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budgeting for dental costs
Old 02-02-2015, 04:22 PM   #1
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budgeting for dental costs

A few questions:

1) Did you self-insure for dental issues after retirement? If so, how did you decide on a number to set? Our costs really have been minimal but the past few years I've needed more crowns. Do dental costs go up as you age?

2) If you did insure, do you have a company your recommend? Is there such a thing as "catastrophic" dental insurance? Is it worth it? I guess my biggest concern is if one of us ended up needing an implant or something like that. I read on this forum some have spent $10 - $15K on that kind of issue.


My gut tells me it is best to self-insure, but just trying to figure out how much to plan for. We have a friend who is a dentist, and he recommended we self-insure. He also advised us that dental costs for private pay vary widely from state to state. For example, Florida has higher costs. He has clients that drive back here to Alabama for dental work. It is definitely something to consider...
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Old 02-02-2015, 04:46 PM   #2
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My base costs for cleanings alone is $375. A small simple filling adds $140-$180 depending on where it is. My only crowns were some time ago, but they cost ~$1200 at that time as I remember.


These costs do in general increase with one's age. For example you posted an implant price. Quite a jolt right there, for one tooth.


Ha
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Old 02-02-2015, 04:57 PM   #3
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The basics are covered by insurance for us, two checkups a year and fillings as needed. Beyond that though it doesn't cover much. I paid $600 OOP for a crown last year but that was the 2nd one and I'm almost 65. Since our teeth are generally in good shape I don't worry about it much.
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Old 02-02-2015, 05:22 PM   #4
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I self insure my dental care.

As I was retiring I spoke to the dentist insurance biller about whether I should get dental insurance. Her suggestion was that the amount dental insurance did not pay plus the premium would be more than 2 cleanings and one dentist visit would cost.

I've been retired almost 10 years and only one year did I have any services over and above my routine preventative care. So, self insuring has worked out for me.
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Old 02-02-2015, 05:37 PM   #5
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Same as above I self insure because the only plans I have found are basically a prepayment of services. Two cleanings and 1/2 a crown.

Thing that ticks me off is they don't cover prevention, in my case a bruxism appliance. Saves a bunch of money and pain, I destroy one every two years, not covered by insurance ~$600, as opposed to how many broken crowns and teeth. It makes sense to the insurance company.

Implants: My dentist first for an estimate. Then I'd check with our local dental college. Then a BIL who's a DDS, at least his portion would be at his cost.
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Old 02-02-2015, 05:54 PM   #6
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I self insure. One main reason is that there really isn't a ""catastrophic"" type dental insurance where you meet a yearly deductible and the insurance picks up the rest. Instead, there's a annual limit that insurance pays.
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Old 02-02-2015, 06:04 PM   #7
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We self insure as I didn't see how it was cost effective, and most retired people I know who have it, have it as a benefit from a former employer.

It's just part of a general set of "rainy day" funds we have set aside for unexpected large expenses. I don't think we ever budgeted for it, but we have let our rainy day fund grow over time so we don't worry about it.

You could do something like: budget $2K a year, and then when it gets up to some amount like $6K stop contributing until it drops below $2K.

Around here, budget conscious seniors go to Mexico for their dental work.
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Old 02-02-2015, 06:05 PM   #8
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I think most of us self-insure. The available dental insurance plans are mostly not worth it. Personally, I treat dental work the same as car repairs.

Things to keep in mind:
  • Implants are expensive. Each one will cost several thousand dollars and involve months (sometimes many months). But they are well worth it.
  • Preventive care is largely up to you. Daily flossing and brushing cost nearly nothing and provide enormous benefits.
  • There is no reason not to get a second opinion if you're uncomfortable with a dentist's diagnosis.
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Old 02-02-2015, 06:38 PM   #9
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I broke a tooth recently. It's a molar with a large old filling in it. I'm getting a Cerec crown in a few weeks. The cost of this is $929. My dentist knows that we don't have insurance and he offered to do the Cerec crown for the price of a regular crown - $520. I didn't even have to ask, he offered.

