I now have dental insurance from the San Diego Community College school district (thank you district! thank you union!), so I set out to get a tooth capped. My local dentist wrote it up, turns out its diagnostic code D2740 for which the Delta dental mandates a $970 fee. The insurance company pays 60% of this, so I will have to pay the 40% or $377.50, a not inconsiderable amount.
Last time I had a cap made I went to Tijuana, to Dra. Claudia Rodriguez who charged $240 for a cap and impressed me as skillful and careful. I have been to other dentists in TJ who I cannot say the same about.
I decided to do some research and maybe get the cap done a little cheaper. I found new dental choice which charges $8.00 a month and functions as a price negotiator for working with the dentists. After I pay the $8.00, I can get the cap made for $722, or $248 cheaper than Delta Dental’s mandated price.
Could I get the Dentist to charge me the $722, take Delta Dental’s $582 and only charge me $140? This way, the dentist would get what they get from Dental Choice, but I have a smaller co-pay. There’s plenty of dentists, Delta dental has over 200 dentists within 10 miles of my zip code, so I start dialing.
My original dentist, the one who told me I needed the cap, said he had to charge me the co-pay because it was part of his agreement with Delta Dental. I called Delta Dental and asked them. “No, you can make whatever deal you want with the dentist. We are going to pay him $582 and we don’t care what you pay him.” Still, my dentist wouldn’t do it for $722 despite charging Dental Choice patients only $722.
Oh well. I figured with so many dentist on both plans, It would be easy to find one who would do it for the Dental Choice price. After all, I’m old, and I have 3 dependents on my plan. We’d probably give the dentist plenty of business in the next couple of years.
After calling 15 Dentists though, I’m still out of luck. None of them would do it. Plenty of their office managers tried to talk me into coming in for an exam. None of them liked that I was calling to find out prices. I tried shopping for a price without telling them I had insurance.
The cheapest price I could get a cap without insurance was $1200. This is probably the worst part of this whole story. The way dentists work, is they charge the insurance company a discounted price based on the “regular” price of dental procedures. What is the “regular” price? That’s the price that poor people with no dental insurance pay. Dentists who resist this, and try to charge people competitive rates are accused of unprofessional behavior.
So I went to my dentist in Tijuana. Dra. Rodriguez did a great job for me and it didn’t cost me a substantial co-pay. And she billed my insurance. While I was sitting in the chair I asked her what she charged Mexican people with no insurance. She told me that she charged them substantially less.