Back to Top
Follow Us
  • Health
    Discover the plan that covers your Medigap needs
    The coverage you need. The prices you want. See Medicare Supplement quotes now.
    See Prices

    Topics

    • Aging
    • Dementia
    • Heart Disease
    • Medicare
    • Dental Care
    • All Stories

    Popular Reads

    • 6 simple ways to cut your dementia risk
    • The dangers of Medicare Part B excess charges
    • The 5 worst things to say after someone dies

    Resources

    • Our Mission
    • Join Our Newsletter
    • Medigap Quotes
    • Medicare Quiz
    • Shop Dental Insurance
  • Home
    What would your name be if you were born today?
    And how has the popularity of it changed over time
    Play the name game

    Topics

    • Gardening
    • Gifts
    • Organizing
    • Pets
    • Technology
    • All Stories

    Popular Reads

    • 6 simple ways to cut your dementia risk
    • The dangers of Medicare Part B excess charges
    • The 5 worst things to say after someone dies

    Resources

    • Our Mission
    • Join Our Newsletter
    • Medigap Quotes
    • Medicare Quiz
    • Shop Dental Insurance
  • Life
    Discover the plan that covers your Medigap needs
    The coverage you need. The prices you want. See Medicare Supplement quotes now.
    See Prices

    Topics

    • Caregiving
    • Divorce
    • Grandkids
    • Marriage
    • Sex
    • All Stories

    Popular Reads

    • 6 simple ways to cut your dementia risk
    • The dangers of Medicare Part B excess charges
    • The 5 worst things to say after someone dies

    Resources

    • Our Mission
    • Join Our Newsletter
    • Medigap Quotes
    • Medicare Quiz
    • Shop Dental Insurance
  • Entertainment
    What would your name be if you were born today?
    And how has the popularity of it changed over time
    Play the name game

    Topics

    • Card Games
    • Hobbies
    • Retronaut
    • Travel
    • Trivia
    • All Stories

    Popular Reads

    • 6 simple ways to cut your dementia risk
    • The dangers of Medicare Part B excess charges
    • The 5 worst things to say after someone dies

    Resources

    • Our Mission
    • Join Our Newsletter
    • Medigap Quotes
    • Medicare Quiz
    • Shop Dental Insurance
  • Money
    Discover the plan that covers your Medigap needs
    The coverage you need. The prices you want. See Medicare Supplement quotes now.
    See Prices

    Topics

    • Retirement
    • Budgeting
    • Scams
    • Social Security
    • Taxes
    • All Stories

    Popular Reads

    • 6 simple ways to cut your dementia risk
    • The dangers of Medicare Part B excess charges
    • The 5 worst things to say after someone dies

    Resources

    • Our Mission
    • Join Our Newsletter
    • Medigap Quotes
    • Medicare Quiz
    • Shop Dental Insurance
Subscribe
Share
Tooth and Justice

Dental shock: six pulled teeth and one unexpected bill

It's an expense that frequently leads to large out-of-pocket bills, because traditional Medicare does not cover dental.

byVictoria Knight / Kaiser Health News•March 11, 2020
SHARE TWEET EMAIL
camera
Getty Images

The ache in three of Kathy McCracken’s teeth started almost four years ago. It was hard for her to chew and swallow. She was sensitive to both hot and cold food.

“Pain, pain, pain” was how McCracken, now 69, described the feeling. After taking X-rays, she said, her dentist told her six teeth would need to be pulled.

She had two teeth with exposed roots, holes in another two, one tooth with a cap that had a cavity underneath, and a piece of a tooth left from one that had been pulled, she said.

McCracken found herself in difficult circumstances. The dental insurance she had through her husband’s employer was already maxed out for the year and, living on a fixed income, she couldn’t afford to pay the $3,000 out-of-pocket estimated cost of treatment. Seeing her predicament, her pastor in Statesville, the Rev. Amy Spivey, offered to use money from Monticello United Methodist Church’s discretionary fund to cover it.

