I think we need to postpone the wedding.

JCbride2015

Thanks everybody! I will look into one of those discount plans. I called around today and as best I can figure out, they are charging me a standard price and not ripping me off. The issue is that they quoted me the wrong (low) price in the first place. Fi is determined to finance the teeth so we don't have to postpone the wedding. We will have to figure out some financing options. And to whoever asked-- yes, care credit just approved me for $9000 independently of the dentist. I don't have any basis for asking them to increase it, I think.

JCbride2015

phira said:

Late to the (really upsetting) party here. I'm so sorry you're going through this. It's unbelievable how shitty insurance is in this country.

You've been getting great suggestions from everyone so far. I also think that it's worth speaking to any of your vendors about payments and schedules for anything you haven't finished paying off yet. The worst that'll happen is that they say you still have to pay everything by the original dates. However, our photographer (who was AMAZING) has flexible payments; she even told us before we booked her that there was no official deposit, and that we would work out a payment schedule after the wedding. That enabled us to get a more expensive package from her than we'd originally budgeted because we knew we could afford the original $2000 and then pay the last $1000 after the wedding if we needed to.

In terms of what you can or can't cut--is it possible for you to cut stuff like flowers? I spent about $100 making my own flower centerpieces and they came out so well that people were fighting (in a good-natured manner) about bringing them home at the end of the wedding. I would be seriously happy to make them for you for the cost of supplies and shipping, and even then, I already have a decent amount of stem wire left over from my wedding.

@Phira thank you so much for this generous offer!! You are so kind. Fortunately we actually aren't locked into a floral contract so that's something we will be figuring out soon. We actually got a very reasonable quote from a local florist in Newark where prices are lower, so after looking at the budget we may go with them or just downgrade that initial plan. Not sure yet.

phira

@JCbride2015 Totally understand Feel free to PM me if you suddenly need paper flowers. I'll leave a photo here because I'm slightly overly proud about them. They were SUPER easy to make, and the vases are fancy 79-cent bud vases from everyone's favorite Swedish discount home-goods emporium.

lc07

rooz103 said:

zitiqueen said:

Are you sure your health insurance won't cover any of this? This doesn't sound cosmetic, it sounds like a medical necessity.

This is an excellent solution if your medical insurance is reasonably generous. A couple things to keep in mind is that those larger procedures usually require pre-authorization (over the phone) and that the dental office will probably have no clue on how to bill out for that, so you might need to submit claims yourself. They won't cover crowns, but hopefully they'd cover the implant and bonegrafts, so ask specifically about CDT codes 21248 and 99070. 

I know another person mentioned dual coverage insurance through your husband; I'd just make sure that your husband's insurance is Standard coordination of benefits, not No Dual. Otherwise you'd just be throwing your money away. 

Sorry I don't have any other real advice so just more good luck wishes are being sent your way

I don't know what you just said but you sound very smart! Really hope your regular health insurance covers some of this bullshit, JC!

beharrington

Not sure about your health insurance covering it. I've had 3 implants done and none of my work was covered by health insurance even though one was my canine tooth which is fairly important. Also, the price does seem right based on what the cost for mine ($4000 between the oral surgeon and dentist). Definitely look into the flipper option. I wore the one for my canine for almost a year while I got the money together for the abutment and crown (took longer than planned because we bought a house during that time and the canine came loose during our honeymoon so we were already short on savings).

rooz103

lc07 said:

rooz103 said:

zitiqueen said:

Are you sure your health insurance won't cover any of this? This doesn't sound cosmetic, it sounds like a medical necessity.

This is an excellent solution if your medical insurance is reasonably generous. A couple things to keep in mind is that those larger procedures usually require pre-authorization (over the phone) and that the dental office will probably have no clue on how to bill out for that, so you might need to submit claims yourself. They won't cover crowns, but hopefully they'd cover the implant and bonegrafts, so ask specifically about CDT codes 21248 and 99070. 

I know another person mentioned dual coverage insurance through your husband; I'd just make sure that your husband's insurance is Standard coordination of benefits, not No Dual. Otherwise you'd just be throwing your money away. 

Sorry I don't have any other real advice so just more good luck wishes are being sent your way

I don't know what you just said but you sound very smart! Really hope your regular health insurance covers some of this bullshit, JC! I just realized that should say ICD codes, not CDT codes -_- 

And the key to getting things covered by medical is the phrase "affects quality of life". Most medical insurances wouldn't cover a canine because technically you could get away with chewing on the other side of your mouth and while it would suck, you could still live a reasonably fruitful life without it (so they say). 

