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Just great; I need Orthodontic work that insurance won't cover

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  • Just great; I need Orthodontic work that insurance won't cover

    Gah. In 2007 I chipped my top fronts in an accident. A year later I caught a front bottom tooth in the chipped area and chipped the bottom tooth. My 'S's whistle when I talk now. Slowly over the next few years my lower front bottom teeth are leaning inwards pushed by the top front teeth which are also leaning inwards, increasing my already small natural underbite to the point where I have a very 'deep' bite (top teeth completely cover the bottom teeth when I bite) and I don't hold my jaw closed very often because the position is awkward.

    I got a consultation after my dentist recommended it. That's when I learned all of the above, in addition to the fact that my bite is also slowly shifting to the right, putting the jaw out of alignment and putting tooth alignment off on that side. Eventually I'll chip more teeth, have jaw problems, etc. Despite checking and making appointments with several orthodontists that my dental plan said they cover, my insurance won't cover and orthodontic work because it's considered 'cosmetic.' It looks like I am going to need braces; the doctor will determine the type that will work best after checking my molds and additional xrays.

    I'm looking at 2-years of work and $6,000 minimum out of pocket because insurance won't cover a thing. I guess it's 'cosmetic' until it becomes debilitating or life-threatening. But if I break a tooth because of my bite, or begin getting TMJ or something, that will be just as much for reconstruction, surgery, etc.

    This sucks. (I was going to say it 'bites' har har har...)

    I also don't want to be 33 years old with braces.
    "If anyone wants this old box containing the broken bits of my former faith in humanity, I'll take your best offer now. You may be able to salvage a few of em' for parts..... " - Quote by Argabarga

  • #2
    FWIW, I had braces as an adult as well (because the folks who did my braces as a teenager made my teeth look pretty but didn't give a * about how my teeth actually functioned).

    There are a lot of options now that didn't exist when I was a teenager, that look a lot less obvious than a mouthful of chrome. I had the opposite problem you have (my front teeth didn't meet at all, so I had a very open bite) so I couldn't use the new Invisalign which are really like clear retainers and are removable. Those may be an option for you.

    Also, I know it sucks not having any insurance coverage, but even if you did have it they really don't cover that much. I still had around $5000 to pay out of pocket after insurance on mine.

    All that to say, I'm much happier now that my teeth actually function and I get a lot fewer headaches because I don't grind my teeth anymore from the uneven bite. Getting your teeth fixed now will be a lot less painful than getting them fixed later… keep that in mind as the silver lining!

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    • #3
      Same boat, here. My teeth aren't that bad, but some front uppers are starting to rotate inward and some outward, and I'd rather get it taken care of now when they just look ugly then later when they've gotten really bad. Dental insurance covers nothing.

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      • #4
        You can always try an orthodontics school.
        Life is too short to not eat popcorn.
        Save the Ales!
        Toys for Tots at Rooster's Cafe

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        • #5
          *hugs* I'm missing a bunch of teeth and while I definitely qualify as low income, most places only want to yank the teeth out. I don't need any more teeth pulled. *cue Anime style tears* I wish you luck in getting this resolved.
          Question authority, but raise your hand first. -Alan M. Bershowitz

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          • #6
            No fun. Im sorry. I also had braces as an adult...for 2 years. Thankfully my inlaws paid my down payment as a gift and then I was able to pay monthly for my braces for the rest of the balance. They (the braces) sucked but my issues are solved now and I can chomp down with the rest of them. I hope you can figure something out. $6k seems like so much but im hoping they can work something out with you.

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            • #7
              Not sure if it will work, but could you work with the doctor to apply for an exception with your insurance, since the issue is causing chipped teeth, and will cause more issues in the future? Some insurances will consider coverage exemptions for health issues, especially if you can show they'll pay more money in the long run.
              The Rich keep getting richer because they keep doing what it was that made them rich. Ditto the Poor.
              "Hy kan tell dey is schmot qvestions, dey is makink my head hurt."
              Hoc spatio locantur.

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              • #8
                Thanks for the advice. I looked for orthodontic schools in my area; none nearby. I have a consultation with another office that my insurance site says takes the insurance, but it may be the same issue that the insurance decides that it's not something it's going to cover; in any case I can compare prices. The first office does have a payment plan with no interest, and I thought I would put the payments on my credit card that earns points on money spent. May as well get something out of it! I will give my insurance a call and ask about some sort of exception. I also read that you can deduct out of pocket medical expenses on your taxes if they go over a certain amount; I'll look into that too.

                I wonder though, what happens if the 2nd office quotes me a lower price or my insurance ends up covering some of it, but I hate them? The doctor at the first office was nice, comforting and REALLY knew what he was talking about; 40some years in the profession.
                "If anyone wants this old box containing the broken bits of my former faith in humanity, I'll take your best offer now. You may be able to salvage a few of em' for parts..... " - Quote by Argabarga

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                • #9
                  Just my 2 cents… if the second office has better pricing or insurance will cover some but you don't like them, keep shopping around or just pay more to the dentist you like! I've found it is well worth the effort/expense to have a dentist or orthodontist you like and trust instead of second-guessing everything they do.

