How to Save on Dental – 10.17.2018

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: Welcome to our new patrons this month- Courtney, Dave and Rachel!

: DAVE!

: Welcome to Oh My Dollar, a personal finance show with a dash of glitter. Dealing with money can be scary and stressful. Here we get practical, friendly advice about money that helps you tackle the financial overwhelm. I’m your host Lillian Karabaic.

: I’m your producer, Will.

: It is healthcare month on Oh My Dollar!

: Yay! Happy October.

: We are going to devote multiple episodes this month to untangling the mess of money confusion in health care. If you’re a non-American listener – we’re sorry, you’re off the hook once again. We’ll have a bonus internationally applicable episode uploaded soon, so please don’t abandon us entirely.

: Please enjoy your more functional health care system and walk off with smug superiority.

: Or listen with smug superiority.

: You could do either. You could walk off while listening.

: Smug and superior.

: So today we’re going to talk about dental!

: *tap tap tap*

: Which is a thing that a lot of people kind of conflate with their health insurance – but usually is a separate part. It is a often separate insurance company. Sometimes it is bundled with vision. Sometimes it is bundled with just general employee support benefits and often you don’t have it at all

: Yup,the latter.

: So dental insurance, we’ve talked a little bit before about, but it is one of those tricky and frustrating things – because it’s something you don’t really think a lot about until you need it. Usually you need it in a kind of urgent way if you really need it, and a lot of jobs simply don’t have it. About 72 percent of adults have some form of dental coverage – which is actually frankly better than I thought.

: I would have thought lower.

: I don’t know that many people dental coverage, I don’t think. Here’s the thing. Teeth can be really, really expensive – really expensive and most dental is not covered by typical health insurance. Some emergency dental might be covered by your regular health insurance, but majority of dental work is something that you are going to have to self-fund or will be partially covered by your health insurance. And what’s even more frustrating is the cost of dental procedures can be totally opaque. It can be really hard to figure out how much things cost. So if you do need some dental work done we’re going to talk about kind of different ways that you can save some money on dental. So first make sure that you do know if you have access to dental insurance – a lot of people just don’t even know.

: Yea! If there is some random provision in your health insurance, that’d be great to know about.

: Yeah. Or just if you have it through work you might not realize that you know you’ve been getting 8 or 10 or 20 dollars taken out of you know every month’s paycheck for dental, and might not realize that you have it. So that is one of the first things.

: That would be a cool surprise.

: Dental is kind of similar to kind of regular health procedures it’s really in two categories there’s preventative and then there is kind of emergency or more urgent care. Preventative is usually your semi-annual cleanings. If you have had trouble with your teeth in the past, you may be asked to do cleanings more often which could be every quarter and your x-rays, which usually you’re supposed to get every one to two years depending on your mouth history. And quite often if you do have dental insurance through your job you will have that preventative care covered. The average rate for a cleaning is somewhere around 200 dollars every six months but you can get it down quite a lot less if you do not have dental insurance. Usually, you can get a discount for paying cash out-of-pocket which can include paying with your credit card.

: Oh! Just because everybody prefers to be paid that way?

: It is because dental insurance is just as frustrating for dentists as it is for you. It is really frustrating to do the billing and filing and so if you’re paying them in cash, you are saving them a lot of time in billing and filing. And so you know I pay. I think I pay a ninety nine dollars every six months for my cleanings.

: Ok that’s substantially cheaper than the 200 you mentioned earlier.

: Yeah. And so getting preventative care is one of the – We’re not a health podcast- but what I will say is it is one of the best ways to save money on dental in the long-term because that preventative care can catch things early.

: Worth a pound of cure or whatever.

: Yeah and dental gets really expensive once you’ve delayed stuff so, you know, once something turns from what could be a minor filling into a root canal. It gets ten times more expensive to get a root canal, as it does to get a filling.

: And so much fun.

: So that is really important and you might also prevent be able to prevent having to get a filling entirely.

: Entirely!

