What's the Point....

Rant mode ON!!!

The topic up for discussion is Insurance, in this case Dental Insurance.

Where I live in the USA, the State I live in requires their residents to carry Health Insurance. Whether you are offered the benefit through your employer, you get the benefit through your spouse's employer or you go out on your own and get a personal plan.

In my case, I get the benefit through my employer and I also opted in for the Dental coverage. Just to give you all an idea, I have had this coverage since March of 2007. Since then I have not needed the Health part of it, and I recently went to the dentist twice, once in March and 2 weeks later in April.

Here's where the rant begins....

The cost of these benefits are automatically taken out of my paycheck every week. For a single person just for Dental, I pay $9.00/week and have been since March 2007. Which for the most part seems reasonable, right?
Once I'm at the Dentist office for my appointment, each visit costs me a $20 co-pay... So far that's 2 visits at $20/each. Then I go in and since it's my first time there and it's been a while since I've gone, I have x-rays done as a standard procedure. Next is the routine cleaning, at which point a loose tooth was noticed and the fact that I have a small mouth which I was blessed with a over crowded lower jaw... basically not having the room for all the permanent teeth to come in properly which in turn gives me a hassle of having a few "hard to reach" places and therefore not being able to clean certain areas as well as they should.

Just for the record, I DO brush, floss, and rinse daily.. sometimes twice.
So during this first visit the assistant starts the deeper cleaning and stops 1/2 way through stating that I'll have to come back to have the rest done.

So, I reschedule and 2 weeks later I go back for the rest of the deep cleaning and the loose tooth gets pulled. Truth be told I was playing with it the night before hoping it would come out before the appointment, but I was too chicken to yank it out myself

A few weeks go by and I get a bill in the mail with an itemized list of what was done and how much each thing cost and a nice fat total at the bottom
$355.00 and the billing clerk "estimated" that my insurance company would take care of $187.00 and I was billed for $168.00.... It seemed a bit high to me, but at least I paid less than 1/2.... I payed that bill in person last Monday.

A few days later I get another bill in the mail, but this one is not itemized, just a big total of $295.00. So I call them today, and get to the bottom of this. Seems my Insurance company declined ALL claims and they didn't cover any thing that was done The second statement was sent before they received my first payment..which explains why the total shows $295.00. So, I went down there today in person and sorted this out... I was told that I owed another $127.00 which I was not happy about... here I was thinking I already paid my share of the bill.... NOPE .... Instead I was responsible for $295.00 from a total of $355.00... For those of you keeping track, there is a $60.00 difference... yep that was for the cost for the first visit that the Dentist himself waived the fee after seeing that my Insurance company was good for NOTHING

My whole point is... What's the point of paying out all this money for Dental Insurance when I pretty much paid it all out of pocket!!!! My plan didn't pay 1 cent of the cost.
I was due to go back in July for a follow up appointment but screw that. That's just gonna be another $20 copay plus $60 that I'll get suckered into paying.

I even went as far as trying to cancel my Dental coverage, nope I can't... seems I have to wait for open enrollment in October Fabulous.... It's good to know my hard earned money that's taken out every week ISN'T for my benefit.

Ok Ok Rant mode OFF

If anything, word of mouth is the best form of advertisement... so for those of you wondering who my provider is... I'll just say that both the Cross and the Shield are BLUE