card issuer, your bank, or an industry-specific one, is a far better alternative than the vendor’s back office.
Go to another country where dental is much cheaper, even with a flight and hotel you will come out way under the cost in the USA. If you are in California, Mexico is a good option, if you are willing to go further, Philippines and Thailand are great, I live in Philippines and have experience with Thailand as well and they are both so much cheaper.
it’s not insurance. it’s a service plan. at best. same with eyes.
Dentists hate insurance too. They haven’t upped their reimbursements for 30 years. You’re absolutely right, they haven’t kept with inflation although all dental materials expense has risen ten fold. It’s not true insurance, it is more or less a coupon. I certainly would not go to Mexico to get work done, I’ve had to fix a lot of those patients’ issues from doing that…
I’m sorry to say but you will have to pay for this. Dental insurance doesn’t really pay for anything anyway.
We had no dental insurance when my husband got a crown. It was $600. Shortly there after we got dental insurance and I needed a crown and it was $600 after insurance.
Same with the doctor. A doctor visit cost me $75 without insurance. It cost me 65 with insurance.
> I am not exactly sure how to cover the other $15,000 in major dental work. Am I supposed to just suck it up and pay for this out of pocket? The periodontist says all funds are due at the time of the procedures
FYI, the procedures you are talking about will take over well over a year from start to finish, so you don’t have to have the full $15k up front.
You will pay for the extraction and bone graft, heal for 6 months, pay for the implant, heal for 3 months, pay for the crown, etc. Your other surgery will add more time.
The fact that we need separate insurance for eyes and teeth is ridiculous.
Health insurance in general is a dumpster fire in the USA.
Most Americans don’t need more than $1.5k a year in dental coverage. I’ve never even spent more than $1k. And generally the premiums are comparably low.
Simply signing up for dental insurance because you suddenly need dental work is part of the reason healthcare insurance costs are so high. The main reason is healthcare in general is extremely expensive. That dental equipment ain’t cheap. Get and maintain dental/healthcare coverage going forward so you’re not in this position again. You think dental care is expensive, wait until you’re in the hospital for 3 or 4 days. 40% of Americans get cancer and cancer treatment can cost hundreds of thousands of dollars.
Your best bet is to literally call every dentist in your area and explain you desperately need care but can’t afford $15k. Most dentists run their own practice, you’ll find a sympathetic one eventually. If not, expand out and literally call every dentist as far as you’re willing to travel.
Another option is to call any surrounding colleges with a dental school. They typically offer far less expensive treatment but they will often be dental students supervised by a dentist.
Other than that, there’s not a lot of options. Any healthcare treatment is outrageously expensive and it won’t change anytime soon. The Obama Admin tried to address some of this but was met with fierce resistance. Outside of a political miracle in your lifetime, it’s not changing.
Never go to a dentist that has his/her own building. The best pricing is at dentists who have an office in a commercial building and does not have an entire private office building dedicated to the practice. Shop around.
The bone grafts should be medical… the other stuff isnt
Do you really need all that work?
What if you skip the perio and just do the extractions and crowns at a regular dentist?
I have heard perio is scammy in itself.
Usually all of these issues don’t arise at the same time, with bi-annual cleanings and exams. That’s how the system is sort of structured.
In your case, get separate opinions from at least one other unrelated dental professional. Then begin doing the work in order of priority. Whatever is most urgent to save your teeth or gums comes first. Go someplace in network, you will still benefit from discounts even after exceeding the annual max.
So you waited until you were slapped with a $15000 bill to buy? Yeah….you dont see the reason insurance always seems like it is too expensive?
And it’s a “scam” because of people like you.
You’re not using it as insurance, you want it to be “free” money.
There is no pool of folks with varying dental needs, it’s all folks who want/need thousands/tens of thousands of dollars worth of work.
​
I would get a second / third opinion.
dental insurance isn’t meant to be insurance in the traditional sense. meant to cover annual visits and some minor stuff.
​
everyone knows people drink soda and all kinds of sugary drinks and eat junk food and will get all kinds of dental issues and no one is going to cover that.
​
get another opinion since some dentists will scam you into unnecessary work to make money. chances are you did this to yourself
Weird I came across this – I literally just got off the phone with dental insurance.
Made the mistake of getting Delta DPO. I wanted to check my bill, and just spent almost an hour just trying to get signed in, even with their support person on the phone we couldn’t get it to work. I finally get signed in (figured out a workaround on my own) and see that for the initial dental exam I just had they won’t cover most of the procedures, so I’m apparently on the hook for $500, just for an initial exam!
I want to put my fist through something right now.
From what I’ve seen, from an employee point of view, Dental insurance is rather cheap, so that probably accounts for the low limits some. I pay ~$173/year for my Delta Dental plan… not sure what it’s running my employer, but I would assume they’re pretty cheap plans. I don’t think our cost has increased much (if at all) in the last four years either…
If you fancy a vacation in India, you may come out cheaper than Mexico as well. Mexico will be quick in and out though comparatively as its much closer and you can go for follow up treatment as well. Medical tourism is the thing.
Since you are in Cali, go to Mexico. I’m having work done in Nogales. The office I go to looks like an American dental office when you walk inside. They have all the newest equipment and they do great work.
As others have suggested, going to another country might be your best bet. A friend of mine goes down to Costa Rica for her work – she also had to have a bone graft and implants. I’m not sure how much it cost her, but no where near 15k.
Have you considered Mexico? I guarantee it will be half the cost.
Is that $15,000 the price after insurance negotiations?
I was quoted $3000 for some work a few years ago. I submitted the estimate to my insurance company and they sent a mock EOB that showed what I would actually be charged based on their negotiated rates.
[deleted]
With $15,000 you could probably have a luxury life in Mexico while still getting your work done.
My friend’s mom used to go to Mexico to get dental work done and would travel each time and still was cheaper than out of pocket here in the US.
I’m not suggesting you do this, just sympathizing with the insane prices of dental care here. A friend of mine needed extensive dental work and it was cheaper for her to take a 1.5-week vacation to Europe and get it done there than to get it done in the U.S., even with dental insurance through her employer.
This is why dental tourism is a thing, fly to Mexico, personally I recommend Guadalajara but I know you can get good dental work in most major cities in Mexico. It will cost you a fraction of what it costs in the US, including expenses.
My yearly cleaning costs ~$75US and fillings are about $100 each. Not sure how much a major surgery would be, but a friend of mine had multiple root canal and veneers put on all her teeth for around $2500
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