: So one thing you can do is to shop around if you do need something substantial done. So, I have some dental that I’m going to need to get coming up for myself which is that I got a retainer installed when I was 13 years old. And at some point my gums grew over it. So, I need to get it removed and as punk rock as I am I don’t want to pull it out with a pair of pliers myself like I did to the other retainer as a teenager.

: Ugh, that’s awful.

: Less hardcore than I was when I was 17.

: *laughing* That’s good.

: And that is exactly the kind of procedure that you can shop around for. If you are willing to spend about an hour on the phone calling around at different places and trying to get a quote, You can probably save yourself some money. A lot of people will default to whatever their closest dentist is. Or, maybe you had dental insurance at a previous job, and you just went to wherever was covered under your dental insurance and you’ve stuck with that place even if you don’t have it now.

: They know your mouth.

: Now you can shop around and you can also shop around even if you have dental insurance! You will have to log into your dental providers web page, If you don’t know it ask your H.R. or whoever plays H.R. at your job how to get on, but you will be able to log in and find in-network providers. You do want to make sure that you’re going if you do have dental insurance that you’re going to someone in-network.

: Yes, so you don’t pay a bunch more out of network out of network.

: You’re essentially just paying cash, the same as cash at that point only you’ll pay more money you.

: Yea, you got your fancy dental insurance you don’t want – Don’t waste that.

: If you do need a complicated procedure you will likely have to go in for an estimate which does involve more dentist office trips. So if you’re scared of the dentist office you might not love doing that.

: Don’t get complicated procedure done!

: But that is worth knowing. So shopping around is one of the big things. Rates really do vary a lot. This is one of those areas where you could be paying thousands of dollars more overall and just not know it because we tend to accept whatever they tell us it is.

: Right

: And you can look up typical rates for different kinds of procedures at fairhealthconsumer.com That is not an official Web site. It’s just a Web site that I find and kind of like that shows you – uh – in different regions, kind of what a typical prices for different things.

: That sounds useful.

: You should always get an estimate, if you are getting something big done.

: And they will have to print out and EOB or explanation of benefits. And that should contain kind of the estimate for everything that they are going to do on your mouth. So that is important. So what if you’re like “OK, I got an estimate. And holy schnickes! There is a lot of money that I’m going to have to spend!”?

: If you are considering getting more than two thousand dollars worth of work done. Say you need multiple root canals or you need a gum grafrt.

: Grit your teeth and bare it.

: *laughs* uhhh!!! Yeah that’s pretty good pun.

: You have different options so one option is to look into dental clinics in your area. So often, dental schools will have a clinic where dentists in training are underneath qualified dentists and usually the work is about half the cost of what it would be at the average dentist. Sometimes they even do take insurance, so even if you do have insurance you could get the cost reduced.

: That sounds promising.

: It can be good. It might take a little longer obviously, like I get my haircut by students and you know what it takes longer. But that is definitely a thing that you can look into if you do have a dental hospital near you. Another thing that you can look into is going even further away, which is dental tourism. So across the board, dental is more expensive in the U.S. than almost every other country in the world.

: Wow.

: Thank you America. And there is high-quality dental work available in numerous countries. Quite often you can get to these by a discount flight or even a drive or a train ticket.

: Sometimes people will tack these on to business trips.

: I’ve definitely heard that even with travel expenses can be much cheaper for some procedures.

: Yeah this can make a huge difference. So countries with high rates of dental tourism are Costa Rica, Czech Republic, Hungary Mexico, Thailand, and South Korea. So that’s all over. I think we think we’ve got -.

: It all sounds like a nice trip.

: Full spread there. Obviously this is a thing where you really need to do your research, but it could make a huge difference if you have tens of thousands of dollars of work that needs to be done. For example you need, you know, implants or flippers or some kind of -.

: I don’t know what flippers are –

: Flippers are – if you knock out your front two teeth. It’s sort of like a temporary denture for

: Oh okay!

: For the front two teeth.

: So if you do need to get some work done, you should seek out evaluations from past patients. General Recommendations I’ve seen are to avoid immediate border towns, because quite commonly those are kind of over flooded with patients.

