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Why Americans Have the Worst Dental Insurance Ever

Why does American dental insurance cover so little for such expensive procedures?
 
 
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Wendell Potter writes, in a series of posts about the poor state of dental coverage, that millions of Americans — 36 percent, according to a 2013 survey —put off visiting the dentist because of the cost of dental care. Last year, I became one of them. In pain, and in need of emergency dental care, I was shocked to find out how little my dental insurance covered.

At the age of six, I was physically assaulted by my dentist. The experience left me with dental PTSD that made my childhood dental visits terrifying. As an adult, my dental visits became rare, were usually emergencies, and required Valium.

Last fall, a toothache drove me back  to the dentist’s office. I was able to get the care I needed, but my fear of being in the dentist’s chair again was nearly matched by anxiety over at how much it would cost, and anxiety over how I would pay for it.

I was fortunate.

I wasn’t one of many Americans who end up seeking dental care in the emergency room — at 10 times the cost of preventive care. The ADA Health Policy Resources Center puts the number of dental-related ER visits in 2010 at 2.1 million, and the cost to the health system between $867 million and $2.1 billion.

I wasn’t one of nearly 50 million Americans who live in areas with too few dentists or none at all.  Potter describeswitnessing thousands of people waiting in the rain for hours to get medical care in barns and animal stalls on a Virginia fairground, during a three-day Remote Area Medical health care expedition. Most were there to see a dentist, not a doctor. Some drove from as far away as Florida and Wisconsin for dental care they couldn’t find or afford back home.

I found a dentist near my office in downtown Washington, who could see me right away. She took an x-ray, and told me that I needed an emergency root canal, set up an appointment with an endodontist, and gave me a referral. I would also need to return for tooth restoration and a dental crown.

I wasn’t one of the estimated 130 million Americans without dental insurance. I had dental coverage — albeit rarely used — through my employer. Otherwise, I might have ended up in an emergency room, in far worse pain, with my health in even greater danger.

I was, however, one of many Americans who didn’t know how much some dental procedures cost. According to the Bureau of Labor statistics, the cost of dental care has risen faster than the cost of medical care overall. Between 2008 and 2012, only hospital and adult day care costs rose faster, but annual spending caps on dental coverage remain stuck at their original Watergate-era levels, between  $1,000 and $2,000.

I was also one of many Americans who didn’t know how little dental insurance covered. The dentist’s office staff assured me I had “very good” dental insurance. Yet, the cost of a root canal, restoration, and dental crown was close to the $1,500 annual spending cap on my coverage.

I got more bad news when I returned to the dentist for restoration and a temporary crown. She did a thorough set of x-rays, and said that I needed another root canal. Unbeknownst to me, a tooth had cracked as a result of bruxism, and decay had set in.

My dental insurance covered two root canals per year, but the cost of just one — and the necessary reconstruction and crown — was within a few hundred dollars of the annual cap on my dental insurance. It would not cover the second root canal, restoration, and crown.

 
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