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Just So Disappointed

wolfen's picture
wolfen
Posts: 1194
Joined: Apr 2009

Just when you think you finally might have all your ducks in a row, one of them drowns!

For months now, have been waiting to squeeze in the opportune moment for hubby to have his dental work done. Have kept in contact with oral surgeon regarding all the various setbacks. Last Friday, they called to schedule the surgery and then informed me that my portion would be $2,200, UPFRONT. Now, I realize that everyone has to make a living. I explained that we don't have that kind of money, and offered to make payments, right along with those 5 hospitals, soon to be 6, and countless doctors, but "no go".

So, got our Clinical Navigator(who I discovered is our "go to" person at MDA) to find out who they use for extractions. Unlike, MDA in Houston, the one here does not have a Dental Onc. on staff. Just feel like for every 3 steps forward, there's at least 5 steps back. Don't we all feel that way? LOL

Appt. this afternoon for Pre-Op for Urology surgery to be done this Friday. Fingers crossed that catheter bag will be removed before upcoming radiation.

Luv and good thoughts to each of you,

Wolfen

katenorwood
Posts: 1821
Joined: May 2012

Wolfen,

I was in the same position with my providers.  But as I had met my deductible of $6000 under my family medical and the teeth that needed to be extracted due to my dx, they included it all as necessary for tx's.  It took awhile, but ended up being paid 100 %.  I only saw the dental surgeon once...and never again.  Went back to my local dentist for chompers.  I don't know if this helps, but I know the sure frustration of it all !  Will be thinking only positives for your hubby !  And know we're here always for you !   Katie 

wolfen's picture
wolfen
Posts: 1194
Joined: Apr 2009

I never got to the point where I saw what the actual charges would be, but this guy must charge a gazillion dollars. This was my portion after Met-life dental payment and UH medical payment. Medicare doesn't cover this, even if medically necessary. Did hear back from clinical navigator. It seems that our Onc. surgeon is also a dental surgeon, as well as H & N. Would have saved some extra work if we had known. In the beginning, they just said they worked with a dental college, which didn't sound promising at the time. So now, I'll pick up the films from the oral surgeon and we'll meet again with the MDA surgeon.

Somewhere in there, I'll remember to breathe. LOL  I think that's the number one rule, isn't it?

Luv,

Wolfen

denistd's picture
denistd
Posts: 491
Joined: Apr 2009

Hi Wolfen, I had my teeth removed, some before and some after treatment. Ther extractions before were covered by medicare as my oncologist at Penn State Hershey wrote a letter to my supplemental insurance (mostly part D). I was informed that medicare would cover it as the Onc stated that it was medically necessary. It cost me $50, I had 4 teeth removed. Two years out from treatment I was told that all of my teeth that were left should come out to preserve the bone. My oral surgeon, oncologist and family doctor all wrote that without the extractions my bone may deteriorate, again medicare paid for all, I did not have to pay a dime for this as my deductible ws met. They extracted 17 teeth during the surgery. I did have to pay for dentures. So all of my teeth were removed at a cost of $50 to me, they even paid the HBO treatments 100%. So try it out. Denis

wolfen's picture
wolfen
Posts: 1194
Joined: Apr 2009

I checked with Medicare and was told that they wouldn't cover any of it, even if medical but hubby doesn't have Part D He just has A & B. The UH is our supplemental, which is the continuation of our coverage from when I was employed. We also have Metlife dental from that same employment. I'll present that one to MDA also. Not quite sure how the Metlife works in a "medical" situation.

On a completely different note, I was searching through posts, H&N and Lung, and noticed an older post from you regarding "no conrtast dye for you" because of poor kidney function. So far you are the only other person I've read with this particular malady. It would have been so nice of our original ENT to read the medical history and medications I presented him with. Because he didn't bother, and we didn't know any better, contrast dye was used on my hubby which hospitalized him with CHF and acute renal failure and started this never ending downill slide he has been on since cancer diagnosis. So glad you had a physician who could read.

Off my soapbox now.

