The Continuing Drama Of Dental Insurance In Retirement

Back in August, I wrote about DH and I getting dental insurance from Humana. You can catch up with that story by clicking here.When you are retired and on Medicare, dental and vision care (as well as hearing aids) aren’t covered. You have to purchase a supplemental insurance plan to go with your Medicare provisions. Our first attempt at dental care insurance a few years back was a total disaster. The insurance paid for nothing. No dentist would take the plan, so after paying $360 in premiums, we cancelled the plan and accepted the loss.

So, you can imagine our hesitancy when again we pressed for dental care insurance. Hubby and I haven’t had our teeth cleaned in years and after listening to all the other retiree dental horror stories (such as flying down to Mexico to get a tooth pulled) DH and I tried once again to apply for dental care coverage.

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This is Humana Dental Insurance Coverage. Cleanings and X-Rays were 100% covered with no deductible.

After going through several insurance companies, we narrowed it down to Humana. We called our favorite dentist and inquired if they took this particular insurance. They said they did. We bought it. When we got in the dentist chair, we were informed the dentist changed his mind. We were asked to either politely leave or pay the $800 fee for both of us to get our teeth cleaned as well as get a full mouth set of Xrays. Needless to say, we left. (Read all about it here).

My husband really wanted dental care. So, we tried one more dentist office, in the area. This time, however, we went to the dental office first, handed in our insurance cards and asked specifically if both the X-Rays and teeth cleaning would be covered by our new insurance. The office clerk took our cards, went into the back office and later came out and told us that yes, indeed, the office would take our insurance. My husband then proceeded to get his teeth cleaned later on that day. I had a later appointment. Hubby also got his full routine oral exam as well as a full mouth set of X-Rays. Ditto for me.

Neither hubby nor I have any cavities, tooth decay, gum disease. Our teeth were in very good shape! No dental horror stories here! After our work was completed, we stopped at the check-out desk to make our next appointments in six months. We were told no money was due and we were ‘good to go’. With a sigh of relief, hubby and I left the dental office happy that we had finally found a dentist who could care for our teeth. And we finally had good dental insurance.

A few weeks later, the bills started pouring in. First hubby. Then me.

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This was hubby’s bill. He owed $263.
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This was my bill. I owed $246.80

People, I find all of this terribly frustrating and disappointing. Especially since Hubby and I were very specific, verified everything before we had anything done to our teeth and voila’. Not only were we paying $43 a month in dental insurance but we were being billed almost full price for the work being done.

Normally, I would have called the dentist office and would have been my usual nasty self. Truthfully, they deserved it. This time, however, I decided to be more reasonable. DH and I liked this particular dental office. We liked the staff. We liked the service. We liked the building. DH wanted to resolve the problem but somehow hold onto having all our future work done at this facility.

First hubby called about his bill, placed on hold and they told him they reduced his bill to $155. This was still not good, as far as I was concerned. 100% coverage and no deductible is what we were promised and what we signed up for. So, I called the insurance company. They in turn told me the dental office did NOT do the regular cleanings our insurance covered. Instead, the dental office did ‘deep cleaning’ which was NOT covered by our insurance. Also, the dental office did NOT follow the insurance procedures and guidelines.

I called back the dental office, spoke with the billing manager, explained what the insurance company told me and asked her, politely, if her staff could go back in and re-bill our services with our dental care insurance company, Humana. A few days later, I followed up with the manager and she told me my revised bill was only $86, Hubby’s bill was reduced down to $105 because he did need to have the extended periodontal work done. Fair enough. At least she got DH’s bill reduced by another fifty bucks.

Needless to say, I called the insurance company back and cancelled our insurance.

We paid $43 for 6 months worth of dental insurance = $258, plus my $86 and DH’s $105 = Grand Total of $450. If we had started from scratch and paid the dental office cash, we would have qualified for a discount and we probably would have paid less for the whole kit and caboodle anyway.

As with our vision care, we pay cash, get discounts and it works out to be less out of pocket expenses than insurance in the first place!

Just another fine day in retirement land. And as I originally expected, Humana denied most of my coverage because they said I was too old for the procedures. Enjoy your old age people! It just keeps getting better and better. And, as the financial wizards have been advising (warning) us: save, save, save and make sure you have loads of money. At least $250,000 in cash as that is what you will need for a couple, age 65, to cover their medical costs for the next 20 years.

After that, all bets are off!

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THIS WAS AS I EXPECTED IN THE FIRST PLACE: THE INSURANCE COMPANY THOUGHT I WAS TOO OLD FOR THE SERVICE THE DENTAL OFFICE PROVIDED AND DENIED ME

 

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13 comments

  1. In 2014 my 20 year old, never more than $200 a month, Humana medical policy was canceled thanks to the Affordable Care Act. Since then I have been paying cash, with discounts for all medical, dental and vision needs. I’ve found the services to be exceptional and am much healthier as I hate to spend cash on illness! I was able to obtain a $67 a month catastrophic policy to feel at ease that 5 big killers would be covered.

    Keep at it girl…you got this!

    Like

    • Hi Laurel. The same thing happened to use. We were never more than $400 a month for the both of us, with no deductible and a very low co-pay. It’s been a nightmare ever since the ACA hit the scene. twice the companies insuring us went bankrupt!!!
      Thank goodness I’m on Medicare. Hubby has another 2 years of this nightmare to go!
      We’re finding out that cash is king. Unbelievable.
      Thanks for your comment!

      Liked by 1 person

  2. I have spent $3000, for my share, on my teeth this year and I have state dental insurance, which pays 50 percent. I do have very sucky teeth, as did my momma and my grandma…… sigh. I will probably be flying to Mexico in a few years also because I spend way more time at the dentist office, than the doctor office.

    Liked by 1 person

    • Hi Cindy. I have heard some really great things about dental care in Mexico. Some retirees rave about it. Clean and super affordable. It’s sad we can’t get affordable dental care here in America.
      Oh well.
      Hang in there. Good luck.

      Like

  3. I have never found dental insurance very useful. The expensive stuff (braces, tooth implants, etc), they only want to pay a fraction. What good is insurance if it only pays the easy stuff? That defies the whole concept of insurance.

    When my son was young, they denied paying for laughing gas during a big cavity. I was incensed. I called my employer’s hotline and the insurance co bitterly complaining. I told them it’s this kind of BS that could cause a dental phobia because the pain wasn’t properly managed. I was lucky and could afford paying for this, but how many people can?

    Rant, rant, rant – I think dental insurance is worthless.

    Like

    • Maggie. I agree with you! Vision insurance is also worthless. Best to just find a less expensive office or at least one that will work with your budget and just get it done that way!
      Sad!
      Thanks for your comment.

      Liked by 1 person

      • I don’t mind vision as much as dental. I ordered a pair of glasses online from Zenni. I wear progressives, so I wasn’t too optimistic. They turned out awesome and cheap -$140 including frame & protective coating. The frame is a little bigger on my face than I like, but who cares?! It’s been a year and they are holding up well.

        Like

      • Maggie that is very good news! My husband needs progressives but is squawking at the $400 price tag. I’m going to have him check out zenni. You just may be a life saver. Thanks for sharing. 💕💕💕

        Liked by 1 person

  4. Check out Costco for glasses. I just ordered a new pair for $149.00. They are regular bifocals as I don’t like progressives, but progressives will still probably be cheaper than anywhere else at Costco. Worth a call!

    Like

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