Have you ever wondered why trips to the dentist can be so expensive, even if you have insurance? It’s not because of inflation — it might be something you’ve said.
In a recent viral TikTokDr. Brady Smith responds to a commenter who asked why a root canal cost $1,200 over and above the portion of the bill covered by insurance.
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The Washington, D.C.-based dentist says the commenter’s bill likely rose so much as a result of a simple question: “Do you take my insurance?”
“It’s a bad question,” Brady says. What you really want to ask, he suggests, is “Are you logged into my security?”
“You’re going to pay more each time at an out-of-network office, and sometimes that’s not fully transparent,” says Brady.
He goes on to say, “It’s one of the less transparent but common practices of many out-of-network dentists.”
Asking the right question, according to the good doctor, could mean paying $200 or $300 for a root canal instead of $1,200.
Here’s how you can make sure you don’t get hit with extra fees at the dentist’s office.
Know your network
It’s not enough to just know if your dental office will accept your insurance plan.
If the office accepts your plan but isn’t part of your insurance company’s provider network, Brady says, “they can bill the insurance company, but they can pay literally any amount they want.”
This is what leads to a situation where a patient pays $1,200 out of pocket for a root canal that is also covered by insurance.
“They’re not very forthcoming in many cases with that information,” adds Brady.
Insurance companies often contractually require dental offices in their networks to cover the full 80% of dental fees, leaving the patient to cover only 20%, known as a “copay,” out of pocket.
If you have employee-sponsored insurance, ask your human resources representative to review your dental benefits with you or call your insurance company yourself to make sure you know which health providers are in network and exactly what is and isn’t covered for you and your family.
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Don’t accumulate your insurance
Most insurance plans run out by the end of the year. So while you may not want to use every dental dollar in January, you’re leaving money on the table by not using your dental benefits at all.
Not only are you losing money in the long term, but in the short term as well. Those who skip dental visits may not realize they have serious oral health problems such as gingivitis or tooth decay. Not only do these cause horrible problems in the mouth, but they can also spread to the rest of your body. For example, the National Institute on Aging found that gum disease is linked to dementia.
By the time you get dementia, you may no longer have an employee benefit plan because you will be retiring. And don’t think Medicare is going to save you. The agency website says it doesn’t cover “most” dental care.
So unless you have a lot large emergency fundmissing dentist visits can create significant unexpected health care costs;now and in the future.
So take advantage of your dental benefits while you still have them. It will keep you smiling long into your old age.
Use your health savings account
If you’ve exhausted all your benefits but still need more dental work, consider using your Health Savings Account (HSA).
An HSA works as a savings account for health-related expenses, according to the US government website Buy Health Insurance. Although some employers offer HSAs, you can qualify as an individual. The IRS oversees the program to ensure you have a high-deductible health plan that qualifies you for an HSA.
The IRS has Increased the 2024 maximum deductions for HSAs at $4,150 for individuals and $8,300 for families;
Even if you don’t end up needing your HSA, you can invest the money from it. So, in any case, it’s a win-win for your mouth and your wallet.
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This article provides information only and should not be construed as advice. Provided without warranty of any kind.
