Is my Dentist Ripping me off?

[mom2rtk]

We have Delta Dental and find this to be true for us as well. They will only cover Amalgam fillings in the back. They will cover up to the cost of the amalgam filling and then you pay the difference for the composite filling. Our dentist doesn't even do amalgam anymore. I think insurances should update their standards for what is covered, but at least part of it is paid for.

Same here. And an update in their standards would be oh so welcome here.

 

[CPT Tripss]

Honestly dental insurance sucks and is pretty much pointless. My suggestion is to ask your dentist if they offer a cash discount for people who either don't have insurance or who choose not to use it. My dentist actually offers a discount plan to cash pay patients where you pay 75 dollars a year and you get 25% off of all treatments. As someone who had the cards stacked against them teeth wise(inherited my mom's bad teeth and on medication for 5 years that basically rot my teeth from the inside out) it works out way better than any dental insurance plan available.

So true about dental insurance . . .

 

[Tuffcookie]

I have dental insurance thru work but I'm lucky if it pays 1/2 of the total.

I have never understood why dental work is not covered under major medical. I mean, if you do not take care of dental problems it can affect your general health.

TC

 

[marybet]

The insurance is probably only paying for a silver filling, did you see the quote from the insurance company?

When we moved to Alabama, 12 years ago, the first dentist we went to did a treatment plan for both of us. He wanted to replace all my old fillings because they will leak, well 12 years later I still have those old fillings, not having any problems. I don't really trust dentist who do treatment plans.

We have gone to a lot of different dentist. We had gone to one for probably 5 years and we liked him but his fees were on the high end. He said my husband needed a crown, very costly, so another dentist was recommended. He is an older dentist, older office but he said all he needed was a filling. I had a tooth chip & he fixed it instead of doing a crown. I just hope he doesn't retire.

Hard to find but the best dentist are the ones who believe if it's not broke don't fix it.

 

[MissManda]

I did some checking around with people at work today. This is the 2nd year with this current insurance company and up until now, I've only had cleanings for several years so I'm out of touch with the cost of other procedures.

The overall consensus is that our current insurance is not nearly as good as our prior insurance (yet it costs more..go figure).

It also sounds like my dentist is a little high price wise, but not too out of reach.

I trust my dentist. One tooth that he wants to fis is in fact causing me problems, so something needs to be done. Because the fillings are between the teeth the other one he wants to fix/redo is almost touching the one that has to be fixed. So, I don't believe he's trying to get one over on me.

I was just a little shocked at the cost. Whew... goog thing I have plenty of money on my Flex Spending card!

 

[chiefmickeymouse]

Actually, sealants can come off if kids eat sticky food liks starburst, taffy, etc. I do feel they are totally worth it though, and would pay to have them put back on my kid's teeth, and have the kid be more careful next time.



We have Delta Dental and find this to be true for us as well. They will only cover Amalgam fillings in the back. They will cover up to the cost of the amalgam filling and then you pay the difference for the composite filling. Our dentist doesn't even do amalgam anymore. I think insurances should update their standards for what is covered, but at least part of it is paid for.

I had this problem with Delta Dental too. The last three dentists I have had don't even do Alamgam fillings anymore.

 

[disneydentist]

So, I get my estimate. My dentist is charging $251 per filling. The fillings are described as Resin-2 surface, posterior by my dentist. Of that, my insurance (who my dentist participates with) only allows for $85/filling. They will pay 80% of the $85 and I have to pay 20% less a $50 deductible plus the difference that is not allowed.

Tell your dentist to try again. Participating means that he is obligated under the terms of the agreement to accept the insurance allowance as full payment. You are responsible for your 20% copay (of the allowance) and deductible. Nothing more.

If he disagrees then ask the insurance if he is actually participating. More than a few providers claim to participate just to make patients happy.

 

[mom2rtk]

Tell your dentist to try again. Participating means that he is obligated under the terms of the agreement to accept the insurance allowance as full payment. You are responsible for your 20% copay (of the allowance) and deductible. Nothing more.

If he disagrees then ask the insurance if he is actually participating. More than a few providers claim to participate just to make patients happy.

The dentist is not responsible for writing off non-covered services. If composite fillings are not covered, they are not obligated to write that off.

 

[aprilgail2]

So, I haven't had to get any fillings for quite a long time. Then, when I went for my last cleaning I told him I was having trouble with a particular tooth. It turns out that an old filling was coming out. So, he said it needed to be replaced. He also recommended replacing another one on the tooth next to it. These fillings were between the teeth and the two he wants to replaced are essentially side by side. They were put in at the same time, have the same wear and tear, and if one was bad it seems logical that the other one should be replaced as well.

