Dental Fees and Expensive Insurance Goofs

I hadn't been to the dentist in a while so when I got dental insurance at my current job I scheduled an appointment with a dentist office near my office. I asked on the phone if they take Delta Dental and their answer was yes.

The first appointment for my annual cleaning (covered at 100%, in theory) went as well as I expected. I was pressured into spending $25 for this newfangled technology to scan my gums to see if I have gum cancer (which in hindsight I shouldn't have agreed to -- I don't smoke and there are plenty other kinds of cancer I'm at high risk for that I'm not spending money on getting screened for) and the dentist told me I needed to get a full deep cleaning (root planning and scaling) and that she wanted to fill in my back teeth (about 6 of them) so that they wouldn't get worse in the dark spots.

After spending too many years avoiding the dentist (mostly due to not having insurance) I agreed to all of these procedures. I've been to a few dentists in my life and didn't trust any of them, but I liked this office and other than the pitch for the cancer screening, I felt like I could trust this doctor.

I gave the woman in charge of billing and the front desk my insurance card for Delta Dental. I'm not sure if the card says "Premier" on it or not, but at the time neither her nor I noticed it. Besides, Dental Dental Premier sounds fancier than Dental Dental PPO. Wouldn't you think, logically, that Premier means better coverage, not worse than PPO?

The billing lady gave me an estimation of how much I'd owe with the insurance paying up to my deductible. And it wasn't cheap. It looked like I was going to be spending about $2000 with the insurance to get all of this work done. Well, $2025 with the stupid cancer screening.

I figured it was worth it to spend the money now and get my teeth squeaky clean and filled and healthy. I went through all the deep cleanings and paid for my estimated portion at the time of service on my credit card (hey, at least I'll get some miles out of this.)

So today when I went in to start the fillings the normal billing lady wasn't there and an assistant came in to the room to tell me what work I was getting done. Assuming nothing had changed billing wise, I just asked about why I was getting all four teeth on one side done and wouldn't it make sense to get the four worst (the back teeth) on both sides done first. I asked if the billing lady would be in and she was apparently at lunch and would be back in a minute...

This is when I was hit with the bad news. My "Premier" insurance actually didn't cover this dentist office. Well, it did a little bit, but at a much lesser amount than a dentist on the Premier plan. And, apparently I owed $500 to the dentist just to cover all the work done thus far.

I was shocked and felt like crying. It's not that the $500 is going to kill me, but I'm just frustrated that the billing assistant didn't notice that. In fact I remember the first day I came in she was having a conversation with another new patient about Delta Premier but I wasn't really listening to it and didn't know that was the kind of insurance I had... I figured she would tell me if I didn't have the right kind of insurance for that office. So maybe she didn't know or maybe she just missed it. I certainly missed it.

Sitting in the dentist chair today with a bib already around my neck and the dentist walking in the room prepping to do the fillings, I had to get my head wrapped around the $500 that I owed and the more than $600 that the work today would have cost for just four of the eight fillings I "need." The billing manager woman seemed to think I was going to stay and get the work done, basically pitching that I have more of my yearly deductible left so it makes sense to get the work done now before the year is over. I couldn't do all the math and without knowing how much the costs were going to be, I had to get out of the chair and cancel my appointment. It was really awkward and anxiety-causing. I felt like my head was going to explode but I just got up, paid the $500 I owed them, got an itemized receipt of all my work done, cancelled all future appointments and left.

It IS my fault that I didn't understand the Delta Premier situation and how it's different from the Delta PPO I had at my last job. I also didn't really pay attention to the mail I've been getting from Delta because I assumed I paid everything at the time of service... I had been paying more than $200 each time I went in and it was adding up fast.

Now I just wonder if I should bother trying to get fillings at another dentist that's actually on my plan. It still won't be cheap and I had budgeted for the dentist office's estimated costs. I didn't think they'd be $500 more just for a deep cleaning. I don't even understand this itemized bill... what should have been covered if I went to a Premier provider versus what wasn't. I thought the original cleaning and basic xrays were free with the insurance, but it looks like they weren't. I have no idea what I paid for or if I should have or what should be covered by my insurance. No freaking idea. This is really making me, well, not happy at all. I spent more than $1000 this month on medical expenses (incl. doc, vision and dental) and I haven't even gotten my fillings done. I give up. I am just going to avoid the dentist in the future. I'll stick to toothbrushes and floss.