Luv,

Wolfen

denistd's picture
denistd
Posts: 491
Joined: Apr 2009

There are a few of us here that has some kidney damage due to the cisplatin chemo we had. The big thing now that I have that is to make sure I do not take anything that has steroids in it. The only pain medication I take is tylenol, Aleve and Ibuprofen is a definite no no. The cntrast is really hard on the kidneys. If I see a doctor at another hospital or whatever I tell them straight off about the kidneys and the need to not have the banned stuff, I do not assume they look at your history, on the bright side I was told thet if I took care of my kidneys they should last, but it's scary.

Hondo's picture
Hondo
Posts: 5736
Joined: Apr 2009

 

Yep I know the feeling, my last visit to the hospital cost right at $80,000, but I was lucky I was at 100% payment on my insurance. Then I found out one of the doctors who treatment me the most were not in my network. So I am having to pay him and He wants his money now. All I could tell him is you have joined the list of doctors and hospital I pay monthly. Sorry old boy I will pay you in time

 

Take care

Hondo

wolfen's picture
wolfen
Posts: 1194
Joined: Apr 2009

While reviewing Medicare and UH websites, I noticed that a bunch of doctors were not being paid by UH. I discovered that the hospitals use in house doctors that are out of network, even though the hospital itself, is in network, so go figure. I think I'll have a little discussion with the patient advocate at the hospital when I start to get the bills. A patient has no control over who is assigned to them at the hospital.

Luv,

Wolfen

hwt's picture
hwt
Posts: 1906
Joined: Jun 2012

Ask plenty of questions before radiation....I was told that because I did not have extractions and implants done before radiation that I require hyperbaric pressure chamber tx prior to the dental work....30 sessions (2 hours each) at $2500 a pop. Insurance has approved but I've been told, I could have avoided the need if the dental work had all been completed between my surgery and radiation. Another 60+ hours out of my life.

wolfen's picture
wolfen
Posts: 1194
Joined: Apr 2009

Yep, we're very aware of some the problems that can arise if the dental work does not precede the H&N radiation. Unfortunately, a lot of hubby's teeth are broken off at the gum line thus requiring an oral surgeon. Also thought oral surgeon would be more competent in dealing with H&N patient. That's the reason I'd been working so hard to get all this done before the radiation started. Being diabetic, hubby is also a very slow healer so wanted to get them out all at once for healing to be complete. Sometimes the best laid plans.....................

I have not heard of the hyperbaric chamber in regards to dental work. That's interesting and very expensive. Thirteen years ago, hubby had half of right foot removed(was only supposed to be one toe). That's another horror story for the grandkids. Anyway, the wound wouldn't heal, so he spent a solid year(once a week) in hyperbarics. Never healed the wound and doctor wanted to take half his leg off. Needless to say, we found another wound clinic where the doctor didn't cut anything off. It took forever, but the new doctor healed the wound(no hyperbarics). He does have special shoe inserts and a tiny pressure ulcer, but I take care of it. I think, at that time it was $1500 a session, and insurance paid it all.

Will be having a consult at MDA with their Surgeon Onc and will certainly try to ask the right questions. Any suggestions on that would be appreciated. I just mostly know of the danger of necrosis of the jawbone. I know the opprtune time would be before chemo also, but have run out of time for that. At least he'll only be having lung radiation around the time of the teeth extracions.

THanks,

Luv,

Wolfen

phrannie51's picture
phrannie51
Posts: 3682
Joined: Mar 2012

was reading up on Medicare, I read that no...they don't pay for dentals UNLESS it is part of a medical necessity...so I had to go look it up again, and this is what I read....

"Currently, Medicare will pay for dental services that are an integral part either of a covered procedure (e.g., reconstruction of the jaw following accidental injury), or for extractions done in preparation for radiation treatment for neoplastic diseases involving the jaw. Medicare will also make payment for oral examinations, but not treatment, preceding kidney transplantation or heart valve replacement, under certain circumstances. Such examination would be covered under Part A if performed by a dentist on the hospital's staff or under Part B if performed by a physician."

http://www.cms.gov/Medicare/Coverage/MedicareDentalCoverage/index.html?redirect=/MedicareDentalCoverage/

and this....

