Dental Financial Planning


E

Elle

Got hit with another big dental bill the other day (which
will bring my total to around $3500 in less than a year),
despite having fairly healthy teeth. That's my dentist and
endodontist talking, not just me.

Word on the street seems to be that self-indemnification
competes well with the cost of dental health insurance. A
relative of mine counseled that one should look at dental
care from mid-life and longer like a car purchase: One puts
in some big bucks for a year or so, and then is good for
another ten years.

What have people here experienced?

P.S. The minor but expensive dental work at least improved
my smile still more (ya, we're all good looking... ), and
admittedly some of it was preventive maintenance. SoI think
it was worth it. I just need to plan a bit more for this.
 
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E

Elizabeth Richardson

Got hit with another big dental bill the other day (which
will bring my total to around $3500 in less than a year),
despite having fairly healthy teeth. That's my dentist and
endodontist talking, not just me.
[snip]

What have people here experienced?
My husband's pension includes system-paid medical care, but dental/vision is
an add-on at $54/mo/person. At first I thought we wouldn't purchase it as
normal years we only have 2 cleanings and x-rays each - less than $600 per
year. But year before last I needed 2 crowns because of fractures and then
early last year I needed to have an old filling replaced. This last got my
attention more than the crowns. I thought, "Yikes, we both have quite a few
fillings that are 25-30 years old." So we signed up for the dental/vision
insurance and even with $150 annual deductible I'm betting we'll come out
ahead over the next 30 years. YMMV

Elizabeth Richardson
 
A

Avrum Lapin

For what it is worth I managed on $35/month between ages 56 (early
retirement) and about age 67 (Delta Dental became available for
individuals). This is in spite of having a filling in almost every
tooth. This covered cleanings, X rays, an occasional filling and a few
crowns).

I used to put a sum of money every month to cover large annual
payments such as auto insurance, vacations, dental etc

Delta Dental costs me about $35/month and covers about 40% of what my
dentist charges (50% if I used one of their dentists) but doesn't pay
over $1000/year. The last few years some of my 35 plus year old
fillings have begun to fail and have needed crowns and we are definitely
pushing the $1 k limit..

Fortunately no root canals or peridontal so far.
 
R

rick++

I was just looking at the AARP dental insurances
recently. The annual premiums ($445) about 42% of
the maximum annual payout ($1200) , suggesting the
average person will spend that amount every 2.5 years.
Employer group insurance is considerably less
costly for similar benefits.
I wonder if self-insurance plus discounts (5-20%)
some dentists give for immediate cash payment is
worth it?
 
T

Todd H.

rick++ said:
I wonder if self-insurance plus discounts (5-20%)
some dentists give for immediate cash payment is
worth it?
Probably, depending on your dental care needs.
 
E

Elle

Thanks for sharing your experiences, Elizabeth, Avrum, and
Rick.
From what you all say, it seems to me that some savviness
about when old fillings fail (with possible root canals
required) might go a long way. In other words, in hindsight,
I think I might have been meaningfully ahead had I gone with
some dental insurance starting when I turned about 40 years
old. I am almost 47 now, and have had pretty good dental
health before the age of about 40. Others not so lucky might
start earlier. I have the one bad tooth but I think it's a
pre-existing condition and so I am really too late to get
insurance. Or I don't know. I have a few other fillings that
are old. I'll have to think more about it. It's such a
tangled web of seeming peace of mind and getting what one
pays for, via discounts etc.

My current dentist gives cash-payers (meaning greenbacks,
credit card payers, and I guess people who write a check) a
7% discount. Problem is, I don't know if that's really
meaningful or not. Who can say what insurers negotiate or
what the bottom line is for the dentist/endodontist to make
a reasonable profit?

I do feel at this point that one gets what one pays for with
dentists. I am paying top dollar for this latest work but I
think it's overdue (the dentist says, no not really, but
he's a new guy for me), and a better dentist would have
commented on it sooner. This fellow comes recommended by
friends.

On the other hand, I think I got a top-dollar, but not
well-qualified, endodontist last summer and he may have
taken me for some kind of ride, doing an expensive
apicoectomy (a "fix" to a failing root canal) that may
really not have been very good counsel for the particular
tooth, especially since he never even mentioned the option
of an implant. Extraction and implant have become very
popular (though person's health-specific) in the last
several years as an alternative to extraction and a bridge.
One of the dental assistants commented that she thinks
prices on implants will come down, since more and more
dentists are doing them, and competition will have its
effect.
 
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A

Alan Ballow

Insurance is about risk and the likelihood of dental work is a sure
thing. Among agents, individual dental insurance is almost a joke. I
once asked a general agent if his health plan had dental and he said
with a straight face "I advise all of my clients to floss."

Dental insurance is like swapping money for money. There are some
good discount plans around, some even have good dentists participating.
Here's a starting place - http://toothplans.com/. Their discounts look
substantial and I recognized at least one good dentist in my area on
their list. Good luck!
 
E

Elle

Alan Ballow said:
http://toothplans.com/. Their discounts look substantial
and I recognized at least one good dentist in my area on
their list. Good luck!
Alan, thanks, interesting site. Several months ago I
happened on a site that seemed at least a little reputable
that gave approximate costs of common procedures by
geographical location, and this was helpful as well. Now I
can't find it, though.
 
T

Tad Borek

Elle said:
Got hit with another big dental bill the other day (which
will bring my total to around $3500 in less than a year),
despite having fairly healthy teeth. That's my dentist and
endodontist talking, not just me.

Word on the street seems to be that self-indemnification
competes well with the cost of dental health insurance.

What have people here experienced?
My last reply didn't get through...the gist was that I self-insure
dental but pay from an HSA (this is an allowable use of HSA dollars).
When you do that at least you're using pre-tax dollars to pay the dental
bills. And my dentist gives a better rate, some deal they have with my
insurer (though I don't have actual dental insurance).

Might not be a huge benefit but it does, in effect, reduce the cost of
the health insurance you need to buy the HSA. This would have been a
$3500 deduction off of your income instead of a $3500 check that
probably won't be deductible - the ~$700? tax benefit might have paid
for almost a half-year of insurance premiums?

If the work wasn't done yet you could have started HSA-compatible
insurance before March, and made 10 months of HSA contributions,
deducting that on your 2007 tax return. Then write a check from the HSA
for the bill. But that's locked-barn-after-horse-gone.

-Tad
 
E

Elle

Tad Borek said:
I self-insure dental but pay from an HSA (this is an
allowable use of HSA dollars). When you do that at least
you're using pre-tax dollars to pay the dental bills.
snip for brevity; all points noted.

Tad, good idea.
 
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E

Elle

Elle said:
Several months ago I happened on a site that seemed at
least a little reputable that gave approximate costs of
common procedures by geographical location...
For the archives, it was
http://www.bracesinfo.com/dentalcosts/ . Only updated
through 2004, and, as usual, its veracity is hard to
confirm. But it might offer some idea of what's reasonable
for standard dental procedures. :)

Had a good talk with dear ol' dad last week about dental
costs and what he and his wife have experienced. He proposed
viewing one's payments on one's teeth kind of like
maintenance costs on a car: Every 5-20 years, expect some
major expenses, then one should be good to go for awhile
(knock on wood, and factor in that genetics may play a role
here in teeth health). Which of course is in the vein of
several people's comments here.

... and on the upside, shucks, I so want one back tooth
gone. It has demanded ridiculously high maintenance (plus,
let me not be too graphic, it's ugly!) over the last seven
years. I don't mind too much shelling out some serious bucks
to have a beautiful, pearly-white implant done. If it helps
my love life... ;-)
 
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