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Edited on Fri Mar-02-07 12:41 PM by haele
It seems as if society thinks that what goes on with teeth is not a medical issue. What is this? - "if you aren't born with it, it ain't important"? If someone has diabetes due to poor health habits, they're treated the same as someone with diabetes due to genetics. Healthy teeth - and by extension, healthy gums - are just as much a product of genetics as is diabetes or heart issues. It's not just cosmetic to insure that people have a full set of healthy teeth. Plaque, bacteria, inflamed nerves and chronic pain in the mouth have been linked to all sorts of chronic and fatal syndromes in the rest of the body.
Why would any competent medical authority consider problems with teeth any different than problems with, say, bones and their connective tissues?
/personal rant -
I have chronic weak teeth and bones due to a work-related chemical exposure a few years back, and while I can be covered by workman's comp for any future bone or respiratory issues, I'm not covered for "any future dental issues". If I had lost my teeth within 6 months of the exposure, they might have covered it, but 8 years (and three employers, two of whom did not provide dental plans) later, they tell me "we can't be sure that it's the chemical or poor hygiene".
I've found out the hard way what separate medical and dental plans ends up costing the average family. The dental plan may only cost a fraction of the medical plan, but a separate dental plan never covers enough if you have more than a cleaning and perhaps one cavity a year. If the medical plan included the dental, the family may pay about $10 to $12 a month more per person on the medical and the minimal co-pay for the dental visits, but in the long run, it would cost less to both the insurance in administration and patient in visits.
I don't understand why non-cosmetic dental would not be covered the same as non-cosmetic medical - I pay a $15 co-pay for medical and they pay 80% of all tests, inpatient procedures and labs, so I never really see more than perhaps $200 for a major procedure, yet should I have two cavities and need a root canal and it's attendant post and crown, I'm paying $700 after the $1200 "limit" of covered dental care is reached - this is what happened with the kidlet this year. She had an urgent care visit/emergency room visit that was billed for over $10K - of which we only had to pay $300 - $200 for the hospital visit and $15 for each of the doctors that saw her.
It seems that it would be far more cost effective to everyone; insurance co., dentist, and consumer that non-cosmetic (i.e. "medical") dental procedures be covered in the same insurance policy as the rest of the other medical procedures - heck, the family Optometrist, my OB/GYN, my kid's Pediatrician, my husband's Rhumitologist, Cardiologist, and certified physical therapist - all of them specialists who are covered equally under my medical plan. So why isn't my dentist under my medical plan, too? Isn't my dentist a doctor, too? Didn't he or she also go to medical school?
Right now, I am being faced with a choice - 6 root canals due to stress fractures in the tooth surface of all my molars or a session of yanking finishing off with a partial bridge. Neither of which I can afford to pay for until the root canals for both the kidlet and the hubby are paid for - which won't be until, say, June? July?
Tell me why this situation should be considered non-medical - why am I faced with waiting on how to choose between "saving my teeth" with a set of root canal procedures for over a $5K, or yanking out the 6 for $200 with an additional $4K for the bridge? The bacteria and plaque build up in my still untreated teeth is just as dangerous and almost as critical as a bacteria and plaque build up in, say a smashed, untreated finger. All of this cost after I pass the $1.2K that my "dental plan" grants me for coverage over the year.
I'm a f'n project manager; mid-level professional. With this economy, I don't seem to be paid very much any more, but I still have responsibilities to my employer. I can't just have all my teeth yanked and still be able to "do my job" and be taken seriously. The mumble factor itself is a huge disability when attempting to communicate with customers and co-workers.
Even with the provided dental plan, I can't afford real dental care until it gets to emergency room visit level of pain. I have to save up a good $1000 up front and will still be paying $100 - $200 a month just to pay off the work that needs to be done, and that's if I want it done at once. If I'm willing to wait 7 years, I can get each tooth done one at a time and live with the pain and the chance of developing a serious medical condition due to the plaque or a possible septic infection in a cracked tooth. Whereas I can go in to my OB/GYN and get a pap-smear, a polyp biopsy and all attendant lab work done for around $120 total. And if they do find a problem like cancer, I can get treated right then and there for about $150 a session and under $100 a month for the perscriptions I will need during the 4 to 6 month period. And follow-up visits would only be $15 to $30 a visit.
That's just unacceptable.
//end Rant
Haele
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