When DH was working we had dental insurance. We also had it when he had decently priced retiree insurance. It was just about equal to 2 cleanings and X-rays a year. It had a $50 deductible and then only paid 25% on major restorative work like a crown.

I shopped for dental insurance at healthcare.gov this year and every one of them had a 12 month waiting period for major restorative. So we are self insured.


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Old 02-02-2015, 06:58 PM   #10
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We might do a healthcare.gov exchange dental plan. The cost was roughly what annual cleanings and x rays would be, and then we would have a portion of major and minor restorative treatments covered.

The kids will be on the State Health insurance plan that includes dental.

Our current dentist participates in the cheapo healthcare.gov dental plan as well as the state dental plan.
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Old 02-02-2015, 07:47 PM   #11
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My father was the son of an Irish immigrant, so he had a full set of dentures by the time he was 35. Never saw a dentist until he was an adult. But, because of fluoride, I am a 52 year old man with all of my own teeth. The problem is that they are full of cavities, so 5 of them have crowns so far. I budget for one crown and one root canal per year. I go to the local dental school, so that costs about $1000 for a crown and $1000 for a root canal.
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Old 02-02-2015, 08:05 PM   #12
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I self insure, but then I self insured before retirement too.

Yes, sometimes big dental expenses arise like the dental implant that I had done in 2013-2014. But, these are to be expected in the same way that the occasional broken air conditioner or plumbing problem is expected for the house. Coping with irregular big expenses is part of life, both before and after retirement.

What you budget for dental care probably depends on lifestyle and what level of treatment you can afford. I'd say the best approach to the budget problem might be to look at what you have paid for dental work over the past few years as a guide. As you point out, dental care can be more expensive as we age so maybe add extra padding to that part of the budget.

My dentist gives me a 15% discount for paying in cash on the spot.


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Originally Posted by audreyh1 View Post
You could do something like: budget $2K a year, and then when it gets up to some amount like $6K stop contributing until it drops below $2K.

Oh, I like this idea! That could work very nicely.
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Old 02-02-2015, 09:00 PM   #13
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Excellent advice, as always. Thank you everyone! We will self-insure. I too like audrey's suggestion of stopping contributions after getting to a certain amount in a fund set aside for bigger dental expenses when/if they should hit.
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Old 02-02-2015, 09:54 PM   #14
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I think it makes a difference in what is covered and the costs....

As an example... my family consists of 4... so 8 cleanings per year.... I was paying about $100 per month or $1200... this means that the cleanings were covered and anything else that was needed I got some money from them (they never paid 100% except for the cleanings).... the other side of the coin is that they had a max OOP of $1,000....

BTW, they did not cover my DW's implants as that was determined to be 'cosmetic'...
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Old 02-03-2015, 01:40 AM   #15
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I am faced with the same issue. For those of you self insure, do you find that your dentists are willing to charge you similar prices as "negotiated prices" set by dental insurance?

I am also thinking about discount plans like Careington. I am able to find "real" dentists (not chain clinics) that accept this plan in my area. Does anyone have experience using this plan?

Thanks!
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Old 02-03-2015, 06:34 AM   #16
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Quote:
Originally Posted by simple girl View Post
1) Did you self-insure for dental issues after retirement? If so, how did you decide on a number to set? Our costs really have been minimal but the past few years I've needed more crowns. Do dental costs go up as you age?
Self insured, I budget 2 * monthly 5 year history.

Quote:
Originally Posted by simple girl View Post
2) If you did insure, do you have a company your recommend? Is there such a thing as "catastrophic" dental insurance? Is it worth it? I guess my biggest concern is if one of us ended up needing an implant or something like that. I read on this forum some have spent $10 - $15K on that kind of issue.
Technically n/a as we self insure, but I did seriously consider insurance. Unfortunately the available plans were too restrictive in my opinion; i.e. no first year coverage for pre-existing conditions, caps on coverage that were approximately 2* premiums, and deductible schemes that provided more "insurance" for the carrier than the insured. Just seemed like a no-win situation to me. I've not seen catastrophic type dental insurance, but that is an interesting concept.