“I thought about her dental health as something that is a major gap in her Medicare and how … because it’s such an extenuating issue and there’s no insurance or resources for it, she was caught,” Spivey said.

But when the bill for the tooth extractions ended up being more than $13,000 and McCracken’s account was sent to collections, McCracken and the church went into protest mode to fight charges four times higher than expected.

“This is a rural, small, country church,” said Bjarne Berg, the finance chair of Monticello United Methodist. “We don’t have a lot of resources, but when the church members get into this sort of trouble, we try to help each other out.”

Dental care is a medical expense that frequently leads to large out-of-pocket bills, since commercial insurers often stipulate a maximum payout of a couple of thousand dollars a year and Medicare offers no or limited coverage. That leaves patients extremely vulnerable.

Though both McCracken and her church had gotten estimates in advance, they fell victim to a common bait-and-switch: Many procedures can be done safely and relatively cheaply at an outpatient center but cost vastly more when performed in a hospital.

Told the procedure would be performed at Viewmont Surgery Center ― about 30 miles away in Hickory, North Carolina — McCracken authorized Spivey to contact the health care provider to confirm the $3,000 price estimate.

“I had to make sure that I had the money in the discretionary fund to cover it, and we did, and I felt confident about that,” said Spivey.

With the church ready to cover her bill, McCracken’s dental work was booked. But a couple of weeks before the surgery, McCracken said, the dentist’s office told her instead to go to Catawba Valley Medical Center, also in Hickory, to sign papers.

She didn’t think too much of it. “I thought that the Viewmont Surgery Center was a satellite of the hospital, but you have to go to the main hospital to sign the papers,” said McCracken.

While she was filling out the papers at the hospital, the administrative staff asked for her insurance card. McCracken had recently gotten her new Humana Medicare Advantage card in the mail and noticed it said dental was included. She handed it over and figured the insurance would help with anything left over after the estimated cost.

Instead of the health care providers’ initial $3,000 out-of-pocket estimate for the procedure, McCracken received a bill of more than $13,000 from the hospital.

But that’s not how it played out.

Still confused about the difference in the two facilities, on the day of surgery, McCracken’s son drove her to Catawba Valley Medical Center, where she had six teeth extracted under general anesthesia in a procedure that took about 45 minutes.

But instead of the health care providers’ initial $3,000 out-of-pocket estimate for the procedure, McCracken received a bill of more than $13,000 from the hospital.

It is unclear why McCracken’s treatment was switched from one facility to another, and her dentist didn’t respond to multiple calls and emails for an explanation.

“I was stunned and hurt. The first thing I thought is, ‘Where are we going to come up with this?’” McCracken said.

After being notified that her account had been sent to collections, McCracken asked the hospital for help. Catawba Valley told her she did not “appear to qualify for financial assistance” under its charity care policy and offered her a 25% discount on the bill.

When asked to respond about McCracken’s account being sent to collections and her not qualifying for financial assistance, Matt Webber, the Catawba Valley Health System’s spokesperson, noted in an email that protecting patient privacy prevented him from speaking about McCracken’s medical care or financial arrangements. He also wrote, however, that KHN’s understanding of how the facility handles patient concerns about billing and financial matters was “incomplete” and “inaccurate,” though he provided no specifics.

But Berg, the church’s finance chair, was determined that neither the church nor McCracken would pay such a high bill, especially because the church had prepaid — before the facility switch — the dentist $1,427. The church also had paid a $700 bill to the anesthesiology group involved in the procedure.

He helped McCracken compose emails and letters contesting the bill and set up a meeting with hospital administrators to negotiate. Thankfully, McCracken had saved all her medical paperwork, including the original cost estimates.

After Berg discussed reimbursement rates with hospital staff, Catawba Valley Medical Center said the $13,000 bill could be settled if the hospital received $3,000 in payment. Berg found additional church funds to cover this amount — bringing the total that Monticello United Methodist paid for McCracken’s tooth extractions up to $5,127.

