May. 2nd, 2017

inmymargins: Green leaves against white sky. (Green Leaves)
I've been spoiled in that, for all but I think six days of my life, I have had some kind of medical insurance, whether it be private as a dependent, COBRA, school plan, ACA-bought, or -- for the past couple of years -- Medicaid. I've always felt some safety in knowing that, even if it's really hard to pull off, I can somehow get the medical care I need.

That changed a bit after the Great Medical Debacle of 2013, which cost $30,000, ruined my since-repaired credit, effectively destroyed my parents' retirement savings, and led to me going on Medicaid. It was one of those great crises you hear about on the evening news, where people are just living their lives and then suddenly find themselves on the verge of bankruptcy because our medical system thrives on the tears of the blindsided innocents. And I survived it, but that confidence that I will always get the care I need was shaken pretty hard.

With Medicaid, things have generally been a blessing. I have no co-pay for medications or office visits, plus my emergency gallbladder removal was fully covered. The one real challenge has been finding specialists who will accept it. And no specialty has given me more trouble than dentistry.

I realize now how spoiled I was by that private insurance for most of my life. For the first 20 or so years, I saw the same dentist my family had used for decades, with his cozy office built onto his home in a cute suburban Connecticut street. When he retired, I switched to another private practice, this time just down the road from the quaint hospital I was born in. When that dentist retired, he sold the practice to a charming young woman who often brings her children to work and who serves tea in the professionally-decorated waiting room. My dentists have always had the top instruments, hour-long appointments, total familiarity with me (and my family), etc. And since that's all I'd ever known, in my privately-insured world, it never occurred to me that that's not how dentistry works for everyone.

When I switched to Medicaid and went in for a regular appointment, I naively thought that my dentist would be required to take it. Oh, no, did I learn...$900 of work too late. So I didn't see a dentist for about 18 months after that, because I couldn't afford my regular dentist and I couldn't find a single "good" provider that would take Medicaid. The only options I could find at the time were charity vans and clinics that set up once or twice a year in church parking lots. No way was I entrusting my pampered chompers to that.

However, in the past year or so, we've had several chain dental offices open up in town. Since I had a cavity large enough that I could see it with my mouth shut, I figured I'd give one of those places a try. I found the one nearest to me, picked up my phone, and took a deep breath. Even though I was extremely skeptical of the shady name/logo and marketing campaign, not to mention the location in a former Indian take-out in a decrepit strip mall, I figured I had no choice left. I'd have to learn to get over my beliefs about what "good" dental care is and go get that sinkhole plugged.

I made that phone call yesterday afternoon. This morning, I was sitting in a perfectly pleasant, clean, modern dental office, where I was greeted by friendly, competent staff. It was nothing fancy, but then again, I didn't need it to be. (I don't need tea service; I just need a leak-proof molar.) The dentist and hygienists were very skilled, attentive, and gentle with me. They spent about an hour making sure they got everything right. The dentist reviewed all of my x-rays with me, tooth by tooth, to help me better understand my teeth and my future care plan. The office staff went over every possible billing and payment scenario with me and never once made me feel bad about needing to factor in every penny.

I left with two big takeaways:

1) My judgment of chain dentistry prior to this experience was completely unfair. I had assumed that only small, local providers could give good care. I had unknowingly become an office snob, thinking that decoration was somehow indicative of care quality. I could've avoided that filling (and the one I'm getting next week) entirely had I gotten past that notion earlier.

2) I am so, so relieved that high-quality care does exist for us low-income folks. We deserve it, too.


inmymargins: Green leaves against white sky. (Default)

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