I’m seeing a dentist covered by my dental insurance and need 3 crowns. I asked for a bill and see that I’m being charged the insurance rate $328 for each of the crowns but additionally I’m being charged $350 per crown for ‘Zirconia Upgrade’ and for tooth number 14 I’m being charged an additional $275 for ‘Upgrad Porc. on Molar’. What are these upgrades. Money is tight for me and I’m wondering if I need to pay $1325 additionally for upgrades. If it makes a significant difference I will take loans and do it, but I don’t want to unless it is necessary.
Ira in Maryland
Whether these charges are “necessary” or not depends on you. You need to have a discussion with your dentist about this. Do you want porcelain on the dental crown for tooth #14, or will a metal crown do? And do you want zirconia crowns on the other teeth, or will the crown the insurance pays for be all right? That part I can’t answer, but I can help you know what is going on here. In the eyes of your dental insurance plan, these extras aren’t necessary, but keep in mind that they only have their bottom line in mind.
Your dental insurance plan is trying to save money to stay within a certain budget that your employer wants to pay for. And this dental insurance plan appears to me to be extra cheap. They have allotted a certain payment for a certain type of crown, and it appears to me that the dentist feels squeezed either in the costs allotted or in the types of crowns your insurance is willing to pay for, and is looking for a little leeway. (I have to admit that I’m going on sketchy information here, so I’m guessing at some things to fill in the blanks.) I don’t fault the dentist for this. When I was dealing with a chintzy insurance company, I would give my patients the option of choosing the more expensive all porcelain crowns for front teeth because they looked so much better. But I gave them a handout that explained their options, the amount of the extra cost, and all the pros and cons of the different choices. It looks, from your confusion, like your dentist left out this step.
You are entitled to complete information from your dentist, including all of the options available and the pros and cons of each choice, to help you make an intelligent choice about these options. So ask for that.
– Dr. Hall
Related information: Read about the costs of porcelain crowns.
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