Seniors should be aware of coverage specifics

McCracken is one of 22 million seniors — or about a third of the total Medicare population — who was enrolled in a Medicare Advantage plan during 2019.

See also

  • Original Medicare vs. Medicare Advantage: what’s the difference?

Traditional Medicare does not cover dental care, except when related to a medical procedure, such as for oral cancer. But dental coverage varies widely for seniors who enroll in Medicare Advantage plans. Even though many of those plans advertise “dental benefits,” that is often limited to routine cleanings and exams, as was the case for McCracken.

More seniors “will get some needed dental coverage, but also more will be confused about how much coverage they actually have, particularly because dental benefits vary so much across plans,” said Meredith Freed, a Medicare policy analyst at the Kaiser Family Foundation. (KHN is an editorially independent program of the foundation.)

For now, McCracken’s tooth pain is mostly gone. But she has only seven top teeth and seven bottom teeth left in the front of her mouth — and she worries about what will happen when those teeth wear down.

But she now feels better prepared to deal with the financial side of these issues and has already started contacting her insurance companies to find out what dental work, like dentures, might be covered.

“I’ve got a feeling if I don’t get some teeth in there, I’m going to have some problems,” McCracken said. But she added: “If it wasn’t for my church and Berg doing what he did, I would still be in a bad position.”

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.

Share This Article

Popular on Considerable

Sponsored Content

Maybe it’s not old age. Maybe it’s aortic stenosis

As you get older, you might not be able to do the things you used to. Maybe your knees give you trouble. Maybe you just can’t stay up late anymore. Maybe your back gets stiff on long car rides. But don’t assume every change is something you need to live with as you age. Do you feel like you can’t do as much as you should be able to do? Do you get fatigued or winded easily? Do you feel like you don’t have any ambition? 

Continue Reading
Sponsored Content

Maybe it’s not old age. Maybe it’s aortic stenosis

Feel like you’re slowing down? Don’t chalk it up to aging. It could be a sign of a heart valve disease.

Health

One simple move could lower your blood pressure by 10% without medication

In popular culture, a firm grip has long been associated with a macho image, but it turns out that an increased handgrip strength can help both women and men reduce the dangers associated with high blood pressure. According to the American Heart Association, over 100 million Americans have high blood pressure, which it defines as being above 130/80. High blood pressure, known as hypertension, increases the risk of stroke and usually increases as

Continue Reading
Health

One simple move could lower your blood pressure by 10% without medication

Getting a grip on your health is easier than you think.

Health

7 surprising early Alzheimer’s symptoms that don’t involve memory

The average Alzheimer’s patient is not "Still Alice,” the 50-something linguistics expert from the Academy Award-winning movie who faces a devastating diagnosis of early-onset Alzheimer's disease. The average Alzheimer’s patient is in her late 70s, whose disease comes on more slowly than depicted in that film, says George Perry, Ph.D., Professor of Biology at The University of Texas at San Antonio and editor-in-chief of the 

Continue Reading
Health

7 surprising early Alzheimer’s symptoms that don’t involve memory

These behavioral changes may warn of Alzheimer's — and they have nothing to do with memory problems.

A new media brand for people who are redefining what it means to grow older and are looking forward to what’s next
copyright 2022 considerable.com

Follow Us

Follow Us Facebook Twitter LinkedIn

Company Info

About ConsiderableContact UsTerms and ConditionsPrivacy Policy
copyright 2022 considerable.com
  • Health
    Discover the plan that covers your Medigap needs
    The coverage you need. The prices you want. See Medicare Supplement quotes now.
    See Prices

    Topics

    • Aging
    • Dementia
    • Heart Disease
    • Medicare
    • Dental Care
    • All Stories

    Popular Reads

    • 6 simple ways to cut your dementia risk
    • The dangers of Medicare Part B excess charges
    • The 5 worst things to say after someone dies

