Poverty and Dental & Vision Health Care
Saw this unfortunate article in the Post about a young boy who died because his abscessed tooth was not removed and the bacteria got to his brain. What stopped me early in the article was "A routine, $80 tooth extraction might have saved him." I had a molar extracted about 2 years ago and it cost me around about $70-$80, and I have health insurance.Let me give you a little of my dental health history. I didn't have any, any health insurance growing up and I had cavities. Every once in a while mom would drag me to the dentist and if it wasn't about finding cavities, it was filling them, so each visit was expensive, and not often. It didn't help that I hated brushing. A far as I know, mom never bothered with Medicare. Jump forward to undergrad, still no insurance, and the needing to remove a wisdom tooth. I waited for hours, and hours, and hours at the university teaching hospital. So long, that I swore then and there that when I got out into the real world I was going to have health insurance so I would never, ever, ever have to spend a full part of a day waiting. I did get it removed, but the student dentists nicked a neighboring tooth, taking off a chip. I can't remember what I paid, or if I had to pay. The grad school I attended required students to have health insurance, so I got the cheapy non-dental only useful if you get hit by a bus insurance and used the campus health facilities. It was at the campus clinic I first heard the word "abscessed" in relation to my teeth. After borrowing $200 bucks from grandma (and learning never borrow money from grandma unless your next option is loan shark) I fixed another wisdom tooth problem, sans insurance.
Fast forward to now. I have a decent job and health insurance which I pay over $100 a month for individual coverage. If I had a family, dependents, it would be about $300 a month. My employer chips in for a significant portion of the premiums, which in total are $400 a month for an individual. I don't have one of the extra dental or vision plans. Going to the dentist still costs me, just not as much. I swear I pay $40-$50 for cleaning but my plan says I'm supposed to be paying less. I'll find out why there is a sizable difference my next visit. I also plan to get some new glasses this year. My health plan will save me with the eye exam but the frames and lenses will be cheaper if I go to an Americas Best or other like place. I expect to blow $200-$400 on a pair of glasses, mainly because of the lenses.
Last year, I chipped in to get my niece glasses. Medicare should have covered some part of her glasses, but because her mother, my sister, didn't want to bother with whatever Medicare hoops needed, which the Post article talks about in relation to the young boy, I and my mom wound up paying for her glasses.
After much typing and deleting and typing and deleting, I've decided not to make a political argument out of it. As some of you know I identify myself as moderate conservative, and I know many of you, my readers and my friends are a diverse group of liberals, and this could get political in the comments section. So what I challenge you with is to avoid theory, if you have something to say, talk about your own experience, your reality of health care in America. And to comply with my screwy interpretation of HIPPA you may just use initials or fake initials to be somewhat anonymous. Not completely anon because I'll start confusing one anon with another anon and that will just drive me nuts.
posted by Mari @ 28.2.07
11 Comments:
If you have a Costco membership, go there for new glasses! The have a surprisingly decent selection of frames, and it's about half the price I'd paid other places. Almost worth the annual fee just for that....
- Bloomingdale chick
what about an MSA? It may be worth the hassle.
for me contacts end up being cheaper than glasses even with paying for the $60 exam. 1-800 contacts gives me good deals. i just got some newfangled lenses & wont have to feel guilty about sleeping in them :)
For me, frames are not a problem, its the lenses. The eye doctor said that I need UV something or another because I work with computers, and I 'want' the thin lenses so I can wear metal frames, 'cause otherwise I'd be sporting coke bottles. Those things add up. So a special on $50 frames cost me about $300 when all was said and done with the lens package, tax, etc. I know it will go up when I get old enough to need bi-focals, 'cause I'm vain enough to want the invisible line ones. I don't do contacts. I tried them for about 2 years and I find it easier to throw frames on my face than to poke my eye to get the $#!* things in.
An MSA? Is that a medical savings account? I'm trying out the medical spending account with my employer this year, since I know I'm going to replace the glasses. I have to spend it all in 18 months, so I'm putting aside a small amount to see if I actually use it as it is supposed to work.
minor clarification - i think you are talking about medicaid, not medicare. the distinction is that medicare is run by the federal government for the elderly and disabled, while medicaid is run by each state with different rules and is supposed to help the poor. as you can imagine the variation in rules, reimbursement, bureacracy, etc varies widely by state. the feds help pay states for medicaid but do not administer. i can iamgine DC's medicaid administration is not particularly smooth.
also HIPAA doesn't apply to posting about your own experiences.
2nd st (work in healthcare admin)
When HIPPA first came out, for some in my profession (archives), we were concerned about public access to personal narratives in archives where health is mentioned. I didn't keep up with the train of thought in the discussion, so thus the "screwy interpretation".
Thanks for the clarification. Mom is of the medicare age and she might have confused me when discussing the niece.
