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Medical card fillings

  • 25-02-2021 11:56am
    #1
    Registered Users Posts: 5,815 ✭✭✭


    Last august I got a filling on a tooth.

    About a month ago started to get pains etc, tried the doc antibiotics route and then had to go dentist.
    Went to dentist and took x-ray and said decay in it and needs to come out.
    As I am a haemophiliac, I must go to St James hospital for extraction, went yesterday and told remove filling, some decay and refill it all and they will not pull a healthy tooth.
    Told I need to go back to place that did filling to be covered under medical card
    I rang original place to be told no we will not do it under medical card as only can do it once in five years, but then online it says two and need be some form filled in as too why redoing a filling.

    I am waiting on the head dentist from St James and then a call from David o Flynn-Dental Council next week.

    I have been quoted from E90 to E120 for a filling, so not a small amount.

    Anyone any experience or info on all this?
    Thanks, in advanced!


Comments

  • Registered Users Posts: 13,864 ✭✭✭✭Dav010


    The HSE impose a 5 yr bar on payment for fillings placed in the same tooth. This is very frustrating as heavily filled teeth are more prone to fracture/recurrent decay. In effect, this means that no Dentist, not just the one you attended, will get paid for a filling on that tooth until august 2025.

    The phone call you should be making is to your local HSE Dental Clinic, or to the Principal HSE Dentist in your area and requesting treatment. Otherwise, unfortunately you will be charged unless the Dentists receives approval from HSE for another filling to be done. Ironically, the HSE allow as many free extractions as you like, but only two fillings per year.


  • Registered Users Posts: 5,815 ✭✭✭jeffk


    Dav010 wrote: »
    The HSE impose a 5 yr bar on payment for fillings placed in the same tooth. This is very frustrating as heavily filled teeth are more prone to fracture/recurrent decay. In effect, this means that no Dentist, not just the one you attended, will get paid for a filling on that tooth until august 2025.

    The phone call you should be making is to your local HSE Dental Clinic, or to the Principal HSE Dentist in your area and requesting treatment. Otherwise, unfortunately you will be charged unless the Dentists receives approval from HSE for another filling to be done. Ironically, the HSE allow as many free extractions as you like, but only two fillings per year.

    Thanks

    I rang my local health centre dentist department before and got told in broken English only do kids and go private

    Her attitude stunk, unless I try again and see if someone more pleasant/helpful

    Such messing and then the row over the PPE cost seems to have the dentists backs up


  • Registered Users Posts: 13,864 ✭✭✭✭Dav010


    jeffk wrote: »
    Thanks

    I rang my local health centre dentist department before and got told in broken English only do kids and go private

    Her attitude stunk, unless I try again and see if someone more pleasant/helpful

    Such messing and then the row over the PPE cost seems to have the dentists backs up

    HSE has responsibility for all medical card holders, they sub contract that to dentists who are registered for the dental scheme. So HSE clinics treat both kids, and adults.

    Yip, according to a report this week, a quarter of all dentists who provide medical card treatments terminated their contracts with the HSE in 2020.


  • Registered Users Posts: 5,815 ✭✭✭jeffk


    Dav010 wrote: »
    HSE has responsibility for all medical card holders, they sub contract that to dentists who are registered for the dental scheme. So HSE clinics treat both kids, and adults.

    Yip, according to a report this week, a quarter of all dentists who provide medical card treatments terminated their contracts with the HSE in 2020.

    Rang my local and told kids and special needs only, so trying another one who deals with medical card issues as well

    End up we all will have false teeth or heading too turkey etc and come back with mouth filled with new teeth


  • Registered Users Posts: 13,864 ✭✭✭✭Dav010


    jeffk wrote: »
    Rang my local and told kids and special needs only, so trying another one who deals with medical card issues as well

    End up we all will have false teeth or heading too turkey etc and come back with mouth filled with new teeth

    You can get dentures on Med card, with approval.


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  • Registered Users Posts: 5,815 ✭✭✭jeffk


    Dav010 wrote: »
    You can get dentures on Med card, with approval.

    A pliers and that be next


  • Registered Users Posts: 24 Masi


    jeffk wrote: »
    Rang my local and told kids and special needs only, so trying another one who deals with medical card issues as well

    End up we all will have false teeth or heading too turkey etc and come back with mouth filled with new teeth

    So Turkey for a mouth filled with teeth (thousands even at their lower prices), flights, accommodation and quarantine time and cost... but €90 to €120 is too much....
    not to mention the bleeding issues....


  • Registered Users Posts: 5,815 ✭✭✭jeffk


    Masi wrote: »
    So Turkey for a mouth filled with teeth (thousands even at their lower prices), flights, accommodation and quarantine time and cost... but €90 to €120 is too much....
    not to mention the bleeding issues....