"This language excludes coverage of ordinary dental services, and Congress placed it in a section of the Medicare statute that excludes coverage of a number of other medical services that are generally considered to be routine, such as common screening tests, personal comfort items, physical checkups, eyeglasses, hearing aids, and immunizations that are not specifically covered. For this reason, the Medicare statute can be read as allowing coverage of dental services that are not "routine," such as the special care necessitated by the effects of radiation and chemotherapy treatments prescribed to treat oral, head and neck cancer."

http://www.medicareadvocacy.org/News/Archives/PartB_Dental%20Services.htm

I'm wondering if maybe some idiot in the medicare office didn't get this memo??  Maybe pushing on them with some back up from the oral surgeon will get this started AND paid for??

wolfen's picture
wolfen
Posts: 1194
Joined: Apr 2009

You're right, I did actually speak to someone at Medicare and we know already there are numerous idiots in the health care system. I'll be sure to mention this to MDA. In fact, they probably are aware of it already. I just "assumed" I had the right info. and you know what that means, too. You have brightened my outlook a bit.

Luv Ya,

Wolfen

George_Baltimore's picture
George_Baltimore
Posts: 303
Joined: Jun 2009

When I had mine pulled before radiation, I didn't have Medicare.  I was strictly BCBS.  I know they covered it because it was presumed to be a medical neccessity.  There was a little confusion earlier in this thread also.  Part D of Medicare deals with prescription plans.

lorig01
Posts: 69
Joined: Jul 2012

I had stage III tonsil cancer and they removed all of my teeth prior to treatment. At first the oral surgeon told me that insurance would not cover it. I think the cost of the extractions was around $20,000.   That was more then my ent charged for the neck dissection! I was furious and called BCBS.  The BCBS rep said that insurance would not pay and I told her that it was medically neccessary.  I gave up and just had surgery. In the end I was never billed so not sure why they wouldn't pay initially but then they paid...

Wish they paid for the implanted dentures! Not sure why breast reconstruction is paid for as part of breast cancer treatment but implanted dentures that actually allow you to eat are not considered necessary!  

Good luck with your extractions! I think that of all doctors the oral surgeons are the hardest to work with.  Most of the ones that I have met seem to be all about the almighty dollar!

wolfen's picture
wolfen
Posts: 1194
Joined: Apr 2009

$20,000! I picked up a copy of the dental x-rays and treatment plan from the oral surgeon to take to the MDA surgeon. This oral sugeon

WHOOPS! HAVE TO FINISH LATER. HUBBY NEEDS HELP

Sorry about that. All is well.

Anyway, this oral surgeon was charging approx. $5,000 for one extraction and 13 "root tip" removals, whatever that means. Maybe that's not so expensive, but sure doesn't fit my meager budget. One other thing I had never heard of from any doctor was an extra charge to put him in the hospital?

Moot point now as MDA is trying to move like wildfire as hubby progressively gets worse. Surgery consultation is on Mon. with dental surgery and port placement on Tues. followed by first chemo on Thurs.

Luv,

Wolfen

phrannie51's picture
phrannie51
Posts: 3682
Joined: Mar 2012

If we never lost any teeth at all in adulthood (including wisdom teeth), that is $625 a tooth....if we do have our wisdom teeth pulled when they come in, which most of us do.....that is a whopping $714 per tooth.  How many of us manage to get to our 50's with all our teeth?  I think you're right Lori, oral surgeons are all about money.  I remember in the 80's when I had 3 teeth that were absessed....one dentist wanted $100 each to pull them....another dentist charged $35.....I got my dentures in the mid 90's, and the dentist pulled my teeth....didn't send me to an oral surgeon to do it....I think the total cost for extractions AND dentures was $2600, and my insurance covered half. 

I'm just shocked that trying to get dentures these days would be over $20,000.

p

fishmanpa's picture
fishmanpa
Posts: 1113
Joined: Jan 2013

Someone has to have a talk with the Tooth Fairy! 

"T"

lorig01
Posts: 69
Joined: Jul 2012

Well I didnt have to pay the 20000 so not sure what final cost was. But I had to pay approx 8,000 to put in posts for implants, then another 1,500 for implant attachments and then approx $5,000 for the attachable dentures. These costs were not covered by insurance. But right now I am thinking if I can eat a burger or pizza than the cost was well worth it!   Working to make money to fight cancer so that I can work to make money to fight cancer so I can work to make money to fight cancer.... :)

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