My physician tells me that annual physical exams, recommended for people my age, are not often covered either. So the secretary there puts it under some other category, which I think is misleading. Wouldn't it benefit an insurance company to cover preventative examinations?
I just went to my dentist for an annual teeth cleaning and exam. I have to pay up $157 up front, then wait for the insurance refund. When I got a $55 check back, I took a closer look at the exam receipt:
Prophylaxis (cleaning?): $97, $42 of which is not supported by my dental health care plan.
Peridontal Evaluation: $60, only covered every 36 months. But my dentist wants one done every year.
I like this dentist, they do a good job, but I'll probably have to find a less convenient location in-network, which may not be as good, just so I won't have to pay up front so much.
Health care in general seems to benefit the providers, not the patients, as I learned when I got a 'discount' health insurance policy while unemployed and had a similar experience to yours.
i am so interested to learn that you identify as a "moderate conservative." I am trying to understand what your position is then on health care? do you agree with me and other liberals that it should be universal? Did your mama and your sister not bother with medicaid because they don't like government handouts? If you are a conservative, how do you square your sporadic lack of insurance (reckless) with personal responsibility? If you wound up hit by a bus without insurance, it's the rest of us who would be paying for it.
I have to second Bloomingdale Chicks recommendation for Costco. They really are much cheaper overall. If the lenses there aren't your style, you can pick up a pair elsewhere and take them to Costco to have the frames put in. One of the Maryland Targets has an optical attached as well. it might be worth checking out. Wal-mart supposedly has good prices, but that requires a car and a lot of travel time.
I'm lucky that my wife is a federal employee so we have insurance through her which is much cheaper than anything I could get through work. They cover dental. We don't pay for cleanings but we have an $18 co-pay for fillings at the dentist we've used. It really does depend on where the dentist is. It is worth calling around and asking ahead of time what they will charge after the insurance kicks in.
I'll have to check out the Target optical and ask about their prices. I'm not sure about the Costco route. I'd have to think about that. Let's just say I'm in Target more often than Costco or Wally-Mart.
Ak, I'm not going to go the argument route. There are people who thrive on conflict, I'm not one of them. I find that we learn more from each other when we tell each other about our life experiences, first hand.
Jimbo! Yes, I noticed the several lines of stuff on my bill, maybe we go to the same dental office. I figure it is just a $50ish trip. That getting reimbursed by the insurance thing would not work for me (which is why I'm cautious about the medical spending account). I can't do mail in refunds for computer equipment right. But $102 for a routine cleaning and examination seems a bit much, but I gather this dentist is not in your HMO's plan.
Viceroy oLU- I'm a Fed and I must of have picked a less dental friendly plan. My plan does offer one thing, women's health screenings are free and that's something at least.
In response to Bogfrog's comment in another post I have budgeted a little less than two thou' for 2007 health care expenses. That's including the $1200 for the employer subsidized insurance and the $500 py HSA (health spending account). I plan to see the dentist, the eye doctor and I really should have a physical, but knowing me I'll put it off till something starts really bugging me.
The problem is that I haven't had a real budget with lines for particular expenses and what not for years. I've tracked my expenses but no conscious decision to say 'ok this month, $500 for food, $25 for entertainment, $40 for the Christmas fund, etc.' I guess I've been like a lot of my friends who budget for the big things like rent/mortgage, car payment, student loan, but let what's left in the bank account, allowed by the credit card limit, to determine the other expenses like clothes, trips, eating out, etc.
So things like routine health care don't get a budget line, because a bunch of other things don't have a budget line either.
i did have dental insurance as a child, but had no idea how much my parents were paying to make sure that we had braces, regular cleanings, the good fillings, etc. (one of those moments where you just want to call your parents and say thanks again.) then i went to grad school, was one year too old to be on my parents insurance, and was faced with an abcess caused by the fact that i grind my teeth. fast forward two years and i not only have 6 cavities (because i don't floss between my teeth), but two root canals that have to be done and a seriously needed bite-guard to pay. cost of bite guard: $500. cost of root canals, crowns and composite fillings: $10K. dental insurance: priceless. did i have decent dental insurance? not on your life. because i was negligent? no, because the federal government (my employer) offers crap dental benefits. sure, now, you can buy supplemental insurance, but i bought that about six months into the whole "renovate your mouth" project, only to find that the in-network dentist put in crap fillings that were bad within 2 months. thank God that i moved overeseas where dental care was fantastic and the cost super cheap, but i can't live overseas forever. as a washington, dc homeowner and resident for almost ten years, i know first hand that finding a good dentist (that has availability) is hard. finding a good dentist (with availability) and that you can afford EVEN WHEN YOU HAVE A DECENT JOB AND INSURANCE is nearly impossible.
i almost cried when i read that article about the little boy...
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