Price of dental

[Valerie]

Medicaid covers dental in the US for children under the age of 21. The trick is finding dental clinics that will accept Medicaid and then getting an appointment when you do find one.

In my state, endodontics are covered - there are 0 endodontists in network. You have to call your MCO and then have a three way call with Dentaquest to demand to see a specialist. They then spend weeks (or months) finding one who is both taking new patients and who will agree to treat you.

In my experience, they find ways to get out of covering almost anything beyond a routine cleaning.

I just wonder how much of the cost that self-pays face is a direct result of the discounts that insurers demand, forcing providers to work below cost, which must be made up somewhere?

From my experience when I was self pay a year I didn't have insurance I was surprised that Dr. bill was pretty low. I think it is the other way around JM. My Mom has medicare and she still spent $8000 out of her own pocket. I have dental insurance through work which pays $1000 in dental a year which is a tiny fraction of what I need done. Apparently we are all paying for the education and advanced technology used today. I'd rather the days gone by where all people could afford dental work for the most part.

[barnhart]

I just wonder how much of the cost that self-pays face is a direct result of the discounts that insurers demand, forcing providers to work below cost, which must be made up somewhere?

This is a valid concern. Just because the provider is willing to settle does not guarantee that is the actual cost. I know a surgeon who was in private practice for a while and his wife was the office manager doing the billing. Settling for what you can get is a valid strategy, the next option is sell the debt to the collectors for pennies on the dollar.

[Josh]

Medicaid standard payments for dental are about $38 for a cleaning, which isn’t really break even. (Insurers are about the same, so dentists that take insurance have to try to sell you other stuff to actually turn a profit.)