Dental care for mother-in-law with low income

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Unicorn1
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Dental care for mother-in-law with low income

Post by Unicorn1 » Sun Mar 10, 2019 8:01 pm

My wife and I provide financial support for her mother, who is recently widowed. My mother in law was just notified that she needs a crown on her tooth at a cost of $2,000. She has very little money and just wants to pull it, but we talked her out of it. Because of her poor dental hygiene overall, I worry that additional crowns may be in her future. We've had the dental hygiene conversation so nothing else to do on that front. She is on Medicare, but with no dental benefits. She is age 70.

My main question is this. Given her age, her poor dental hygiene, and our personal investment of money and worry that go in to her keeping her teeth, what are best options for dental care in seniors?

Dental insurance options through Medicare? On the private market? Anything available for lower income seniors? Just negotiate a discounted rate and pay cash? Other? Thank you

DarthEnol
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Re: Dental care for mother-in-law with low income

Post by DarthEnol » Sun Mar 10, 2019 8:12 pm

Are there any colleges/universities nearby that have dental programs? They may offer discount dentistry services.

Topic Author
Unicorn1
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Re: Dental care for mother-in-law with low income

Post by Unicorn1 » Sun Mar 10, 2019 8:14 pm

Thank you, yes there are local dental schools, but they only do routine cleaning and x-rays, but no fillings, crowns, etc.

capsaicinguy
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Re: Dental care for mother-in-law with low income

Post by capsaicinguy » Sun Mar 10, 2019 8:20 pm

Unicorn1 wrote:
Sun Mar 10, 2019 8:14 pm
Thank you, yes there are local dental schools, but they only do routine cleaning and x-rays, but no fillings, crowns, etc.
I would vote to go to a dental school. Sounds like you found a dental hygiene school. Look for one that has a DDS or DMD doctoral program and they should be able to do a crown.

miamivice
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Re: Dental care for mother-in-law with low income

Post by miamivice » Sun Mar 10, 2019 8:40 pm

You have a salary of $185,000 a year.

Why don't you and your spouse just pay for the dental work that she needs?

quantAndHold
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Re: Dental care for mother-in-law with low income

Post by quantAndHold » Sun Mar 10, 2019 9:25 pm

Is she poor enough to qualify for Medicaid? Some states have dental as part of Medicaid. If she qualifies, she can have both Medicare and Medicaid at the same time, and use the Medicaid for dental.

Does she live near Mexico? Lots of seniors go to Mexico for dental care. English speaking, US trained dentists are common in the border towns. Price is about 1/3 of what he same thing costs in the US.

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cheese_breath
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Re: Dental care for mother-in-law with low income

Post by cheese_breath » Sun Mar 10, 2019 9:27 pm

Sign her up for a dental discount program such as DentalPlans.com https://www.dentalplans.com/
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123
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Re: Dental care for mother-in-law with low income

Post by 123 » Sun Mar 10, 2019 9:34 pm

There are some Medicare Advantage plans in some states that have a tier of coverage that includes dental benefits for a higher premium. I don't know how broad the coverage of that dental benefit program is.
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Bubbacat
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Re: Dental care for mother-in-law with low income

Post by Bubbacat » Sun Mar 10, 2019 9:37 pm

General advise for dental care - you can save a significant percentage if you drive a little and have extensive/expensive work done in a LCOL area.

A few years back I needed work not covered by my very limited dental insurance, and drove about 2 hours from ATL to Montgomery Alabama. The work was done by a board certified provider, and I saved close to $1000 over what my out of pocket would have been at the specialist recommended by my regular dentist.

Bubbacat

toofache32
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Re: Dental care for mother-in-law with low income

Post by toofache32 » Sun Mar 10, 2019 11:07 pm

quantAndHold wrote:
Sun Mar 10, 2019 9:25 pm
Is she poor enough to qualify for Medicaid? Some states have dental as part of Medicaid. If she qualifies, she can have both Medicare and Medicaid at the same time, and use the Medicaid for dental.
In many states, Medicaid only covers extractions and basic fillings. Might be worth looking into this first.

toofache32
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Re: Dental care for mother-in-law with low income

Post by toofache32 » Sun Mar 10, 2019 11:09 pm

Unicorn1 wrote:
Sun Mar 10, 2019 8:14 pm
Thank you, yes there are local dental schools, but they only do routine cleaning and x-rays, but no fillings, crowns, etc.
Dentist here. Dental schools DO perform fillings and crowns. How else do the dentists learn to do these? The main downside to a dental school is that everything takes 3-4x as long and appointments are often a half day. But if she has nothing else to do, this can be a good option.

If she has poor oral hygiene, you also need to ask yourself what are you gonna do next year when 3 more teeth are in the same situation? OR if the crown you paid for has a new cavity underneath because of her neglect and needs to be removed? Remember, a crown simply replaces the damaged tooth structure but does not stop the disease process. Only the patient can stop the disease process with better hygiene.
Sometimes it's cheapest to replace teeth with a removable partial denture. When another tooth is extracted later, it can be added to the partial with minimal expense.

