Why We Pay More Than We Have To For Dental Work

Nobody likes going to the dentist, right?

The way I figure, though, is that it’s a necessary part of life (if you want teeth past your 50’s), so you might as well make the most of it.

I’ve always paid more for dental work than is absolutely necessary, and I’ve never regretted it.

We have a dentist that doesn’t participate as members in any dental plan.

Dentist by Gamma Man, on Flickr

What does this mean?  That while insurance plans will cover their work, they do not have negotiated rates with any one insurance company.

And I wouldn’t have it any other way.

The way my insurance is structured, a basic cleaning is still covered, but instead of covering 100% of a negotiated rate with an in-network provider, they instead cover 90% of the negotiated rate cost, with the rest being my responsibility.

So, I’ve found that the basic cleaning is covered at $65 by my insurance plan.  This means if I went to an in-network provider, they would pay that provider $65 and I would pay nothing.

My dentist charges roughly $75 for the same cleaning.  The insurance company pays them 90%, but only 90% of the $65 that they normally cover, meaning they pay $58.50.  Since my dentist isn’t participating, they expect the full $75, meaning I pay $16.50.

But why would I pay $16.50 when I could pay nothing?

Because I know the office.  I’ve been going to the same office for about thirty years.  I had the same dentist for roughly 25 years, and I’ve had the same hygienist for almost ten years now.  When it’s time for my appointment, they don’t have to tell me what room I should go to, because I go to the same one.

I know the care they provide.  Even though there’s new dentists, the original dentist still has majority ownership of the practice, and institutes standard practices of care that the other dentists must abide by, and they’re high standards.

Plus, I’ve heard too many horror stories otherwise.

Before we were married, my wife used her insurance, found the office closest to her and went.  Each time she went, she got a different dentist.  She got one filling done that never felt right and later had to be completely re-done (by my dentist).  She had to constantly wait.

After awhile, she even went to a different practice.  Same results.

I’ve heard others started postponing or even skipping appointments because they hated the experience at these ‘sweat shops’.

Outside of the cleaning, there are the x-rays and other work that they do.  The average out-of-pocket is $25-30 for each visit.  For the two of us, that’s meant that we pay about $115 a year, which will increase as the kids start getting dental care.

Still, that’s a small price to pay for having confidence that our dentists and their office staff are trustworthy and will provide good care and accurate diagnosis.

Will this practice be around for another thirty years?  Maybe, maybe not.  But, for as long as I live here, this practice is open, and they still provide dependable care, they’ll get our business.  Even if it costs a little more.

Do you pay more for dental or medical care than you otherwise have to?