: too obvious

: Yeah and don’t forget to ask for proof of competence before you make an appointment. Things you might want to consider that you might not thought of or whether or not the water is filtered especially in places like Mexico where water quality can be an issue. They put a lot of water in your mouth when they’re working on your mouth.

: Yea! And not all of it gets squirted back up through the little mouth tube.

: Yeah. And also look into what the local standard of care is because kind of the typical procedure that you might get done for different kinds of thing on your teeth varies by country. And it is called “standard of care.” So. really look into that. But that could save you tens of thousands of dollars if you have a lot of work to get done. It usually won’t pencil out if you only have a couple of hundred bucks worth of work to do. Like I need this retainer removed. It’s not going to cost that much.

: Not going to justify a trip to Thailand.

: I mean, I could justify a trip to Thailand but I’m very good at justifying travel.

: Some insurance companies even if you do have insurance actually do have an international treatment option to their U.S. dental plans where they will actually pay a larger portion of your costs, if you’re willing to travel.

: Well, yea, I mean, I guess if it’s cheaper for them.

: Yup yup. So do look into that if you do have a lot of expensive things to get.

: One thing to note – one reason why we’ve previously not been a huge fan of dental insurance on this show which is great if you have it,.

: I would like it.

: Yeah I would like it, too. It usually doesn’t pencil out to get for yourself, simply because the cost does not kind of pencil out to the out-of-pocket maximum (I MEANT TOTAL MAXIMUM). So you know all of those sort of things that we changed with the Affordable Care Act for health insurance they don’t apply to dental so most dental insurance has an [total] maximum of about a thousand dollars a year which barely covers a root canal. And so if you’re paying 30 dollars a month and, you know, you’re only getting you know you know some cleanings it ends up not pencilling out as compared -.

: yea, you might as well just paid without insurance.

: And it’s not like regular health insurance where we say get it. In case you, you know, crash your face into the ground. Dental insurance is not going to be that catastrophic coverage similar to how we say you should get health insurance because your cancer –

: Is there catastrophic dental coverage?

: There is not. Dental – dental insurance –

: For hardcore bands and skateboarders.

: It’s kind of like a discount plan. Right. I mean I would really like that. Right. As someone who does things that are potentially risky for my teeth

: Potentially tooth smashing.

: And drinks a lot of caffeine and grinds my teeth.

: Hand-in-hand I think.

: And the other thing is they often have waiting periods, so quite often when you do get dental insurance, you are not able to get certain kinds of things – like fillings or root canals within three to six and sometimes – months – sometimes even a year after you get the plan. And that is meant to prevent you from having to get a lot of dental work done and then immediately signing up for a dental plan. So they do have those waiting periods, sometimes you can also be denied from joining a dental plan or denied coverage for certain kinds of things based on the history of your mouth.

: huh.

: But if you have it through work, take it it’s great. I’m so glad that you have it! Uh, unless it’s outrageously expensive.

: Hook me up. *laughs*

: So another option,that we’ve talked about before our dental discount plans, which often don’t have [total] maximums because they’re essentially like a network of coupons that you pay to be part of. And usually costs like 50 or 100 bucks to join each year to be a member. But then you can search through and you can get discounts at different doctors offices that have pledged to be part of it –

: Half off braces on Wednesdays or whatever.

: Yeah. totally! exactly like that.

: So what’s cool about this is that you can search by provider, by your neighborhood, by your zip code before you join the plan and see if maybe it’s going to pencil out. And it’s not like insurance where it has to get billed to them. So it’s a little less frustrating for the providers so quite often the discounts are really good and can save you money if you’re paying in cash so it can often be worth it. It can even be worth it, if you just have to get preventative care and you’re not going to have to get any fillings or anything because, as we talked about you can often negotiate a deal if you’re paying in cash and these discount plans will allow you to do that.

: I should look into that!

: Those can be really great. Another thing to do is to look into an FSA or HSA, we talked about these last week on the show but these are flexible spending accounts and health savings accounts. These are special tax-advantaged accounts for medical expenses. Both you can open on your own but your employer may provide them. But for the HSA, you need to make sure you have an HSA eligible plan. We talked about that on last week’s show!