Zonian59
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Re: Dental care for mother-in-law with low income

Post by Zonian59 » Sun Mar 10, 2019 11:51 pm

I tried to get some major dental work, i.e., fillings, crown, etc. done at a dental school when I didn't have dental insurance. The projected cost was reasonable, much lower than a regular dentist and I didn't mind that it would take 3 to 4x longer with multiple visits.

How is your mother-in-law's blood pressure? Dental schools have strict guidelines for blood pressure. If high, they won't touch her.

Mine is marginal around 140/85, but for some reason I get "white coat syndrome" whenever I go to the dental school and the blood pressure shoots way up. Everything screeches to a halt at that point. Then I had to play their game to get a statement from my regular doctor that the blood pressure is under control via medication. So I go back to the dental school with statement in hand and again blood pressure shows very high. They were very inflexible and refused to further consider me as a patient.
Funny thing is that whenever I visit my regular doctor, blood pressure is within acceptable range. Go figure.

At the beginning of the year I signed with Delta Dental (PPO) under the ACA but have to pay 6 months of premiums before I can get needed major work done.

TN_Boy
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Re: Dental care for mother-in-law with low income

Post by TN_Boy » Mon Mar 11, 2019 8:45 am

miamivice wrote:
Sun Mar 10, 2019 8:40 pm
You have a salary of $185,000 a year.

Why don't you and your spouse just pay for the dental work that she needs?
Let's see, they are probably on the hook now for 2K, worried about more crowns at 2k apiece, and suppose later she needs a bridge (if teeth need to be pulled). You could be looking at 7k+ for a bridge. It can add right up.

Figuring out how to plan for and minimize these large expenses (and they are already providing other support) seems like a pretty smart idea to me.

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dm200
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Re: Dental care for mother-in-law with low income

Post by dm200 » Mon Mar 11, 2019 8:55 am

Unicorn1 wrote:
Sun Mar 10, 2019 8:01 pm
My wife and I provide financial support for her mother, who is recently widowed. My mother in law was just notified that she needs a crown on her tooth at a cost of $2,000. She has very little money and just wants to pull it, but we talked her out of it. Because of her poor dental hygiene overall, I worry that additional crowns may be in her future. We've had the dental hygiene conversation so nothing else to do on that front. She is on Medicare, but with no dental benefits. She is age 70.
My main question is this. Given her age, her poor dental hygiene, and our personal investment of money and worry that go in to her keeping her teeth, what are best options for dental care in seniors?
Dental insurance options through Medicare? On the private market? Anything available for lower income seniors? Just negotiate a discounted rate and pay cash? Other? Thank you
No expert, but many things I read say that staying up on dental issues positively affects many other aspects of health - and that dental problems (untreated) can harm overall health.

Some Medicare Advantage plans offer a degree of dental benefits. Mine does.

Yes - dental hygiene is certainly an issue. I suspect that some dentists (and/or their staff such as dental hygienists) may be better than others in "encouraging" patients to do better.

At age 70, she may have many decades to get the benefits of crowns.

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Unicorn1
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Re: Dental care for mother-in-law with low income

Post by Unicorn1 » Mon Mar 11, 2019 9:22 am

Thanks everyone for the comments so far. A little more info and commentary:

--She lives in NC and makes just a bit too much to qualify for Medicaid.
--She is 70, in great health (aside from her poor dental habits), and probably won't drive a long ways for dental work.
--The local dental school does not do crowns or fillings.
--We can afford to pay for her dental care, but obviously want to plan ahead and identify strategies to keep her bills as low as possible down the road.
--I don't doubt that a removable partial is in her future, but we're trying to avoid that until necessary. Definitely understand the point about her maintaining her dental hygiene. It's something that we try to remind her about often.
--Will look into DentalPlans.com and Medicare Advantage plans.

Thank you.

toofache32
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Re: Dental care for mother-in-law with low income

Post by toofache32 » Mon Mar 11, 2019 9:31 am

Unicorn1 wrote:
Mon Mar 11, 2019 9:22 am

--The local dental school does not do crowns or fillings.
Which dental school is this? I would never want a dentist graduating from there doing a crown on me.

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RickBoglehead
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Re: Dental care for mother-in-law with low income

Post by RickBoglehead » Mon Mar 11, 2019 9:36 am

Does she realize that YOU are bearing the cost ($2,000) of her poor dental hygiene?

My in-laws both had lousy teeth and poor hygiene. When my MIL was in assisted living, she had some dental issues creep up. Given that she could eat, we elected for simple extractions, and even ended up with a missing front tooth.

