I have a Medicare Advantage Plan that includes $1000 a year for dental care. While at 71 I have all my original teeth, I also have periodontal disease which necessitates occasional deep cleaning into my gums. So, while my teeth felt okay, I visited a dentist last summer in Oregon and asked for deep cleaning.
The dentist's assistant x-rays me and deep cleans 1/4 of my mouth. Dentist drops by, looks at the X-rays, says in addition to the deep cleaning I have two cavities and need two caps.
I say, "Ballpark, what's that gonna run me?" He says not to worry, his admin staff will give me a complete, detailed written estimate. They do.
The estimate shows that to deep clean my teeth, the original mission, costs $250 per 1/4 of my mouth, so $1000 for my entire mouth. It shows my insurance covers $1000, but since I had whatever, x-rays?, it's only gonna cover about 3/4s of the cleaning cost so I will be on the hook for $250.
The cavities and caps, however, will run me well over $3000.
I tell the dental office to finish cleaning my teeth this year (2023), and I'll hold off on the cavities and caps until next year to see of I can get better dental coverage. I return a couple more times over the summer to finish getting my teeth cleaned. In early September, the dental office sends me a bill for ~ $700 saying the insurance company says they will only cover $250 for the deep cleaning of one quarter of my mouth.
I call the insurance people and they say, "Yes, indeed," they only will cover deep cleaning 1/4 of my mouth per year. I say, "So if I want my entire mouth deep cleaned that'll take me four years?!" They say, "Yes." I say, "But what about the $1000 coverage?" They say, "Does not cover more than one deep cleaning per year..."
I ask my medicare insurance broker to look for better dental care for 2024. She finds one with $4K per year coverage, BUT, with it I am not covered by insurance when I travel, plus some other drawbacks, so I pass.
I send the dentist a polite letter in late September. Essentially I explain I am unhappy with him because he said I would get an accurate estimate as to costs, and while his staff gave me a detailed estimate which I acted upon, they now tell me I owe ~ $700 because when they called up the insurance company, the company denied the claim. I point out they should have called the insurance company to confirm before giving me the estimate. This is a disservice to patients, I tell him.
I tell the dentist I will pay the bill, but I want him to acknowledge by phone, email or letter that he has personally read my letter. No response. After a month, end of October, I mail, without comment, the dental office a check for the ~ $700 they say I owe. I'm no deadbeat, even though I feel ripped off.
In early December I come back to Japan for the holidays. I visit a dentist here, one I used for many years while I lived here. I explain I no longer have Japanese national health insurance, but will pay out of pocket. He recommends that I get national health insurance, even if only temporarily, because it is much cheaper. Out of pocket I will have to pay 10X the insured cost. I say, no — Im no longer a taxpayer here, and I don't like feeling I am taking advantage of the system — I'll pay out of pocket.
The Japanese dentist x-rays me, finds one cavity which he fixes at first visit with a temporary filling, and on the next with a large filling made from a mold of the resultant hole in my tooth. He also deep cleans my teeth, entire mouth, again, doing a far better job, and then, on a final visit, polishes/cleans the surface of my teeth. This takes place over three visits of an hour each, over a month, the dentist himself doing all the work. My last visit was today.
Total cost, all in, three visits, at ten times the national health insurance rate: $145.
Meanwhile, just before Christmas, a letter from my Oregon dental office is forwarded to me over here. It's dated end of November. It's written by the dental clinic's office manager. It's a polite letter. She apologizes for the faulty estimate, says she has chastised those responsible and will ensure it does not happen again, returns my check, says my account is marked paid up, says they would never want to lose a customer over such a mistake, and asks me to return for further treatment in January.
I think about this for a while, and then mail her a letter back. I explain that I appreciate her courteous letter, have had my teeth treated in Japan at a much more reasonable cost and hence do not require further treatment for the time being. I also explain that I am keeping the check, as I think her practice can afford it, but that if she personally faces any reprisals, e.g., a paycheck deduction, to please contact me and we'll work something out.
