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Dental checkups are not free "wellness" stuff for me


MickinMD
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I got a surprise $99 bill in the mail from my dentist's office for my April checkup and teeth cleaning, marked "Maximum benefits have been reached."

When I mentioned it to a couple people they said, "That should a 'wellness' thing your insurance pays for even if you used up your benefits."

But it isn't regular medical insurance so I doubted 'wellness' was a dental category.

I just spoke with Carla, the retiree health benefit specialist at A.A.Co. Public Schools, who had checked for me with Carefirst BCBS to see if I had to pay for a regular checkup and cleaning if I had used up all my $1500 in annual dental benefits (root canal and crown) in the calendar year.

She found the $1500 max. dental benefits for our BCBS Traditional Dental are for everything - so I have to pay for dental checkups after I the $1500.

So I just paid over the $99 bill over the phone - I'm glad I didn't have any cavities!

I rescheduled my October checkup for Jan. 19, 2022 - I have a $25 annual deductible that hopefully will be all I pay all year.  The annual deductible plus the occasional 20% of a crown's cost have been all I ever paid before this year!
 

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41 minutes ago, Old No. 7 said:

 

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this has been working very well for me for past 8 months. My gums are in fantastic shape and not bleeding anymore.  My hygienist was very pleased with the result,,she just had to clean the back of my jaw set because it's tough for anyone to get into those back corners with layperson's equipment.

Worthwhile investment...if you water floss at least once per day before going to bed. This is the order of my daily regime in evening:

  • brush my teeth with toothpaste
  • water floss
  • then use string floss to catch leftover
  • then brush my teeth 2nd time and may leave slight toothpaste residue in mouth-gum area.  The dental office said having a tiny bit of toothpaste residue on teeth/gum, actually can heal your gums abit.
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No matter what insurance plan you have - or don't have - there isn't anything 'free'.  I often hear of various plans advertised that tout 'free' eyeglasses, 'free' hearing aids, 'free' wellness physicals, etc.

That's the way such services are marketed, and since the language and terminology is so prevalent it's very easy to pick it up and continue to use it as well.

As I did until I realized the insured person may receive those benefits at no cost, but ''at no cost' doesn't render them free

Somebody has to pay the health care professionals providing those services, and that's either the other rate payers for commercial insurance plan or the taxpayers for insurance sponsored or administered by the state.

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14 hours ago, shootingstar said:

I've never heard of dental checkups as a wellness check in any health care benefit plan.  Dentist hygienist time or dentist's time..is money.

Me either.  One of the people claiming I should have gotten it free under "wellness" is the one I sent $500 to because she didn't have the money for jaw X-rays to make sure her bones were ok for dental surgery after taking a known bone-weakening medication.

Maybe her state, Pennsylvania where some of the state lottery money goes to Senior health programs (PACE for Prescriptions, etc.), pays for certain Senior dental expenses.

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14 hours ago, shootingstar said:

this has been working very well for me for past 8 months. My gums are in fantastic shape and not bleeding anymore.  My hygienist was very pleased with the result,,she just had to clean the back of my jaw set because it's tough for anyone to get into those back corners with layperson's equipment.

Worthwhile investment...if you water floss at least once per day before going to bed. This is the order of my daily regime in evening:

  • brush my teeth with toothpaste
  • water floss
  • then use string floss to catch leftover
  • then brush my teeth 2nd time and may leave slight toothpaste residue in mouth-gum area.  The dental office said having a tiny bit of toothpaste residue on teeth/gum, actually can heal your gums abit.

I have an electric toothbrush and my dentist says to think of it as brushing my gums more than brushing my teeth.  I am lazy about flossing.

I seldom have cavities.  My crown and root canal work are the result of a large, slow drill replacing cavities with huge fillings in large teeth from my younger days that eventually led to cracking of the small amount of tooth remaining around each filling.

Outside of that, I seldom have tooth problems.  As I wrote, before 2021, I seldom paid more than my annual deductible (now $25) each year for dental work.

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14 hours ago, Thaddeus Kosciuszko said:

No matter what insurance plan you have - or don't have - there isn't anything 'free'.  I often hear of various plans advertised that tout 'free' eyeglasses, 'free' hearing aids, 'free' wellness physicals, etc.

That's the way such services are marketed, and since the language and terminology is so prevalent it's very easy to pick it up and continue to use it as well.

As I did until I realized the insured person may receive those benefits at no cost, but ''at no cost' doesn't render them free

Somebody has to pay the health care professionals providing those services, and that's either the other rate payers for commercial insurance plan or the taxpayers for insurance sponsored or administered by the state.

Actually, before 2021, I've never had to pay much for dental care, except an annual deductible which used to be $20 and is now $25 and my 25% of the monthly dental insurance premium - my share has always been less than $10.  I pay 20% for crowns, which is now normally about $200 of the about $1000 cost.  I got my 4th crown in October and my 5th after the root canal in January.

The root canal I had in January was supposed to be something like $1550, but the dentist accepted Carefirst BCBS's $1082 as 100% of payment, which left me $418 worth of benefit to apply to the crown I got on the the root canaled tooth.

I ended up paying $572 out of pocket to my dentist after my $1500 max. benefits were exceeded for that crown.  Now I've paid $99 more for the regular dental checkup and cleaning ( had no cavities).  I scheduled my next checkup for Jan. 2022.

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I had a tooth extracted to do some sort of weird thing where the tooth eats itself from the inside out, usually because of trauma to the tooth.  Resorption I think.  Anyway, it costs so much to get the tooth replaced that I just live with a gap in my smile.  May get it fixed, but low on my priority list, as there are lots more things I could spend 3 grand on.

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