                  My first ortho didn't do his job right, that's why I had to do it again. Trust is key for me.

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                  • #10
                    Try indiegogo or GoFundMe.
                    cindybubbles (👧 ❤️ 🎂 )

                    Enter Cindyland here!

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                    • #11
                      Had another consultation with another orthodontist who actually had more of an upkeep and long-term plan for me than the first one. The first one never addressed how we were going to move my bite back into place and what was going to maintain my tooth position after. The second also has a few more equipment options for me. I did not know that the wires used are sometimes coated nickel; I'm allergic to nickel, so they made a note to use another wire. Their quote is just a little less than the first doctor also, but same type of payment plan to the office. The 2nd office also said they would credit the account for what I paid the first place to get molds and panoramic xrays. It will still be a monthly payment of about $230 for the work. I really like this 2nd doctor; he was really easy to talk to - the first was very serious school professor-like. I also found out that even if insurance says it covers orthodontics, it really only ever does if the work is being done as the result of an accident or you're under 18. They said they could try checking with my regular insurance, however. I think I'm going to go with the 2nd Office, and am going to look into some of those funding sites.
                      "If anyone wants this old box containing the broken bits of my former faith in humanity, I'll take your best offer now. You may be able to salvage a few of em' for parts..... " - Quote by Argabarga

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                      • #12
                        I ended-up going with the 2nd orthodontist because he believes he can move my bite back without removing teeth. I got the bands to create gaps between my back teeth in a few days ago in preparation for the braces. They've made sure to have all non-nickle equipment for me; they put a HUGE sticker on my folder "Nickle Allergy" It was like, well, pulling teeth to get the mold and xrays from the first office though, even though I paid for them! These bands though...THEY HURT! They're rubber loops pulled between the back molars and they're putting pressure on every other tooth up the line, so they're all sore. I'm trying to eat small bites and soft foods. Literature says the first several days are the worst. It's worse on the right side than the left; my teeth have less room there.

                        I did find that I could claim the out-of-pocket expenses on my taxes as a deductible, so I'll see what happens with that.
                        "If anyone wants this old box containing the broken bits of my former faith in humanity, I'll take your best offer now. You may be able to salvage a few of em' for parts..... " - Quote by Argabarga

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                        • #13
                          Quoth LillFilly View Post
                          I ended-up going with the 2nd orthodontist because he believes he can move my bite back without removing teeth.
                          That's good news. It's always great when you can get the same result with less invasive care.

                          Quoth LillFilly View Post
                          It was like, well, pulling teeth to get the mold and xrays from the first office though, even though I paid for them!
                          They're supposed to give that stuff to you at your request. I'm not sure I'd go back there if they gave you that kind of grief.

                          Quoth LillFilly View Post
                          These bands though...THEY HURT! They're rubber loops pulled between the back molars and they're putting pressure on every other tooth up the line, so they're all sore. I'm trying to eat small bites and soft foods. Literature says the first several days are the worst. It's worse on the right side than the left; my teeth have less room there.
                          Yes, that was my world for five years when I was a kid. It sucked. But it was worth it. I have straight teeth, and they've stayed straight 35 years later. I have no doubt that's helped me avoid a lot of dental problems.

                          Quoth LillFilly View Post
                          I did find that I could claim the out-of-pocket expenses on my taxes as a deductible, so I'll see what happens with that.
                          You have to spend so much of your income before you can claim that deduction. However, odds are your annual income is low enough you should be able to claim all your out of pocket expenses. Dental/orthodontic care is bleeping expensive. Save all receipts. I've used that deduction to save a boatload on taxes in the past.
                          They say that God only gives us what we can handle. Apparently, God thinks I'm a bad ass.

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                          • #14
                            Day 3 of braces.

                            I don't think they put braces in my mouth; rather jagged shards of volcanic glass!

                            These things are probably banned at GTMO!!!!
                            "If anyone wants this old box containing the broken bits of my former faith in humanity, I'll take your best offer now. You may be able to salvage a few of em' for parts..... " - Quote by Argabarga

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                            • #15
                              Those little strips of wax that your orthodontist probably gave you? Those are going to be your very good friends until your mouth gets used to the braces. I had the best results by putting them on before I went to bed (after any snacks, etc). Since you're not doing a lot of talking, etc, while you're asleep, they stay put better and it gives your cheeks and lips a several-hour break from rubbing against the braces.

                              The other trick is to dry your braces as much as you can before applying the wax, as it helps it stick better.

                              If you need more wax and can't get to the ortho office to pick it up, I was able to purchase some at the local drugstore/Red Bullseye.

                              Erin

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