It sounds like JC is talking about full anteriors though, and when you're dealing with several teeth in a row, it's all about convincing the insurance company that the patient wouldn't really be able to eat at all without this procedure and life would be HORRIBLE without it. If you do find that your medical covers it, ask your dental office for a write up including all the possible ramifications of keeping things the way they are, and how it'd negatively affect your ability to eat like a normal human. 

Going on 7 years arguing with insurance companies for a living: call me the insurance whisperer. 

cupcait927

rooz103 said:

lc07 said:

rooz103 said:

zitiqueen said:

Are you sure your health insurance won't cover any of this? This doesn't sound cosmetic, it sounds like a medical necessity.

This is an excellent solution if your medical insurance is reasonably generous. A couple things to keep in mind is that those larger procedures usually require pre-authorization (over the phone) and that the dental office will probably have no clue on how to bill out for that, so you might need to submit claims yourself. They won't cover crowns, but hopefully they'd cover the implant and bonegrafts, so ask specifically about CDT codes 21248 and 99070. 

I know another person mentioned dual coverage insurance through your husband; I'd just make sure that your husband's insurance is Standard coordination of benefits, not No Dual. Otherwise you'd just be throwing your money away. 

Sorry I don't have any other real advice so just more good luck wishes are being sent your way

I don't know what you just said but you sound very smart! Really hope your regular health insurance covers some of this bullshit, JC!

I just realized that should say ICD codes, not CDT codes -_- 

And the key to getting things covered by medical is the phrase "affects quality of life". Most medical insurances wouldn't cover a canine because technically you could get away with chewing on the other side of your mouth and while it would suck, you could still live a reasonably fruitful life without it (so they say). 

It sounds like JC is talking about full anteriors though, and when you're dealing with several teeth in a row, it's all about convincing the insurance company that the patient wouldn't really be able to eat at all without this procedure and life would be HORRIBLE without it. If you do find that your medical covers it, ask your dental office for a write up including all the possible ramifications of keeping things the way they are, and how it'd negatively affect your ability to eat like a normal human. 

Going on 7 years arguing with insurance companies for a living: call me the insurance whisperer. 

I work for an insurance broker and I can attest to both your posts, @rooz103. Medical insurance usually does not cover dental work, unless it is medically necessary. It can take a lot of back and forth and a lot of persistence, but it can certainly pay off. The medical insurance would definitely cover more than the dental insurance if you can get them to agree to cover it.

JCbride2015

cupcait927 said:

rooz103 said:

lc07 said:

rooz103 said:

zitiqueen said:

Are you sure your health insurance won't cover any of this? This doesn't sound cosmetic, it sounds like a medical necessity.

This is an excellent solution if your medical insurance is reasonably generous. A couple things to keep in mind is that those larger procedures usually require pre-authorization (over the phone) and that the dental office will probably have no clue on how to bill out for that, so you might need to submit claims yourself. They won't cover crowns, but hopefully they'd cover the implant and bonegrafts, so ask specifically about CDT codes 21248 and 99070. 

I know another person mentioned dual coverage insurance through your husband; I'd just make sure that your husband's insurance is Standard coordination of benefits, not No Dual. Otherwise you'd just be throwing your money away. 

Sorry I don't have any other real advice so just more good luck wishes are being sent your way

I don't know what you just said but you sound very smart!

Really hope your regular health insurance covers some of this bullshit, JC!


I just realized that should say ICD codes, not CDT codes -_- 

And the key to getting things covered by medical is the phrase "affects quality of life". Most medical insurances wouldn't cover a canine because technically you could get away with chewing on the other side of your mouth and while it would suck, you could still live a reasonably fruitful life without it (so they say). 

It sounds like JC is talking about full anteriors though, and when you're dealing with several teeth in a row, it's all about convincing the insurance company that the patient wouldn't really be able to eat at all without this procedure and life would be HORRIBLE without it. If you do find that your medical covers it, ask your dental office for a write up including all the possible ramifications of keeping things the way they are, and how it'd negatively affect your ability to eat like a normal human. 

Going on 7 years arguing with insurance companies for a living: call me the insurance whisperer. 

I work for an insurance broker and I can attest to both your posts, @rooz103. Medical insurance usually does not cover dental work, unless it is medically necessary. It can take a lot of back and forth and a lot of persistence, but it can certainly pay off. The medical insurance would definitely cover more than the dental insurance if you can get them to agree to cover it.

Thanks both of you! Medical insurance said I will just have to submit the claim and see what they think but I will take all this into account when arguing with them.

MrsMack10612

Maybe it's different in MA, but my H just had a wisdom tooth extracted, under general anesthesia and his medical insurance covered part of it no problem.

I've also done a couple going under dental issues that were covered partially by medical insurance without all the back and forth that folks are talking about.