Quite an eyeopener.
I think for as long as I am able to travel back and forth between Japan and the US, I'm just gonna get my dental care done over here.
The dentist's assistant x-rays me and deep cleans 1/4 of my mouth. Dentist drops by, looks at the X-rays, says in addition to the deep cleaning I have two cavities and need two caps.
I say, "Ballpark, what's that gonna run me?" He says not to worry, his admin staff will give me a complete, detailed written estimate. They do.
The estimate shows that to deep clean my teeth, the original mission, costs $250 per 1/4 of my mouth, so $1000 for my entire mouth. It shows my insurance covers $1000, but since I had whatever, x-rays?, it's only gonna cover about 3/4s of the cleaning cost so I will be on the hook for $250.
The cavities and caps, however, will run me well over $3000.
I tell the dental office to finish cleaning my teeth this year (2023), and I'll hold off on the cavities and caps until next year to see of I can get better dental coverage. I return a couple more times over the summer to finish getting my teeth cleaned. In early September, the dental office sends me a bill for ~ $700 saying the insurance company says they will only cover $250 for the deep cleaning of one quarter of my mouth.
I call the insurance people and they say, "Yes, indeed," they only will cover deep cleaning 1/4 of my mouth per year. I say, "So if I want my entire mouth deep cleaned that'll take me four years?!" They say, "Yes." I say, "But what about the $1000 coverage?" They say, "Does not cover more than one deep cleaning per year..."
I ask my medicare insurance broker to look for better dental care for 2024. She finds one with $4K per year coverage, BUT, with it I am not covered by insurance when I travel, plus some other drawbacks, so I pass.
I send the dentist a polite letter in late September. Essentially I explain I am unhappy with him because he said I would get an accurate estimate as to costs, and while his staff gave me a detailed estimate which I acted upon, they now tell me I owe ~ $700 because when they called up the insurance company, the company denied the claim. I point out they should have called the insurance company to confirm before giving me the estimate. This is a disservice to patients, I tell him.
I tell the dentist I will pay the bill, but I want him to acknowledge by phone, email or letter that he has personally read my letter. No response. After a month, end of October, I mail, without comment, the dental office a check for the ~ $700 they say I owe. I'm no deadbeat, even though I feel ripped off.
In early December I come back to Japan for the holidays. I visit a dentist here, one I used for many years while I lived here. I explain I no longer have Japanese national health insurance, but will pay out of pocket. He recommends that I get national health insurance, even if only temporarily, because it is much cheaper. Out of pocket I will have to pay 10X the insured cost. I say, no — Im no longer a taxpayer here, and I don't like feeling I am taking advantage of the system — I'll pay out of pocket.
The Japanese dentist x-rays me, finds one cavity which he fixes at first visit with a temporary filling, and on the next with a large filling made from a mold of the resultant hole in my tooth. He also deep cleans my teeth, entire mouth, again, doing a far better job, and then, on a final visit, polishes/cleans the surface of my teeth. This takes place over three visits of an hour each, over a month, the dentist himself doing all the work. My last visit was today.
Total cost, all in, three visits, at ten times the national health insurance rate: $145.
Meanwhile, just before Christmas, a letter from my Oregon dental office is forwarded to me over here. It's dated end of November. It's written by the dental clinic's office manager. It's a polite letter. She apologizes for the faulty estimate, says she has chastised those responsible and will ensure it does not happen again, returns my check, says my account is marked paid up, says they would never want to lose a customer over such a mistake, and asks me to return for further treatment in January.
I think about this for a while, and then mail her a letter back. I explain that I appreciate her courteous letter, have had my teeth treated in Japan at a much more reasonable cost and hence do not require further treatment for the time being. I also explain that I am keeping the check, as I think her practice can afford it, but that if she personally faces any reprisals, e.g., a paycheck deduction, to please contact me and we'll work something out.
Quite an eyeopener.
I think for as long as I am able to travel back and forth between Japan and the US, I'm just gonna get my dental care done over here.
