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Old 11-06-2013, 09:12 AM   #21
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My son is having four wisdom teeth removed next month and it is covered as a medical procedure, not a dental procedure. Check with your insurance carrier as this may vary with different policies.
The key is getting the doctors and the insurance company to accept coding this might be as a precautionary treatment to avoid maxillofacial and TMJ problems down the road, which are *sometimes* covered by health insurance, especially for minors.
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Old 11-06-2013, 09:57 AM   #22
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I have retiree-benefit dental insurance for a family of 4. I pay half the premium. My part is $643 dollars a year.

It will pay up to $1,500 per year per person for cleanings and repair work including oral surgery, crowns, implants, fillings, and bridges.

I have found that dental expenses in excess of the $1,500 limit are a huge chunk of health care expenses as my own teeth degrade.

The dental insurance premium is well worth it to me in my situation. YMMV

Edited to add:
My vision premium is $123/year. For that we get contacts or glasses once per year per person plus coverage for exams. Again, well worth it.
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Old 11-06-2013, 10:21 AM   #23
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Good luck on your impending retirement.

You may want to check out the Dental plan offered through Costco. If you are Costco member you can look under services, and you need to figure out if they offer it in your state. It costs about $250/year for a family of 3.

It covers cleanings 100% and pays out a specified rate for everything else. Last time I checked there is no cap on payments! If you are going the self insured route, I would still think this would make sense. You just need to make sure that you are okay with some Dentist in the plan. Although it is through Delta, it is one of the more restrictive networks -- so it is a much smaller selection of dentists.

If the retinal specialist care that you are talking about is more of a preventative check-up rather than anything currently active, it will be fully covered as part of medical in the ACA plans. You need to get your Primary physician to order that as part of the annual check-up visit and notate it as preventative screening.

============= added

ACA has some provisions for children's dental and vision. Check the new ACA plans in your state to see what is available and what is covered. It's possible that you may have to only worry about the adults in your family.

http://www.washingtonpost.com/nation...46b_story.html
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Old 11-06-2013, 10:22 AM   #24
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You may want to check out the Dental plan offered through Costco. If you are Costco member you can look under services, and you need to figure out if they offer it in your state. It costs about $250/year for a family of 3.
This is currently only available in California.
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"Hey, for every ten dollars, that's another hour that I have to be in the work place. That's an hour of my life. And my life is a very finite thing. I have only 'x' number of hours left before I'm dead. So how do I want to use these hours of my life? Do I want to use them just spending it on more crap and more stuff, or do I want to start getting a handle on it and using my life more intelligently?" -- Joe Dominguez (1938 - 1997)

RIP to Reemy, my avatar dog (2003 - 9/16/2017)
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Old 11-06-2013, 10:51 AM   #25
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This is currently only available in California.

My bad. I realized too late that Costco offers it only in CA.

But the insurer is Deltacare USA, and it seems to be available in most other states too. You can go to Delta website and poke around, or Google Deltacare HMO, or Deltacare USA and look for it. It may be just a bit more expensive than from Costco, but not by much.

As with any insurance offering it is all mangled up by state and county with no uniformity. While searching for it I found the following link. Not sure which outlet this particular brochure belongs to -- but the coverage information should be pretty close to the "generic" Deltacare offering.

http://www.deltadentalins.com/utae20...highlights.pdf
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Old 11-07-2013, 06:15 PM   #26
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I also go to a retinal specialist and it is covered by my BCBS plan. The plan also covers one routine eye doctor appointment per year--I use it to update my glasses prescription. While my work place offers a separate vision insurance plan, as far as I can see it only gives discounts on glasses/contacts and is thus not worth it.

As to dental, my BCBS plan also covers dental surgery, root canals, and the like. Each year I also opt for my work place's dental coverage, but it only really pays for two exam/cleanings per year as well as minor work (ie fillings) up to $1500. year. However, combining it with the BCBS plan covers a whole lot. The exception, sadly, are things like implants which are considered "cosmetic" and not likely to be covered.
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Old 11-08-2013, 04:54 PM   #27
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Unfortunately in California aca has no dental or vision for adults, just children.
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Old 11-08-2013, 04:55 PM   #28
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I will be with blue shield California for my employer paid medical
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