Wisdom Tooth Removal - Insurance not covering IV sedation

Evd-Burner

Hi All,

In need of an impacted wisdom tooth removal, luckily it's covered by the insurance company to either do it in the Mater private or in the dentists dental surgery. I can have it done with the next 6 weeks.

In the Mater private it is covered 100% with only having to pay for 50 euro excess. But to have it completed in the dentists dental surgery they will not cover the IV sedation, I can't understand this as the IV sedation is only 250 euro, I'm sure a general anesthetic and a visit to the Mater private would surely cost much more than this?

Thinking of going ahead with the Mater private to avoid the extra cost as times are tight. Thoughts?

Evd.

Oral Surgeon

Evd-Burner wrote: »

Hi All,

In need of an impacted wisdom tooth removal, luckily it's covered by the insurance company to either do it in the Mater private or in the dentists dental surgery. I can have it done with the next 6 weeks.

In the Mater private it is covered 100% with only having to pay for 50 euro excess. But to have it completed in the dentists dental surgery they will not cover the IV sedation, I can't understand this as the IV sedation is only 250 euro, I'm sure a general anesthetic and a visit to the Mater private would surely cost much more than this?

Thinking of going ahead with the Mater private to avoid the extra cost as times are tight. Thoughts?

Evd.

Historically the medical insurers have "fully" paid for these procedures in the private hospitals under GA with 3 main components to the payment (payment to oral surgeon for extraction, payment to the anaesthetist for the anaesthetics and payment to the hospital for the bed/ support staff and facilities), you then have asmall technical fee of €50.

In the oral surgeons own rooms, he/she will only be paid the extraction fee by the medical insurers. So no payment from the insurers for the sedation, support staff or facilities.

Personally, if removing one wisdom tooth under local anaesthetic, I'd allow a 30min appointment. If removing the same tooth under IV sedation, I'd allow 90mins as I need to sedate, treat and monitor the patient... The insurance companies pay me nothing for this...

Why they don't pay is complex.... They don't want to open up a new stream of payment if they don't have to...
Vested interests, many of the advisors on the medical insurers boards are clinicians who stand to gain from keeping the status quo of general anesthesia, paymnts to anaesthetists and paymnts to private hospitals. If they pay for IV sedation, then less work will be done in private hospitals....

Bottom line is that IV sedation is generally safer, easier on you systemically, quicker recovery etc....

I know that its extra money but it's a better way to have this treatment IMO

btkm8unsl0w5r4

OP its totally silly they dont pay for the sedation but will pay five times the amount for a GA to have exactly the same thing done.

A general anesthetic is a severe proceedure, you are given a mixture of drugs to relax you muscles, knock you out and then a tube is inserted down your throat or nose to breath for you. Afterwards you are given very strong centrally acting painkillers. Its all total overkill, its very hard on your body and will leave you with a lot of post operative issues related to the anesthetic rather than the dental proceedure. Its a lubricious situation where the insurer would rather you take a chance of acquiring a hospital infection, have serious complications due to the anesthetic and suffer pain and discomfort rather than have the proceedure done simply, quickly and economically under IV sedation.

Air your grievances with your insurer, and at the end of the day decide wheather you want to take the risks of the GA to save the money.

MFlack2012

Evd-Burner wrote: »

Hi All,

In need of an impacted wisdom tooth removal, luckily it's covered by the insurance company to either do it in the Mater private or in the dentists dental surgery. I can have it done with the next 6 weeks.

In the Mater private it is covered 100% with only having to pay for 50 euro excess. But to have it completed in the dentists dental surgery they will not cover the IV sedation, I can't understand this as the IV sedation is only 250 euro, I'm sure a general anesthetic and a visit to the Mater private would surely cost much more than this?

Thinking of going ahead with the Mater private to avoid the extra cost as times are tight. Thoughts?

Evd.

I was told the same thing, I had to have all four removed. He told me he could do it in his office, under sedation, but that I wouldn't feel anything but would be aware and awake! Would have to pay €300 for the pleasure. Found out General An was fully covered. Went in to the Hermatige at 6am, was fully out of recovery and home on the sofa by 1pm. Access to call himself whenever needed. Stitches dissolved and fell out themselves ten days later. No further issues.

Evd-Burner

Thanks for the information, that clears things up!

It seems completely nuts they don't cover it. I'll likely go with sedation, I worked it out after tax that it will cost 160 extra.

MFlack2012

Evd-Burner wrote: »

Thanks for the information, that clears things up!

It seems completely nuts they don't cover it. I'll likely go with sedation, I worked it out after tax that it will cost 160 extra.

No problem, It was totally crazy to me, but I was kinda on the side of 'knock me out completely, I don't wanna see' so worked out better for me

Best of luck.

Evd-Burner

MFlack2012 wrote: »

No problem, It was totally crazy to me, but I was kinda on the side of 'knock me out completely, I don't wanna see' so worked out better for me

Best of luck.

I've been thinking that myself. Not a fan of seeing sharp knives

MFlack2012

Evd-Burner wrote: »

I've been thinking that myself. Not a fan of seeing sharp knives

It was much better for me. No pain whatsoever. Absolutely disgusting salt-water taste when the stitches do dissolve, that can't be rinsed, but fades after a few hours; but nothing to dramatic happened. I do know that my top two hadn't cut through, my bottom two had cut through but didn't 'come up'. The two that had cut through were more problematic to be removed (Which surprised me), I also have some 'holes' left in the gum some four years on. Not actual holes but feel like it