    It was a joke, but like the medical card dental system

    Need a filling on already filled tooth, no

    But we can pull out that mostly healthy tooth no bother


  • Registered Users Posts: 24 Masi


    jeffk wrote: »
    It was a joke, but like the medical card dental system

    Need a filling on already filled tooth, no

    But we can pull out that mostly healthy tooth no bother

    Sorry missed that, you need to work on your delivery....


  • Registered Users Posts: 13,864 ✭✭✭✭Dav010


    Masi wrote: »
    Sorry missed that, you need to work on your delivery....

    Perhaps you should work on your own.

    As a Dentist, the op’s description of the HSE dental scheme is absolutely on the money, it is a joke, and were it not for the fact that it impacts people’s lives so much, you would laugh at it.

    Unfortunately people have little option but to have teeth removed, and resign themselves to the gaps, or wearing dentures as a result. It is not a case that the op is choosing between a €90 filling or a trip to Turkey, it is a case that the second may be a later consideration/consequence of not being able to access remedial treatments because of a silly policy imposed by the HSE.


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  • Registered Users Posts: 26,897 ✭✭✭✭Dempo1


    jeffk wrote: »
    Last august I got a filling on a tooth.

    About a month ago started to get pains etc, tried the doc antibiotics route and then had to go dentist.
    Went to dentist and took x-ray and said decay in it and needs to come out.
    As I am a haemophiliac, I must go to St James hospital for extraction, went yesterday and told remove filling, some decay and refill it all and they will not pull a healthy tooth.
    Told I need to go back to place that did filling to be covered under medical card
    I rang original place to be told no we will not do it under medical card as only can do it once in five years, but then online it says two and need be some form filled in as too why redoing a filling.

    I am waiting on the head dentist from St James and then a call from David o Flynn-Dental Council next week.

    I have been quoted from E90 to E120 for a filling, so not a small amount.

    Anyone any experience or info on all this?
    Thanks, in advanced!

    Sadly and bizzarely more and more Dental practices no longer doing treatment under the medical card scheme. My own was kind enough to inform me by email a few months back saying they've left the scheme due to additional costs, PPE, covid protocols etc, blaming tge HSE for lack of financial supports.

    Whilst the HSE state there's plenty of dental practices still covering medical card holders, it's easier said than done finding one.

    Is maith an scáthán súil charad.




  • Registered Users Posts: 5,815 ✭✭✭jeffk


    I will give a side note to this, the place that did the filling said they dont accept medical cards on a Saturday


  • Registered Users Posts: 26,897 ✭✭✭✭Dempo1


    jeffk wrote: »
    I will give a side note to this, the place that did the filling said they dont accept medical cards on a Saturday

    They either work under the scheme or not, when my dentist worked under the scheme (no longer), my appointments were a Saturday mainly due to work commitments. Seems extraordinary a dental practice can dictate what days they work under the scheme.

    Is maith an scáthán súil charad.




  • Registered Users Posts: 13,864 ✭✭✭✭Dav010


    Dempo1 wrote: »
    Sadly and bizzarely more and more Dental practices no longer doing treatment under the medical card scheme. My own was kind enough to inform me by email a few months back saying they've left the scheme due to additional costs, PPE, covid protocols etc, blaming tge HSE for lack of financial supports.

    Whilst the HSE state there's plenty of dental practices still covering medical card holders, it's easier said than done finding one.

    It’s not bizarre in the slightest that so many Dentists are leaving the scheme. The Government don’t want to pay for the service being provided on their behalf.


  • Registered Users Posts: 26,897 ✭✭✭✭Dempo1


    Dav010 wrote: »
    It’s not bizarre in the slightest that so many Dentists are leaving the scheme. The Government don’t want to pay for the service being provided on their behalf.

    It is bizzare, particularly the excuse given to me, the practice in question has two premises in a Midlands Town, has by all means a very large successful practice. Whatever their reasons, blaming lack of funding for PPE and covid protocols was I believe inappropriate. Their contract fees an entirely seperate matter but I seriously doubt the scheme runs at a substantial loss to a practice.

    Is maith an scáthán súil charad.




  • Registered Users Posts: 13,864 ✭✭✭✭Dav010


    Dempo1 wrote: »
    It is bizzare, particularly the excuse given to me, the practice in question has two premises in a Midlands Town, has by all means a very large successful practice. Whatever their reasons, blaming lack of funding for PPE and covid protocols was I believe inappropriate. Their contract fees an entirely seperate matter but I seriously doubt the scheme runs at a substantial loss to a practice.

    Your doubts are misplaced.

