Small Change

Anything but a vacation

The long and short of a long credit card bill

The last two months of the year are a lovely time, with most people busy planning their holidays. Even those in my office not taking a vacation had much to look forward to, such as parties and charity sales.

Inevitably, these months are also when expenses tend to pile up. This year was no exception and I just received a lengthy credit card bill to prove it. But there were no holiday photos, unless you count dental X-rays as memorabilia.

You see, medical procedures took precedence for my staying put in Singapore.

My older daughter Yanrong has had to undergo dental surgery and a subsequent bracing of her teeth. This took up a big chunk of the November school holidays, from the date of surgery to the fitting of braces and a monitoring period for any undue discomfort.

It's funny - not in a hilarious sense - how something that had seemed trivial turned out to be a vexing problem.

Sure, my wife and I had noticed that Yanrong had an uneven teeth line for a while. In particular, she had stunted growth in one of her premolars, a term of medical jargon that easily rolls off my tongue now thanks to recent repeated visits to the National Dental Centre Singapore (NDCS).

Initially, we thought it was nothing a good bracing couldn't fix. But a fuller examination and diagnostic X-ray showed she had a partially erupted tooth and two fully buried teeth under her gums.

Leaving them alone was not a viable option as the root of one tooth was near her nasal sinuses wall while the other was close to a nerve. The dentist advised us to extract and surgically remove the impaired teeth before the buried teeth grow bigger.

It was best done under general anaesthesia, a prospect that made us even unhappier as this would be Yanrong's second. She had spinal surgery done three years ago for scoliosis. Thankfully, the wait during this surgery was far less nerve-wracking than the last one.

The bill, however, was another matter. Even after taking into account a government subsidy, the cost of the treatment, including teeth bracing, amounted to more than $5,000.

In comparison, I paid a tad more than $500 for the scoliosis surgery, although admittedly it cost far more than the dental surgery. The total bill, after government subsidy, was almost $17,000.

The key difference is due to insurance coverage.

The Integrated Shield Plan that our family has covers inpatient hospitalisation and surgery, as well as certain major outpatient treatments. Elective day surgery isn't on the list. Neither is dental treatment, unless it is the result of an accident.

Hence, I can understand why some people facing complicated dental issues would choose to forgo treatment, especially when they do not cause immediate problems. It's also no wonder that some people buy online cheap plastic braces for as little as a few bucks to straighten their teeth, as reported in The Straits Times last month. But this could potentially create health risks for the wearer, NDCS orthodontist Priscilla Lu warned in the paper.

Coincidentally, Dr Lu is the attending orthodontist to Yanrong. Having witnessed her work at first, I must say proper teeth bracing cannot be replicated by simply fixing on a piece of off-the-shelf plastic. It's not a one-off procedure.

The straightening process requires Yanrong to see Dr Lu every month to adjust the brace to guide the teeth alignment. I can see why it costs anything from $3,000 to $10,000, as cited by my colleague Salma Khalik, that orthodontists charge to do a proper job.

To help mitigate the cost, government restructured hospitals provide additional subsidies to low-income patients. Those who do not qualify but are tight for cash may opt for a monthly instalment plan. Although I didn't take up the offer, I'm heartened that hospital administrators are trained to volunteer information about the various financial assistance schemes available as well as help patients fill out the forms.

Amid all that, my annual health screening produced an unexpected red flag. When I showed the report to my company doctor, she promptly dispatched me to see a specialist for further assessment. Fortunately, nothing came out of it and the hefty bill was covered by group insurance.

By then, I was already halfway into my annual leave and decided to enjoy the rest of my vacation in Singapore rather than dash off on a trip, paying a premium in airfares and hotel rates for late booking.

2017 has turned out to be a year of unexpected big-ticket, out-of-pocket expenses; there were other things aside from medical expenses that I have not mentioned. Such experiences underscore the reason financial planners often tell clients not to be fully invested but to keep spare cash for a rainy day. As a matter of prudence, it is advisable to keep cash or cash-like investments like Singapore Government Bonds ranging from six to nine months of your gross monthly salary.

My year-end expenses piled up even when I didn't go away for vacation, thanks to some costly and scary medical procedures.

But having contingency funds helped to ensure the Grinch who stole my Christmas didn't also rob me of my financial peace of mind.

A version of this article appeared in the print edition of The Sunday Times on December 31, 2017, with the headline 'Anything but a vacation'. Print Edition | Subscribe