Dental insurance and wisdom tooth removal
April 29, 2020 12:51 PM Subscribe
My wisdom teeth are impacted and decaying. My appointment to consult with a surgeon was cancelled because of the pandemic, and now I have turned 26 and am no longer on my parents' dental insurance. All of the Marketplace insurance plans have 6 months waiting periods. Help?
My wisdom teeth don't cause me pain, but the dentist told me that there is decay on one of them and it is caused more cavities in my other teeth. I scheduled an appointment with an oral surgeon but then the pandemic happened. I've now turned 26 and am no longer covered by my parents' dental insurance. I went to apply for a Marketplace dental plan but all of the options that show up have a waiting period of at least 6 months.
Can my wisdom teeth wait that long? I have a cavity that is causing me mild, occasional pain. This was also scheduled to be addressed before the pandemic happened and the appointment was cancelled. There seem to be waiting periods for fillings too. I can maybe afford a filling on my own, but not oral surgery. I have an autonomic nervous system disorder and my dentist thinks I should have it in the hospital to be safe. I don't think there's any specific identified risk though, it's a "just in case" sort of thing.
If my wisdom teeth can't wait that long, what should I do? There's a local dental school but I'm not sure they'll be taking new patients for a while; they're closed for the pandemic and I'm sure will be quite backed up. I don't qualify for Medicaid since my state didn't accept the expansion.
My wisdom teeth don't cause me pain, but the dentist told me that there is decay on one of them and it is caused more cavities in my other teeth. I scheduled an appointment with an oral surgeon but then the pandemic happened. I've now turned 26 and am no longer covered by my parents' dental insurance. I went to apply for a Marketplace dental plan but all of the options that show up have a waiting period of at least 6 months.
Can my wisdom teeth wait that long? I have a cavity that is causing me mild, occasional pain. This was also scheduled to be addressed before the pandemic happened and the appointment was cancelled. There seem to be waiting periods for fillings too. I can maybe afford a filling on my own, but not oral surgery. I have an autonomic nervous system disorder and my dentist thinks I should have it in the hospital to be safe. I don't think there's any specific identified risk though, it's a "just in case" sort of thing.
If my wisdom teeth can't wait that long, what should I do? There's a local dental school but I'm not sure they'll be taking new patients for a while; they're closed for the pandemic and I'm sure will be quite backed up. I don't qualify for Medicaid since my state didn't accept the expansion.
Can you have a telehealth appointment with your dentist to discuss timelines?
Generally speaking, if you are not in pain, the wisdom teeth could wait for several months, I think. (Basis for this: my partner had to have a lot of dental work done last year and they were fine with his wisdom tooth surgery being one of the last things to get scheduled after several months of other work.) But it might be good to hear from your dentist if there are any special considerations for your specific teeth that can’t wait.
It might also be worth it to call the dental school to see if they’re keeping a waitlist that you can get on. If you end up not needing it because you've found a better solution before they reopen, so much the better, but you could do your future self a favor by getting on the list.
posted by Stacey at 1:06 PM on April 29, 2020 [3 favorites]
Generally speaking, if you are not in pain, the wisdom teeth could wait for several months, I think. (Basis for this: my partner had to have a lot of dental work done last year and they were fine with his wisdom tooth surgery being one of the last things to get scheduled after several months of other work.) But it might be good to hear from your dentist if there are any special considerations for your specific teeth that can’t wait.
It might also be worth it to call the dental school to see if they’re keeping a waitlist that you can get on. If you end up not needing it because you've found a better solution before they reopen, so much the better, but you could do your future self a favor by getting on the list.
posted by Stacey at 1:06 PM on April 29, 2020 [3 favorites]
Dental insurance is not great. They typically have a maximum payout of under $2000 a year or less (anything above that you have to pay), and often only cover a fraction of the fee. If you're buying it on your own, you may want to find a dentist first and ask them what insurance they accept/recommend and how much money it would save you, because it may not be worth it. And, of course, pay attention to waiting periods on any insurance coverage, which may be a year or more.
posted by alexei at 2:22 PM on April 29, 2020 [3 favorites]
posted by alexei at 2:22 PM on April 29, 2020 [3 favorites]
Seconding looking closely at the waiting periods - every dental insurance I've looked at has waiting periods for anything other than very routine stuff. As well as restrictions on how many procedures they'll pay for within some amount of time.
It might be worth looking at whether any of the surgery could be covered under medical insurance. Particularly if it's in a hospital, or for any other reason "medically necessary". Here's one page of info, of course there are many others.
posted by still_wears_a_hat at 2:39 PM on April 29, 2020 [1 favorite]
It might be worth looking at whether any of the surgery could be covered under medical insurance. Particularly if it's in a hospital, or for any other reason "medically necessary". Here's one page of info, of course there are many others.
posted by still_wears_a_hat at 2:39 PM on April 29, 2020 [1 favorite]
Can you get COBRA for your parents’ plan to extend the coverage long enough to deal with dental stuff? (Assuming that coverage is good enough that it’s worth the COBRA costs, which are likely high.)
posted by needs more cowbell at 3:02 PM on April 29, 2020
posted by needs more cowbell at 3:02 PM on April 29, 2020
The Delta Dental page on waiting periods says "In certain cases, a waiting period will be waived if a comparable dental insurance plan was terminated in the 30 to 60 days prior to the effective date of your new plan, but your former dental plan must include very similar coverage."
It would probably be worth checking whether any of the plans available to you would waive the waiting period since you previously had insurance.
posted by Redstart at 4:06 PM on April 29, 2020 [2 favorites]
It would probably be worth checking whether any of the plans available to you would waive the waiting period since you previously had insurance.
posted by Redstart at 4:06 PM on April 29, 2020 [2 favorites]
That sucks. Contact your state's Insurance Commission; it will be under the Attorney General's Office web pages. There might be something they can do; many people will be in this situation.
posted by theora55 at 4:13 PM on April 29, 2020
posted by theora55 at 4:13 PM on April 29, 2020
For what it’s worth, when I had my wisdom teeth removed it fell under regular insurance and not dental, because it’s “surgery.”
posted by Slinga at 4:29 PM on April 29, 2020 [4 favorites]
posted by Slinga at 4:29 PM on April 29, 2020 [4 favorites]
This doesn't directly answer your question, but a friend of mine recently had expensive back surgery. While she did have insurance, she still had to pay 20% of the cost of the surgery. The hospital let her make monthly payments. If it turns out that you are unable to acquire insurance and must pay out of pocket, perhaps your dentist and hospital would be willing to allow you to make manageable monthly payments.
posted by SageTrail at 8:48 PM on April 29, 2020
posted by SageTrail at 8:48 PM on April 29, 2020
Try Stride Health. You should be able to buy a very affordable plan through them that starts today.
posted by amaire at 11:19 PM on April 29, 2020 [1 favorite]
posted by amaire at 11:19 PM on April 29, 2020 [1 favorite]
Response by poster: Thanks all! Made a bunch of phone calls and my health insurance covers wisdom teeth insurance when medically necessary (e.g. impacted and symptomatic) at only 10% coinsurance which is better than I expected. I also got set up with a Delta Dental plan; my parents' plan was through them, and having been on that plan for 2 years they were willing to waive the waiting period. Now I just have to wait for my dentist to open up again, but at least I won't have to worry about insurance!
posted by brook horse at 2:11 PM on April 30, 2020 [1 favorite]
posted by brook horse at 2:11 PM on April 30, 2020 [1 favorite]
This thread is closed to new comments.
posted by Alensin at 1:01 PM on April 29, 2020 [1 favorite]