You definitely want to tell the dentist that she has no dental insurance and is low income and ask for a discount.
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Re: Dental care for mother-in-law with low income

Post by pshonore » Mon Mar 11, 2019 9:37 am

I believe East Carolina University Dental School does crowns, etc. Most insurance plans cover crowns at 50% (if at all) and there is usually a $2K max per year. And there maybe a waiting period for major work like crowns (since they usually cost the insurance co. more than a years premium.)

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Re: Dental care for mother-in-law with low income

Post by voodoo72 » Tue Mar 12, 2019 11:21 am

Unicorn1 wrote:
Mon Mar 11, 2019 9:22 am
Thanks everyone for the comments so far. A little more info and commentary:

--She lives in NC and makes just a bit too much to qualify for Medicaid.
--She is 70, in great health (aside from her poor dental habits), and probably won't drive a long ways for dental work.
--The local dental school does not do crowns or fillings.
--We can afford to pay for her dental care, but obviously want to plan ahead and identify strategies to keep her bills as low as possible down the road.
--I don't doubt that a removable partial is in her future, but we're trying to avoid that until necessary. Definitely understand the point about her maintaining her dental hygiene. It's something that we try to remind her about often.
--Will look into DentalPlans.com and Medicare Advantage plans.

Thank you.
HMMMM, you have 2 dental schools at UNC and ECU, I assure you both do crowns and filings, what local dental school is this? you are mistaken when you say they dont do crowns or filings, and yes I am a dentist. Depending on where the tooth is, an extraction is not the worse thing in the world.

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Re: Dental care for mother-in-law with low income

Post by hicabob » Tue Mar 12, 2019 11:43 am

A dental vacation in Mexico might be very cost effective?

hayhayday
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Re: Dental care for mother-in-law with low income

Post by hayhayday » Tue Mar 12, 2019 2:34 pm

If you can wait 6 months waiting period , delta has plan that covers 50% for crowns 100% for preventative\ diag for around $750 a year. If you were to sign up now wait period would expire in sept giving potential to hit 1500 cap in 2019 and then again in jan 2020 before cancel march 2020 assuming other work might be needed.


https://www.deltadentalins.com/individuals/plans/

mrc
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Re: Dental care for mother-in-law with low income

Post by mrc » Tue Mar 12, 2019 5:09 pm

She can't pay for a crown and wants to pull the tooth. For very valid reasons, you don't want that, and would rather pay for a crown to keep the tooth. So do that, but don't expect her to change her ways to protect your investment.

If you gave her the ultimatum: brush and floss every day or I'm not going to pay for your crown, what would she most likely decide? To change her life-long habit or to just have the tooth pulled. See?

Sometimes you must do what you can, and that is good enough. Paying for her dental work is a nice gesture. Leave it at that.
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Unicorn1
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Re: Dental care for mother-in-law with low income

Post by Unicorn1 » Tue Mar 19, 2019 6:29 am

My final follow-up on this thread.

Checked into a number of local dental schools (thanks for the ECU recommendations!). None are accepting new patients and have extensive waiting lists.

Dental insurances appear to offer limited benefits in relation to premiums, and waiting periods for major work often apply.

Our final solution? I called the dentist's office and negotiated the $2,100 bill down to $1,600 in exchange for upfront payment via check (not CC to avoid fees). We also bought by MIL a new Sonicare and reminded her how important it is to brush/floss. We'll see how it goes...you can lead a horse to water, but you can't make it drink.

Thanks everyone.

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Re: Dental care for mother-in-law with low income

Post by mariezzz » Tue Mar 19, 2019 6:23 pm

TN_Boy wrote:
Mon Mar 11, 2019 8:45 am
miamivice wrote:
Sun Mar 10, 2019 8:40 pm
You have a salary of $185,000 a year.

Why don't you and your spouse just pay for the dental work that she needs?
Let's see, they are probably on the hook now for 2K, worried about more crowns at 2k apiece, and suppose later she needs a bridge (if teeth need to be pulled). You could be looking at 7k+ for a bridge. It can add right up.

Figuring out how to plan for and minimize these large expenses (and they are already providing other support) seems like a pretty smart idea to me.
I'd suggest an implant instead of a bridge.

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dm200
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Re: Dental care for mother-in-law with low income

Post by dm200 » Wed Mar 20, 2019 11:52 am

Perhaps few and far between these days, but I know that certain dentists allocate a certain portion of their practice to providing dental services to such low income folks at a reduced (or zero) charges. Not sure how to find one, though.

Hillview
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Re: Dental care for mother-in-law with low income

Post by Hillview » Wed Mar 20, 2019 7:13 pm

We are in Mass and there is a Medicare plan for dental work that was worth it for my mom who is on fixed income and in the market for a lot of expensive dental work.

starfish26
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Re: Dental care for mother-in-law with low income

Post by starfish26 » Wed Mar 20, 2019 9:14 pm

Since she's not great with dental hygiene, what about paying for more frequent cleanings at the local cheaper dental school? Instead of 2 cleanings per year, maybe 3-4? An ounce of prevention... This might save money in the long run.

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