: Yea, it will say HSA eligible.

: Yeah we will link to that in the show notes so that you can dive into that. But what’s cool about these is they let you spend tax free dollars on dental costs, so it’s essentially like an automatic discount plan whatever you pay in taxes – so if you pay 25 percent of your income – in taxes you will get a 25 percent bonus of money that you can spend on dental and also vision.

: If you are somebody who needs glasses.

: So these do apply to dental despite the fact that a lot of other health plans don’t apply to dental.

: Yes so these savings account it is your own money, or your employer’s money and so they you can use them on dental and vision. You can have both an HSA and an FSA in rare circumstances. But if your dental is really expensive and you know you’re going to need a lot of work, it could be worth looking into opening both in one year. So that can be particularly awesome ways to save money on dental. So let’s re-cap.

:  *laughs*

: re –

: Yea, I guess it is called cap isn’t it?

: I guess! I am not a dentist.

: `Let’s re-crown!

: To recap, negotiate your rates. Shop around, look into different costs. Look for a dental school. If you need a lot of work, consider actually going abroad. It could work out well. Use tax free money through an HSA or an FSA on yours and if you don’t have access to dental insurance, you may want to look into a dental discount plan. I will link in the show notes to some different kind of dental discount plans, which are not dental insurance but are essentially coupon programs for people without.

: I’m gonna look into that. I’m intrigued.

: And last but not least is kind of orthodontia, which falls outside of – most dental plans will not cover orthodontia especially adult orthodontia unless you like actually cannot meet your teeth to chew.

: Yea – it’s for like a health, health-impacting orthodontia.

: Yeah, that is a rare circumstance but if you do need some kind of orthodontia for various reasons, there are some cool different things that I will link to in the show notes, that will let you like get your orthodontia through the mail now. Oh hey. You know those invisalign – is it was the brand name of them – but essentially those clear braces that you would put on and they would slowly, you would get a new set like every month as your teeth change.

: Yeah yeah yea.

: Which is like only the cool rich kids had them.

: I know some of those kids who had them.

: – when I was in school but, um, now they are quite common and what most adults, if they do want to get some kind of orthodontia want to get simply because braces tend to make you look like you’re 12 or 13, no matter your age. So, a lot of people tend to want to get those invisible things and now you can get those through the mail. So there’s lots of cool things that you can do.

: Braces always seemed like a nightmare. I was lucky.

: You didn’t need braces?

: I have very straight teeth. You can see them through the microphone.

: I was very lucky that my parents were able to afford to get braces for me –

: Gah! That’s even luckier in a way.

: So I’m very happy that they did that, although I do have this pesky little permanent retainer I need to remove because

: Yea, it’s extra permanent now. *laughs*

: Seriously permanent! *laughing*

: So that wraps up dental!

: teeth!

: Teeth! Well, Will, I think our listeners know the drill. At the end of the episode.

: Brace yourselves!

: Brace yourselves. We are on a mission to get 50 reviews and 100 ratings on iTunes before the end of the year. Right now we’re at 11 reviews and 47 ratings. It takes three minutes to leave a review so please help us out. The link is on the show notes. And ohmydollar.com – Where you can also find transcripts now!

: Yea!

: We now have full transcripts for each show made possible by our supporters on patreon and the members of the purrsonal finance society. So thank you so much. And if you like to read to scan and click to see what you like you can click on the transcripts and jump right into the audio which is very exciting.

: Very cool. It looks great.

: Well hopefully you’re not too *unnerved* by this dental discussion, but I think that wraps our show for today.

: Our producer is Will Romey. Our intro music is by Aaron Parecki, and I’m Lillian Karabaic, your personal finance educator and host. Thanks for listening until next time, remember to manage your money so it doesn’t manage you.

: Just a quick reminder that we are on a mission to get 50 reviews and 100 ratings on iTunes before the end of the year. Right now 11 reviews and 47 ratings takes what three minutes leave review. So please help us out.

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