So, I get my estimate. My dentist is charging $251 per filling. The fillings are described as Resin-2 surface, posterior by my dentist. Of that, my insurance (who my dentist participates with) only allows for $85/filling. They will pay 80% of the $85 and I have to pay 20% less a $50 deductible plus the difference that is not allowed.

Holy heck, that is a lot of money!!! Like I said, I haven't needed a filling for a long time and so I'm curious if the amount my dentist is charging is outrageous or does my insurance just suck???? I hate to leave my dentist because I really do like him and I really like my hygienist. But if I'm being overcharged, I may have to look elsewhere.

My daughter just had some of her gum cut off her back molar and a pulp cap done- 1600 -my insurance covered 100.00....she also has to get 2 filings done and that is 475.00 for the 2 fillings- my insurance covers 9.00 a filling! If I use one of 2 union dentist they cover it in full but its like going to a welfare type dentist compared to a decent one and the work really isn't anywhere near you get when you pay a good dentist so I would rather pay for the better care.

Yea dental insurance doesn't cover anything worth while. I would like to have my bottom teeth pulled and replaced with a plate. Dentists here don't like to do that but want to do implants instead. Implants cost 3,500 dollar a tooth. OUCH!!!

I would gladly get an implant for 3500! I need one and I can't get a quote under 5,000!

 

[runsandjumps]

I don't blame the dentist for their fees, I blame the insurance companies for the cheap ways. Ever noticed Delta dental promotions at professional sporting events?

I have found they will do almost anything to deny a claim just because most people are not willing to fight the mighty insurance company. Medical seems to be the same way.

I have dealt with insurance for years now and it's only getting worse.

 

[maelstrom]

I don't blame the dentist for their fees, I blame the insurance companies for the cheap ways. Ever noticed Delta dental promotions at professional sporting events?

I have found they will do almost anything to deny a claim just because most people are not willing to fight the mighty insurance company. Medical seems to be the same way.

I have dealt with insurance for years now and it's only getting worse.

I hate Delta Dental so much!

Last May my husband had three teeth pulled in one visit; he went in because one tooth was causing him a lot of pain, and while the dentist was in there saw 2 more that could come out (yes, he has terrible teeth). Delta Dental denied the claim, saying that it needed to first be submitted to our health insurance confused3), then once we got the denial from them (because of course it's going to be denied; health insurance isn't dental insurance, that's the whole point), it had to be resubmitted with that denial attached.

 

[leebee]

Honestly, I think it's all a racket. I went 24 years without having my teeth cleaned, because when I was a kid, dentists didn't clean teeth; it was unheard-of. THey just didn't do it. I do have quite a few fillings, but my guess is that everyone in my age group has far more fillings than younger folks, because dental hygiene has its place. However, twice a year at $300 each is extreme, I think. I have dental insurance, but all it really covers is two cleanings a year, and a small portion of other things (yes, it's Delta). It only covers me. It would be about $2000 a year to put DD and DH on it, and it'd still only cover a portion of things after a one-year waiting period. Our compromise on dental care is insurance only for me (because premiums are free through work), cleanings for everyone once a year, and wait until you get a toothache to have something done. So far, DD has needed only three trips to the dentist in her life (she is 20)- once for sealants, once for a filling, once for a toothache that resulted in having a baby tooth taken out. DH needs to have a crown replaced; work was originally done 20 years ago in San Francisco for $50 (he had good insurance), he had it replaced about 3 years ago at Aspen Dental and they botched it, and he needs it taken care of now. I think he's just going to have it pulled; it's a lower molar, he has another behind it, and his lower jaw is crammed with teeth (no braces). He could have a root canal and crown for about $4000, or have it pulled for about $400. THere's plenty of teeth down there and he figures if things shift after the extraction, he won't have crooked teeth anymore!

We are actually very happy with our dentist. He understands that dental work is expensive and didn't balk when we took DD for cleanings at the local dental hygiene program, where it was $30 and you got a student AND a hygienist to do the cleaning. On my last trip, I asked about my 40+ year old silver fillings, thinking they'd need replacing soon. He hemmed and hawed and poked around, and pronounced them sound and not needing replacement unless I really wanted them done! He also said that my chipped crown is going to be really difficult to fix, but that it, too, is sound, and if I didn't mind, he'd prefer to file it a bit to smooth one edge instead of replace it. Yes, I am a happy girl, because with Delta insurance, I'd pay about $85% of all this if I had a dentist who believed in treatment plans! I guess we are lucky that we've found a dentist we like and trust, because I know the shysters are out there (ASPEN DENTAL)!!