Quote:
Originally Posted by simple girl View Post
My gut tells me it is best to self-insure, but just trying to figure out how much to plan for. We have a friend who is a dentist, and he recommended we self-insure. He also advised us that dental costs for private pay vary widely from state to state. For example, Florida has higher costs. He has clients that drive back here to Alabama for dental work. It is definitely something to consider...
I expect there will be some tough years, but between budgeting for it in overall healthcare and having some potential flex in other areas of our budget I think we'll be OK. Last resort would be to pull money from our HSA accounts to pay for major unexpected dental costs. If I get by with cleanings and an X-ray now and then, all is good. At my first cleaning in January, I asked about cash discount; didn't even get as much as a sideways glance as I was given the amount due - but then I recall reading an article about the state-to-state variations in salaries among dentists and periodontists. We happen to be in one of, if not the highest areas of compensation for those professions.
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Old 02-03-2015, 07:36 AM   #17
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I have been self insured since I retired 4 years ago. I am now 59 and so far am ahead of the game $$ wise so to speak (Just paying for my 6 month checkups and had a crown that fell off that needed to glued on, I think that was $75 or so). My dentist (who I want to keep) gives a 30% discount for cash.

I will probably pick up some dental insurance sometime in the next few years.
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Old 02-03-2015, 07:50 AM   #18
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I looked at dental insurance when retiring and decided not to bother. It really annoyed me that there was a waiting period on any work other than cleanings- one policy was 6 months, the other was an entire year. I'd had continuous dental coverage for decades so it wasn't like I was going to come in with neglected teeth. So, I'm self-insuring. The dentist applied a "friends and family" discount without my even asking.


In my case, I have a very expensive mouth. I've got a lot of crowns and one remaining bridge and I decided I'm done with crowns and bridges. If something goes bad and a filling or a root canal are unlikely to work (and I really love my dentist and trust his judgment), it will be replaced by an implant. Last year, replacing a tooth under a bridge that decayed beyond repair and placing another implant in the gap the bridge covered cost $10K and I figure at some point the other bridge will have the same problem.


All this is despite the fact that I get 4 cleanings a year and use a Sonicare, a WaterPik and a bite guard! They tell me my gums are in great shape.


I suspect there's no catastrophic dental insurance because only people like me would pay the premiums for it.


Don't forget that you can use your HSA to fund dental expenses so if you have an HDHP and want to fund dental expenses in advance you'll get a nice tax deduction.
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Old 02-03-2015, 08:42 AM   #19
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In my case, I have a very expensive mouth. I've got a lot of crowns and one remaining bridge and I decided I'm done with crowns and bridges. If something goes bad and a filling or a root canal are unlikely to work (and I really love my dentist and trust his judgment), it will be replaced by an implant. Last year, replacing a tooth under a bridge that decayed beyond repair and placing another implant in the gap the bridge covered cost $10K and I figure at some point the other bridge will have the same problem.
Yikes, $10K and that was WITH insurance. Holy crap! I suspect my teeth are like yours, and I have this in my future at some point. And yes, I take good care of my teeth, too. But I suspect because grew up on well water (no fluoride) I developed many cavities in my youth. No new cavities as an adult, but the old fillings are big and there isn't much tooth left, so the tooth tends to crack easily especially now as I am getting older.

One thing I haven't done is get a bite guard for sleep. I really don't want one. But I keep cracking teeth (hence the crowns), so they suspect I grind my teeth. So maybe I need to "bite the bullet" lol and get one. I just really don't want to do anything else to interrupt my sleep...not a great sleeper to begin with!
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Old 02-03-2015, 08:52 AM   #20
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One thing that puzzles me is the claimed need for semiannual dental visits.

All through my youth, once a year was the norm (although that may have been due to the fact that we didn't have much money).

Then all through my military career, annual dental checkups were the standard.

After retiring from the military and rejoining the civilian world, I learned that semiannual cleanings were considered essential. I quickly concluded that it was mainly the dental community that held this opinion.

A good daily routine of flossing and brushing has let me continue my annual checkups, and I'm always told that I'm "doing a good job" of taking care of it.

Certainly there are some who benefit from the semiannual visit, but I believe it's a minority.
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