 

 

arrippa

MrsMack10612 said:

Maybe it's different in MA, but my H just had a wisdom tooth extracted, under general anesthesia and his medical insurance covered part of it no problem.

I've also done a couple going under dental issues that were covered partially by medical insurance without all the back and forth that folks are talking about.

 

 

I live in MA and my medical insurance denied my coverage for my implant. I had to use my dental insurance, which covered only 20%. I had to pay $3,000 out of pocket for my one implant. I ended up using my FSA card from Wageworks to pay for it.

theartistformerlyknownas

MrsMack10612 said:

Maybe it's different in MA, but my H just had a wisdom tooth extracted, under general anesthesia and his medical insurance covered part of it no problem.

I've also done a couple going under dental issues that were covered partially by medical insurance without all the back and forth that folks are talking about.

 

 

Wisdom teeth are often impacted in the jaw bone and affect nerves in the face, so I could see that being an easier argument for medical coverage than other things. Especially since it was likely an oral surgeon who did the work rather than a dentist (at least, it's required to be in Michigan, any time you undergo general anesthesia).

You may also just have a really super great medical insurance plan. They are not all created equal.

phira

I mean, basically, the moral of the story is that medical insurance should cover dental costs because SERIOUSLY.

sarahufl

lolo883 said:

MrsMack10612 said:

Maybe it's different in MA, but my H just had a wisdom tooth extracted, under general anesthesia and his medical insurance covered part of it no problem.

I've also done a couple going under dental issues that were covered partially by medical insurance without all the back and forth that folks are talking about.

 

 

Wisdom teeth are often impacted in the jaw bone and affect nerves in the face, so I could see that being an easier argument for medical coverage than other things. Especially since it was likely an oral surgeon who did the work rather than a dentist (at least, it's required to be in Michigan, any time you undergo general anesthesia).

You may also just have a really super great medical insurance plan. They are not all created equal.

I had to go under general as well, because I had a panic attack when they tried to do the local that is usually done. I had to get a doctor to write a note that I had a psychological issue that prevented them from doing local.

It was covered, but I do think it took some back and forth.

blabla89

Not sure if anyone has mentioned this already, but does your job offer a FSA option?

With mine, the amount that I elect for the year is deducted from my paychecks through out the year, but the full amount is available for spending at the beginning of the year. It was a huge relief when I had a medical emergency early in the year and couldn't pay the entire bill out of pocket. Not sure if all FSA's work that way, but it's worth looking into, as it could be an interest and tax free way to finance some of it.

Sugargirl1019

I would add to the argument that this procedure is a medical necessity because if you cannot have, say, all of your front teeth (right?), you cannot bite into foods. In order to get proper nutrition, you'll need a PEG tube and enteral feedings forever, which they would be paying for, forever. The cost of the dental procedure is less than the cost of the rest of your life enteral feedings and PEG tube maintenance.

Every time I click on here I hope that you have a solution. Waiting on some good news

MrsMack10612

@arrippa - I must, like @lolo883 said, have had really good luck with medical/dental insurance.

 

H's wisdom tooth was not impacted so I'm not sure why the decision to do it under.  I do know his copay for the procedure was only $144.

 

flutteringinfl

phira said:

I mean, basically, the moral of the story is that medical insurance should cover dental costs because SERIOUSLY.

Also, dental insurance needs to freaking get with the times. One of the things I learned working in my dad's dental office is that dental insurance costs about the same as it has for the last few decades, but because dental costs have of course increased, it covers less. So most dental plans are pretty useless for anything beyond cleaning and x-rays. A lot of dental offices, including my dad's and the one I attend now, don't even bother contracting with insurance companies because they don't want to be bound by what insurance companies will pay for, which is usually crap.

cupcait927

flutteringinftmyers said:

phira said:

I mean, basically, the moral of the story is that medical insurance should cover dental costs because SERIOUSLY.

Also, dental insurance needs to freaking get with the times. One of the things I learned working in my dad's dental office is that dental insurance costs about the same as it has for the last few decades, but because dental costs have of course increased, it covers less. So most dental plans are pretty useless for anything beyond cleaning and x-rays. A lot of dental offices, including my dad's and the one I attend now, don't even bother contracting with insurance companies because they don't want to be bound by what insurance companies will pay for, which is usually crap.

And this is exactly why I cancelled my dental insurance for next year. Even with two cleanings and, say, one filling, I will still pay less than I would've in payroll deductions and the deductible on my dental plan.

flutteringinfl

cupcait927 said:

flutteringinftmyers said:

phira said:

I mean, basically, the moral of the story is that medical insurance should cover dental costs because SERIOUSLY.