 

[jrmasm]

Honestly, I think it's all a racket. I went 24 years without having my teeth cleaned, because when I was a kid, dentists didn't clean teeth; it was unheard-of. THey just didn't do it. I do have quite a few fillings, but my guess is that everyone in my age group has far more fillings than younger folks, because dental hygiene has its place. However, twice a year at $300 each is extreme, I think. I have dental insurance, but all it really covers is two cleanings a year, and a small portion of other things (yes, it's Delta). It only covers me. It would be about $2000 a year to put DD and DH on it, and it'd still only cover a portion of things after a one-year waiting period. Our compromise on dental care is insurance only for me (because premiums are free through work), cleanings for everyone once a year, and wait until you get a toothache to have something done. So far, DD has needed only three trips to the dentist in her life (she is 20)- once for sealants, once for a filling, once for a toothache that resulted in having a baby tooth taken out. DH needs to have a crown replaced; work was originally done 20 years ago in San Francisco for $50 (he had good insurance), he had it replaced about 3 years ago at Aspen Dental and they botched it, and he needs it taken care of now. I think he's just going to have it pulled; it's a lower molar, he has another behind it, and his lower jaw is crammed with teeth (no braces). He could have a root canal and crown for about $4000, or have it pulled for about $400. THere's plenty of teeth down there and he figures if things shift after the extraction, he won't have crooked teeth anymore!

We are actually very happy with our dentist. He understands that dental work is expensive and didn't balk when we took DD for cleanings at the local dental hygiene program, where it was $30 and you got a student AND a hygienist to do the cleaning. On my last trip, I asked about my 40+ year old silver fillings, thinking they'd need replacing soon. He hemmed and hawed and poked around, and pronounced them sound and not needing replacement unless I really wanted them done! He also said that my chipped crown is going to be really difficult to fix, but that it, too, is sound, and if I didn't mind, he'd prefer to file it a bit to smooth one edge instead of replace it. Yes, I am a happy girl, because with Delta insurance, I'd pay about $85% of all this if I had a dentist who believed in treatment plans! I guess we are lucky that we've found a dentist we like and trust, because I know the shysters are out there (ASPEN DENTAL)!!

I'm curious how old you are ? I'm in my 40s and have had cleanings all my life.

 

[mom2rtk]

Honestly, I think it's all a racket. I went 24 years without having my teeth cleaned, because when I was a kid, dentists didn't clean teeth; it was unheard-of. THey just didn't do it. I do have quite a few fillings, but my guess is that everyone in my age group has far more fillings than younger folks, because dental hygiene has its place. However, twice a year at $300 each is extreme, I think. I have dental insurance, but all it really covers is two cleanings a year, and a small portion of other things (yes, it's Delta). It only covers me. It would be about $2000 a year to put DD and DH on it, and it'd still only cover a portion of things after a one-year waiting period. Our compromise on dental care is insurance only for me (because premiums are free through work), cleanings for everyone once a year, and wait until you get a toothache to have something done. So far, DD has needed only three trips to the dentist in her life (she is 20)- once for sealants, once for a filling, once for a toothache that resulted in having a baby tooth taken out. DH needs to have a crown replaced; work was originally done 20 years ago in San Francisco for $50 (he had good insurance), he had it replaced about 3 years ago at Aspen Dental and they botched it, and he needs it taken care of now. I think he's just going to have it pulled; it's a lower molar, he has another behind it, and his lower jaw is crammed with teeth (no braces). He could have a root canal and crown for about $4000, or have it pulled for about $400. THere's plenty of teeth down there and he figures if things shift after the extraction, he won't have crooked teeth anymore!

We are actually very happy with our dentist. He understands that dental work is expensive and didn't balk when we took DD for cleanings at the local dental hygiene program, where it was $30 and you got a student AND a hygienist to do the cleaning. On my last trip, I asked about my 40+ year old silver fillings, thinking they'd need replacing soon. He hemmed and hawed and poked around, and pronounced them sound and not needing replacement unless I really wanted them done! He also said that my chipped crown is going to be really difficult to fix, but that it, too, is sound, and if I didn't mind, he'd prefer to file it a bit to smooth one edge instead of replace it. Yes, I am a happy girl, because with Delta insurance, I'd pay about $85% of all this if I had a dentist who believed in treatment plans! I guess we are lucky that we've found a dentist we like and trust, because I know the shysters are out there (ASPEN DENTAL)!!

Sounds like genetics have been kind to you. Some people can get away with that.

It would never work for us. I went about 10 years in my early 20s getting no dental care and the problems just mounted. When it came time to pay the piper, I had a second opinion. And yes, I needed the work.

I would always prefer to get the work done when the problem is small and hopefully avoid things like root canals and crowns.