    Resources

    • Our Mission
    • Join Our Newsletter
    • Medigap Quotes
    • Medicare Quiz
    • Shop Dental Insurance
  • Home
    What would your name be if you were born today?
    And how has the popularity of it changed over time
    Play the name game

    Topics

    • Gardening
    • Gifts
    • Organizing
    • Pets
    • Technology
    • All Stories

    Popular Reads

    • 6 simple ways to cut your dementia risk
    • The dangers of Medicare Part B excess charges
    • The 5 worst things to say after someone dies

    Resources

    • Our Mission
    • Join Our Newsletter
    • Medigap Quotes
    • Medicare Quiz
    • Shop Dental Insurance
  • Life
    Discover the plan that covers your Medigap needs
    The coverage you need. The prices you want. See Medicare Supplement quotes now.
    See Prices

    Topics

    • Caregiving
    • Divorce
    • Grandkids
    • Marriage
    • Sex
    • All Stories

    Popular Reads

    • 6 simple ways to cut your dementia risk
    • The dangers of Medicare Part B excess charges
    • The 5 worst things to say after someone dies

    Resources

    • Our Mission
    • Join Our Newsletter
    • Medigap Quotes
    • Medicare Quiz
    • Shop Dental Insurance
  • Entertainment
    What would your name be if you were born today?
    And how has the popularity of it changed over time
    Play the name game

    Topics

    • Card Games
    • Hobbies
    • Retronaut
    • Travel
    • Trivia
    • All Stories

    Popular Reads

    • 6 simple ways to cut your dementia risk
    • The dangers of Medicare Part B excess charges
    • The 5 worst things to say after someone dies

    Resources

    • Our Mission
    • Join Our Newsletter
    • Medigap Quotes
    • Medicare Quiz
    • Shop Dental Insurance
  • Money
    Discover the plan that covers your Medigap needs
    The coverage you need. The prices you want. See Medicare Supplement quotes now.
    See Prices

    Topics

    • Retirement
    • Budgeting
    • Scams
    • Social Security
    • Taxes
    • All Stories

    Popular Reads

    • 6 simple ways to cut your dementia risk
    • The dangers of Medicare Part B excess charges
    • The 5 worst things to say after someone dies

    Resources

    • Our Mission
    • Join Our Newsletter
    • Medigap Quotes
    • Medicare Quiz
    • Shop Dental Insurance
About ConsiderableContact UsTerms and ConditionsPrivacy Policy
Follow Us
  • Health
    Discover the plan that covers your Medigap needs
    The coverage you need. The prices you want. See Medicare Supplement quotes now.
    See Prices

    Topics

    • Aging
    • Dementia
    • Heart Disease
    • Medicare
    • Dental Care
    • All Stories

    Popular Reads

    • 6 simple ways to cut your dementia risk
    • The dangers of Medicare Part B excess charges
    • The 5 worst things to say after someone dies

    Resources

    • Our Mission
    • Join Our Newsletter
    • Medigap Quotes
    • Medicare Quiz
    • Shop Dental Insurance
  • Home
    What would your name be if you were born today?
    And how has the popularity of it changed over time
    Play the name game

    Topics

    • Gardening
    • Gifts
    • Organizing
    • Pets
    • Technology
    • All Stories

    Popular Reads

    • 6 simple ways to cut your dementia risk
    • The dangers of Medicare Part B excess charges
    • The 5 worst things to say after someone dies

    Resources

    • Our Mission
    • Join Our Newsletter
    • Medigap Quotes
    • Medicare Quiz
    • Shop Dental Insurance
  • Life
    Discover the plan that covers your Medigap needs
    The coverage you need. The prices you want. See Medicare Supplement quotes now.
    See Prices

    Topics

    • Caregiving
    • Divorce
    • Grandkids
    • Marriage
    • Sex
    • All Stories