Also, dental insurance needs to freaking get with the times. One of the things I learned working in my dad's dental office is that dental insurance costs about the same as it has for the last few decades, but because dental costs have of course increased, it covers less. So most dental plans are pretty useless for anything beyond cleaning and x-rays. A lot of dental offices, including my dad's and the one I attend now, don't even bother contracting with insurance companies because they don't want to be bound by what insurance companies will pay for, which is usually crap.

And this is exactly why I cancelled my dental insurance for next year. Even with two cleanings and, say, one filling, I will still pay less than I would've in payroll deductions and the deductible on my dental plan.

Next year I will have dental insurance, but only because it's *barely* worth it. People think of dental insurance as this huge luxury, but generally it's cheap as hell and pretty much useless.

cupcait927

flutteringinftmyers said:

cupcait927 said:

flutteringinftmyers said:

phira said:

I mean, basically, the moral of the story is that medical insurance should cover dental costs because SERIOUSLY.

Also, dental insurance needs to freaking get with the times. One of the things I learned working in my dad's dental office is that dental insurance costs about the same as it has for the last few decades, but because dental costs have of course increased, it covers less. So most dental plans are pretty useless for anything beyond cleaning and x-rays. A lot of dental offices, including my dad's and the one I attend now, don't even bother contracting with insurance companies because they don't want to be bound by what insurance companies will pay for, which is usually crap.

And this is exactly why I cancelled my dental insurance for next year. Even with two cleanings and, say, one filling, I will still pay less than I would've in payroll deductions and the deductible on my dental plan.

Next year I will have dental insurance, but only because it's *barely* worth it. People think of dental insurance as this huge luxury, but generally it's cheap as hell and pretty much useless.

I kept mine last year and this year because I had six fillings that I needed (was scared of the dentist for YEARS and stopped going) but now that they're taken care of and I'm getting regular cleanings, my dental insurance is useless. H's is expensive as well and he's had one cavity ever so it's just cheaper for us to pay out of pocket with our HSA for our 4 cleanings in total and save the money in our paycheck.

wandajune6

We don't bother with dental insurance. DH had a ton of dental work at the beginning of the year and we priced it with his dentist. It was cheaper for us to join their family discount program and skip the insurance. I have good teeth (thanks, Dad) so I supplement it with random cleanings bought off Groupon.

phira

Yeah. I don't bother with dental if it's not 100% covered in my benefits (which right now, it's not). My husband's dental is 100% covered, though, so at least I can get free cleanings.

@flutteringinftmyers I really appreciate that insight! Insurance needs to get with the times (make more sense, cover more stuff, and generally BE USEFUL TO PEOPLE).

flutteringinfl

Yes, insurance in general really needs to do that! My sister had surgery to correct her scoliosis, which was so bad her organs were close to collapsing on themselves. This was seven years ago. I believe my parents are still trying to convince the insurance company it was medically necessary, or at least they were until very recently.

OP, my offer does still stand. I would be happy to talk to my father and see what he thinks of your situation, but it's your medical business so only if you feel comfortable :-)

JCbride2015

flutteringinftmyers said:

Yes, insurance in general really needs to do that! My sister had surgery to correct her scoliosis, which was so bad her organs were close to collapsing on themselves. This was seven years ago. I believe my parents are still trying to convince the insurance company it was medically necessary, or at least they were until very recently.

OP, my offer does still stand. I would be happy to talk to my father and see what he thinks of your situation, but it's your medical business so only if you feel comfortable :-)

@flutteringinftmyers Thanks for the offer!  I actually had my friend's husband, who is a dentist who also does implants, take a look at the bill and he thought it was reasonable.

JCbride2015

So I had the oral surgery today!  It was really God-awful.  But I actually feel better now that it's done and the decision is off my chest.  I'll be really sore for a couple of days but the temporary bridge looks good and this really needed to be done so it's a huge thing checked off my health to-do list.

jenna8984

Yay! Hope it doesn't hurt too much/ hope it heals fast & well!

ShellD13

Here is to a speedy recovery from the surgery JC.

KatieinBkln

JCbride2015 said:

So I had the oral surgery today!  It was really God-awful.  But I actually feel better now that it's done and the decision is off my chest.  I'll be really sore for a couple of days but the temporary bridge looks good and this really needed to be done so it's a huge thing checked off my health to-do list.

Rest up and feel better! You got this.

theartistformerlyknownas

All the ice cream to you JC! Hope it's a quick and easy healing process!

birdybride2014

I'm glad the surgery is over and you can at least no longer be worried about your dental health! The rest will work itself out, even if it seems scary looking at numbers for a while.