Dental Insurance for Dummies?

Advanced warning: The following plunges the reader into the world of Dental Insurance. It isn’t for the faint of heart.

That tooth’s got to come out. Ever hear your dentist utter that phrase? Yikes!

I say that not because of any physical pain that you may be in for, but for the financial pain. In an earlier blog about this same subject, I commented that I’d cheerily accept pain in order to save some greenbacks. And by “some” greenbacks, I mean a lot.

In that case, I declined the oral surgeon’s anesthesia, because the insurance wouldn’t cover it. I don’t need your stinking anesthesia, I said … in my head. Don’t want to offend the guy that’s drilling into my jawbone.

The procedure I was undergoing was the installation of a dental implant. And it’s a marvelous leap forward in dental science, compared to the removable false-tooth options available to our parents.

But it isn’t cheap — and insurance companies view it as an extravagance. Couldn’t you get by on a set of hand-carved wooden teeth, like the father of our country? If it was good enough for George Washington, yada, yada, yada. I’m sure that’s in their internal company literature somewhere.

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Anyway, after the oral surgeon was done with me, I had a bolt in my jaw. Thus equipped, my regular dentist could then cover the bolt with something indistinguishable from a real tooth.

Here’s where it gets interesting.

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When the oral surgeon did his thing, I was covered by my wife’s dental insurance from work. But before my dentist could complete the procedure, my wife left her job, vowing never to work again.

Not to worry, I thought. I’ll just purchase an individual plan for us, with the same company. They will then help pay for completing the procedure that was started under their watch. They even confirmed that there would be no waiting period to cover any dental mayhem, since we were just with them.

So all was well, right?

Wrong!

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My dentist informed me that the insurance company was balking at paying her. She tried several times. With steam coming out of my ears, I called Customer Service. The entity on the phone (I don’t want to say person because it’s hard to believe a human could be that monotone) stated that they’re not obliged to pay, because the missing tooth issue was under a different company.

My wife worked locally, but her former employers’ headquarters is out of state. They purchased group coverage through the out of state branch; my individual plan was purchased through the Massachusetts branch. Surprisingly to me, and any rational person, the two branches consider themselves separate companies.

“You’ve got to be effing kidding me,” I said. But Monotone Man’s voice inflection never budged in telling me that’s the way it is.

I appealed by email to a higher authority at the company. I tried to blend contrition for having been born with a set of teeth and a sense of “oh, come on; let’s be reasonable.”

Several weeks later, I answered a knock at my front door. It was a certified letter from the insurance company. I had pretty much given up any hope of recouping some of the cost — but this move surprised me.

I tore open the important communiqué. In case I hadn’t been sure that I was being screwed over before, the letter put an exclamation point on it:

Shockingly, they had reviewed my case with respect to internal company rules, and confirmed that I could go pound sand.

Thankfully, I had already canceled my coverage the prior month, after they’d paid for a cleaning and an X-ray.

So take that, insurance company whose name I won't even utter!

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An old boss of mine used to say that insurance was legalized extortion. Boy, was he right.

Now, while I shudder at my next run-in with the dental community, I’ll close with a question:

Know any good dental plans?

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The End

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