    Popular Reads

    • 6 simple ways to cut your dementia risk
    • The dangers of Medicare Part B excess charges
    • The 5 worst things to say after someone dies

    Resources

    • Our Mission
    • Join Our Newsletter
    • Medigap Quotes
    • Medicare Quiz
    • Shop Dental Insurance
  • Entertainment
    What would your name be if you were born today?
    And how has the popularity of it changed over time
    Play the name game

    Topics

    • Card Games
    • Hobbies
    • Retronaut
    • Travel
    • Trivia
    • All Stories

    Popular Reads

    • 6 simple ways to cut your dementia risk
    • The dangers of Medicare Part B excess charges
    • The 5 worst things to say after someone dies

    Resources

    • Our Mission
    • Join Our Newsletter
    • Medigap Quotes
    • Medicare Quiz
    • Shop Dental Insurance
  • Money
    Discover the plan that covers your Medigap needs
    The coverage you need. The prices you want. See Medicare Supplement quotes now.
    See Prices

    Topics

    • Retirement
    • Budgeting
    • Scams
    • Social Security
    • Taxes
    • All Stories

    Popular Reads

    • 6 simple ways to cut your dementia risk
    • The dangers of Medicare Part B excess charges
    • The 5 worst things to say after someone dies

    Resources

    • Our Mission
    • Join Our Newsletter
    • Medigap Quotes
    • Medicare Quiz
    • Shop Dental Insurance
More
  • Company Info
    About ConsiderableContact UsTerms and ConditionsPrivacy Policy

Tell Us About Yourself

Help us send the best of Considerable to you.
A valid email is required
Please enter your first name
Please enter your last name
Birth month required!
Birth day required!
Birth year required!
Zip code required
Sorry, it looks like you were previously unsubscribed. Click here to sign up again.
You can unsubscribe at any time, for more info read our Privacy Policy

Success!

This looks like the beginning of a beautiful friendship.
Close this window
179k Likes Like Us
10.7k Followers Follow Us

Sign In

Get started by entering your email address
Sorry, we don't recognize that email A valid email is required
Questions about our Premium Membership? Read our FAQ

Welcome back!

We sent you an email to create a new password. After creating a password, please click the link below to login.
Sign In
How did we recognize you? Grandparents.com is now Considerable.com. Use your Grandparents.com login info to manage your account details

Welcome Back

{{member.email}}
Please enter your password
Forgot my Password
Privacy Policy Terms of Service

Forgot Password

Get started by entering your email address
A valid email is required
Already a member? Sign in

Check Your Email

We sent you an email to reset your password
Sign In

Create an Account

Get started by entering your email address
A valid email is required
Already a member? Sign in

You're Almost Done!

Just enter some information for us
A valid email is required
Please enter your first name
Please enter your last name
Birth month needed!
Birth day needed!
Birth year needed!
Please enter a better zip than that...
Password must be at least 8 characters, including uppercase, lowercase, and a number.
Password needs to be stronger...
Passwords should match.
Privacy Policy Terms of Service

Thanks For Joining

User generated content in real-time will have multiple touchpoints for offshoring.
Ok, got it. Close this window
179k Likes Like Us
10.7k Followers Follow Us
Close
My Account

{{member.firstname}}

Premium Member
My Account Settings
Edit Profile Manage Subscriptions Billing Details Member Benefits Sign Out
Change my password Send Reset Link

Let's make sure you're eligible and we'll show you plans

It's that simple, we won't try to sell you anything. We won't even ask for your phone number. We promise.

{{ validation.zip.message }}
{{ user.tobacco.value }} edit
{{ confirmTobacco }}
{{ user.gender.value }} edit
{{ validation.birthdate.message }}
{{ confirmBirthdate }}
{{ user.addtl_medicare.value }} edit
{{ confirmMedicare }}
{{ user.partb.value }} edit
{{ confirmPartb }}

Answer the questions above to see plans