American Federation of Teachers (Implant related)

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#1 Post by **iBorg** » Mon Mar 12, 2007 7:22 pm

I am trying to figure out what to do. Today we met with my ortho concerning my son starting braces. At the end of the meeting I asked the amazing Dr. P about replacing my missing bicupsids (pre molars) with implants and if they would help make a better smile and help with my TMJ issues. These teeth were pulled my first round or braces some twenty years ago. She left the meeting pulled my records and said it was something that was worth considering. She then told me that the going rate for implants locally was about $2200 per tooth.
In trying to figure out if this was doable I checked Delta Dental, and was told they'd cover 50% of crowns. Implants not covered. Checked my AFT membership and they have preferred providers that makes the price affordable. Here's the catch, my nearest provider is 110 miles away. Is this too much distance? Also anyone ever worked with AFT or CAREINGTON for dental work?

THanks!

Mike

#2 Post by **Delag** » Mon Mar 12, 2007 7:31 pm

HOw many times would you have to make the trip? If they are good doctors and you don't have to go too many times it would be worth it IMO. I was just looking over on 'igotbraces' and there is an almost dentist (about to graduate) talking about implants on one of the threads - which brand is best etc.

#3 Post by **Betty Bat** » Mon Mar 12, 2007 8:01 pm

Howdy,
I'm also missing premolars (baby teeth with no permanent ones behind them). I'm scheduled to get implants after my braces.

I had one meeting with the implant specialist pre-braces, just to find out what was possible. It sounded like it would take only one visit when the time came, but the time hasn't come yet for me.

So, count on at least one visit to determine what can be done - then, hopefully, one for the implants.

#4 Post by **rsprouse** » Tue Mar 13, 2007 5:46 am

Hi Mike,

You are going to be hard pressed to get much of an implant procedure covered by most normal dental insurance. I have a friend that was the lead dental actuary for a large national health care company. He said they were in the works to introduce some implant coverage in the near future. It will not be much and will likely cover 1 implant for the life of the patient with a 50% deductible. This is simply my guess based on coverage for other major services and I would expect to see it introduced to most good plans in the coming few years based on demand. Is it $2200 for everything, or is that the implant crown fee? Does it include implant placement surgery and all follow ups by your periodontist/OS? Bone graft if necessary? Is the CAT scan included in that price? If it is $2200 for the whole enchilada including the restoration then you will be hard pressed to find anything cheaper including at a university or teaching institution.

110 miles is likely a 1.5-2 hour drive each way depending on traffic and where you are located. You will be doing 1-2 pre-op consultations, the surgery date, a 1 weekish follow up, an uncovering of the implant site visit months later, custom abutment placement, and finally delivery of the implant crown (probably another visit or two in there). The visits will be split between the Perio/OS and the restorative dentist. Personally that is a bit too far for my taste, unless you are doing this to deal with the best of the best. If it is simply to save a few bucks, I think you would be penny wise-pound foolish for traveling this far. Just my opinion....

Good Luck,
Rory

#5 Post by **iBorg** » Tue Mar 13, 2007 6:22 pm

I agree with you completely. There is one thing about the insurance game. Most plans state that they pay what's reasonable and force the provider to accept it. I was told by one person today that means if the insurance says itâ€™s worth $500 and the dentist normally charges $800 they have to accept $500. If the insurance only pays 50%, I'm out $250 instead of $800. Itâ€™s a weird game. Also, my provider today suggested I do the implants in two phases separated by three months to hit two policy years which doubles what the insurance company would pay if I did it one year.

I also realize that I need to contact my HR people and see what would be required to have the limit raised above their $1500.

There is one side of the equation that may justify the low limits. With more people taking care of their teeth and higher costs maybe more people are hitting the upper limits than ten years ago.

On a closing note, tomorrow I go for X-rays and molds to see if this is even feasible. My general dentist is running a pre certification so I have an accurate guess as to what my out of pocket would be.

Wish me luck. I need it.

Mike

#6 Post by **grinning** » Wed Mar 14, 2007 8:51 am

I must agree with all about the frustration that insurance causes! I'm in Canada but for those of you who don't know our health care only covers doctors here. Thus dentists, optomitrists, ambulance etc all come out-of-pocket without some sort of insurance. Anywhoo... my husband went to the dentist two years ago and needed the panoramic x-ray. Found out that a front tooth had serious root resorbtion issues meaning that he was going to loose it. So he had to choose either a bridge or an implant to replace it (the root was too far gone to save). The implant was the obvious choice because you don't have to whittle down the two side teeth, plus the lose of bone over time where there would no longer be a tooth root or titanium implant. Both would cost just over $2000, but insurance would only cover a bridge.

It would almost seem that insurance companies make their choices on what to cover based on what they can convince the public to pay for themselves! Not to mention that the life of a bridge is not supposed to be near that of an implant. So if he had gone with a bridge they would have had to fork out more money to replace it later! I truely don't get it. Needless to say we paid for the implant. (I think he had to go in for about four appointments before it was all said and done).