    The primary duty of care for providing treatments to medical card holders and children under 16 lies with the HSE. They subcontract that care to private dentists through the DTSS scheme. When Clinics reopened last May the Government/HSE said they would provide access to, and payment for PPE to Dentists providing treatment to Med Card patients on their behalf. That PPE costs a lot and up to recently was difficult to get, but the HSE/Government reneged on their commitment. The fees for Med card treatments are very low compared to private fees, so, Dentists have low fees along with additional higher costs of providing treatment. No matter what sector you work in, that is not sustainable. Hence why Dentists are exiting the scheme in droves.


  • Registered Users Posts: 26,897 ✭✭✭✭Dempo1


    Dav010 wrote: »
    Your doubts are misplaced.

    The primary duty of care for providing treatments to medical card holders and children under 16 lies with the HSE. They subcontract that care to private dentists through the DTSS scheme. When Clinics reopened last May the Government/HSE said they would provide access to, and payment for PPE to Dentists providing treatment to Med Card patients on their behalf. That PPE costs a lot and up to recently was difficult to get, but the HSE/Government reneged on their commitment. The fees for Med card treatments are very low compared to private fees, so, Dentists have low fees along with additional higher costs of providing treatment. No matter what sector you work in, that is not sustainable. Hence why Dentists are exiting the scheme in droves.

    All fair points and I appreciate how the scheme is supposed to work. Whatever about the fees being low, that's a matter for whomever negotiated those fees. I just feel yet again its patients caught up in an unsavoury dispute between medical professionals and the HSE. My primary point was the communication I recieved which I found inappropriate, my dentist could have just left it at we've withdrawn rather than bring PPE and covid protocol expenses into it. But I do accept fully your points.

    Is maith an scáthán súil charad.




  • Registered Users Posts: 13,864 ✭✭✭✭Dav010


    Dempo1 wrote: »
    All fair points and I appreciate how the scheme is supposed to work. Whatever about the fees being low, that's a matter for whomever negotiated those fees. I just feel yet again its patients caught up in an unsavoury dispute between medical professionals and the HSE. My primary point was the communication I recieved which I found inappropriate, my dentist could have just left it at we've withdrawn rather than bring PPE and covid protocol expenses into it. But I do accept fully your points.

    The fees were not negotiated. In a cost cutting exercise in 2010 the Government reduced the amount of treatments covered (there used to be no limits on number of fillings, other items were also covered) and the fees. They have not been “negotiated” since, despite requests from the Dental Association, this is why Dentists are leaving what should be a guaranteed source of income.

    Do you not feel that your Dentist had a responsibility to inform you why they were leaving? Your ire should be directed to the Department responsible for the shortcomings of the scheme, your local TD.


  • Registered Users Posts: 10 gdpman


    Dempo1 wrote: »
    It is bizzare, particularly the excuse given to me, the practice in question has two premises in a Midlands Town, has by all means a very large successful practice. Whatever their reasons, blaming lack of funding for PPE and covid protocols was I believe inappropriate. Their contract fees an entirely seperate matter but I seriously doubt the scheme runs at a substantial loss to a practice.

    I had a medical card contract for nearly 25 years and resigned from the scheme.
    The level of fees paid is only one of the many problems with being a contractor for the HSE.
    The scheme has been dysfunctional for years and we were forced into providing a level of care that was unfair to patients and the practice.
    The manner the practices that held a medical card contract were treated during the covid pandemic has been poor. The majority of practices have not even been contacted yet for receiving the vaccine yet, we were promised PPE last year and the HSE disconnected the phone and never responded to a single email.
    This was unfortunately the last straw for many practices that were strongly committed to the scheme.
    We contacted our patients to apologise for leaving the scheme, but unfortunately we were a small business NOT a HSE clinic and had to take a commercial decision to leave the scheme. We did urge all our patients to contact their local representatives and raise this issue but until the coverage this week has received little if no air time.


  • Registered Users Posts: 24 Masi


    Dav010 wrote: »
    Perhaps you should work on your own.

    As a Dentist, the op’s description of the HSE dental scheme is absolutely on the money, it is a joke, and were it not for the fact that it impacts people’s lives so much, you would laugh at it.

    Unfortunately people have little option but to have teeth removed, and resign themselves to the gaps, or wearing dentures as a result. It is not a case that the op is choosing between a €90 filling or a trip to Turkey, it is a case that the second may be a later consideration/consequence of not being able to access remedial treatments because of a silly policy imposed by the HSE.

    No I'm good....:rolleyes:


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  • Registered Users Posts: 13,864 ✭✭✭✭Dav010


    Masi wrote: »
    No I'm good....:rolleyes:

    Helps to be informed, before you start taking the piss out of posters in difficult positions, asking for advice.


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