 

[leebee]

I'm curious how old you are ? I'm in my 40s and have had cleanings all my life.

Sounds like genetics have been kind to you. Some people can get away with that.

It would never work for us. I went about 10 years in my early 20s getting no dental care and the problems just mounted. When it came time to pay the piper, I had a second opinion. And yes, I needed the work.

I would always prefer to get the work done when the problem is small and hopefully avoid things like root canals and crowns.

I'm almost 60. We had three different dentists growing up, and none of them did cleanings; nobody ever mentioned cleanings back in the 50s/60s/70s, at least not to us (and one of my dentists was my uncle, so I'd think he was pretty attentive). I've had plenty of fillings- most of my molars have been filled, two of them extracted, two of them crowned- but my upper wisdom teeth moved in and took over for the missing upper molars. When I was a kid, we brushed twice a day, had fluoridated water, and went to the dentist when we had a toothache. My mom had terrible teeth (had them all extracted by the time she was 45), but my dad's were OK. My DH and DD have impeccable dental habits; they both brush twice a day (more when needed), he flosses 2X and she flosses once a day. Even when DD was really little (4? 5?), she's always brushed- we'd come home from someplace with her asleep in the back seat of the car, carry her in to bed, and she'd get up and brush. She had her first filling at age 20. DH has few fillings, and I think for the 30 years I've known him the only tooth issue he's had is the one that he is still having- originally the tooth was cracked and crowned in 1993 and he's had 2 problems with it since. I am not as diligent about flossing as DD and DH, but I brush twice a day, more when needed. I have a cavity in one lower, impacted wisdom tooth but it gives me no problems at all; the dentist reminds me that at some point it'll need to come out but isn't in any particular hurry to refer me to the oral surgeon.

Genetics? Habit? Luck? Whatever, I'll take it. I hate going to the dentist! I think it's fear of pain in my mouth AND my wallet!

 

[Malibustyle23]

Sorry didn't read to see if this has been mentioned but our insurance will not cover white fillings. Can't remember if they won't cover it all or just a price cap. My son needed a filling a few years ago and the gray/silver filling was covered 100% by our insurance company. Apparently both options are still available (hopefully everywhere) but isn't heavily offered unless asked. If the appearance isn't as important to you I would ask about that option. I too think I would of had to cover $2-3 hundred dollars if I hadn't asked.

Honestly I probably would of paid that because the dentist is wonderful with the kids. My son who is terrified of needles had a filling never even realizing he had a needle in his gum!

 

[ronandannette]

Just got back from taking DS in for 4 fillings this morning. Total charge = $672.00. Out-of-pocket (after my insurance company's fee schedule shortfall and my co-pay) = $172.80. Again I am 'ing my dental insurance!! Including the root canal I had on Monday (total cost $1,600 for which I paid OOP $400) it would have been a prohibitively expensive week without it.

 

[lizzi6692]

Just got back from taking DS in for 4 fillings this morning. Total charge = $672.00. Out-of-pocket (after my insurance company's fee schedule shortfall and my co-pay) = $172.80. Again I am 'ing my dental insurance!! Including the root canal I had on Monday (total cost $1,600 for which I paid OOP $400) it would have been a prohibitively expensive week without it.

Just saw that you're in Canada. That explains a lot. There is basically no dental plan in the US that would pay that much.

 

[vgrandy]

Our dental insurance, Cigna, pays 80% after a $50 deductible. Cleanings and xrays are covered 100%. AND it's only about $40 a month for a family plan!

Victoria

 

[trishwal]

You guys are on the ball here! I'm impressed with all of the comments so far. Dental insurance is not what it used to be for most people, and if you're limited to which dentists you can go to you're more likely to run into the dental practices that won't let you out of the office without a treatment plan (after all, they aren't making very much from your insurance plan, let's face it!). I think you can tell if you're in an office where their priority is your health and not their bottom line. The chains like Aspen are all about which dentist produces the most income, never "who is having the best treatment outcomes." I would stay away from ALL of them just to be safe as a rule.

If you're lucky and have good genetics you don't need to go to the dentist as often, but if your family history is riddled with people losing teeth, it's just one of those priorities you have to make in life. In other words if you want a quality of life like a person who's just "born with good teeth" you're going to have to invest in it, otherwise you'll end up not being able to enjoy a good meal because your mouth doesn't work properly.

The fees everyone is quoting is just the cost of having decent work, and in my area they actually seem quite reasonable. Think how much you pay for haircare? Don't you want someone MUCH more trained to give you the same quality of care for your teeth? They are a commodity, after all. Teeth aren't life and death, which is why dental pre-paying (I would NEVER really consider it insurance) is separate from health insurance.