Join Early Retirement Today
Reply
 
Thread Tools Search this Thread Display Modes
Crappy dental 'insurance'
Old 02-08-2016, 02:55 PM   #1
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
 
Join Date: May 2005
Posts: 13,288
Crappy dental 'insurance'

I know there have been many threads on dental insurance and how it is not really insurance etc. etc.... I know about that etc., but will complain about something else...


I decided to buy dental insurance this year for the 4 of us... cost about $120 per month... it states that it will pay 100% of normal preventative starting when we purchase the insurance.... both in and out of network...

So, kids went in January (their normal time, had been scheduled 6 months earlier).... normal stuff, I do not even believe any X-rays...

I just go my EOB and to my surprise the amount they will pay is only about 40% of the bill... WHAT They agree on the three charges being submitted, but their 'normal' cost is so much lower than what you can get it for around here... they are paying their 'normal' charges....


Now, I have called around and the price my dentist is charging is almost the same as others... I did not call any of those dental mill places as they do not provide the level of care that I think we need....

Will be dropping this insurance pretty quickly....
__________________

__________________
Texas Proud is offline   Reply With Quote
Join the #1 Early Retirement and Financial Independence Forum Today - It's Totally Free!

Are you planning to be financially independent as early as possible so you can live life on your own terms? Discuss successful investing strategies, asset allocation models, tax strategies and other related topics in our online forum community. Our members range from young folks just starting their journey to financial independence, military retirees and even multimillionaires. No matter where you fit in you'll find that Early-Retirement.org is a great community to join. Best of all it's totally FREE!

You are currently viewing our boards as a guest so you have limited access to our community. Please take the time to register and you will gain a lot of great new features including; the ability to participate in discussions, network with our members, see fewer ads, upload photographs, create a retirement blog, send private messages and so much, much more!

Old 02-08-2016, 03:02 PM   #2
Thinks s/he gets paid by the post
 
Join Date: Dec 2015
Posts: 1,088
did they pay out in benefits as much as you paid them in premiums?
__________________

__________________
HadEnuff is offline   Reply With Quote
Old 02-08-2016, 03:04 PM   #3
Recycles dryer sheets
 
Join Date: Nov 2014
Posts: 381
Was your dentist "in-network"?
Not surprised - my wife, daughter and myself all go to different dentists. Back when I was looking for private insurance, it was just about impossible to find somebody "in-network" for all 3 of us. Now that I'm w*rking again that just doesn't seem to be problem with the insurance we get through my employer.
__________________
big-papa is offline   Reply With Quote
Old 02-08-2016, 03:29 PM   #4
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
pb4uski's Avatar
 
Join Date: Nov 2010
Location: Vermont & Sarasota, FL
Posts: 16,461
I had dental insurance when I was working. Our dentist who we had used for years and was a childhood friend was not in network.... we ended up paying the difference between what he charged and the insurance company paid... about $25/visit as I recall. Annoying but not the end of the world.
__________________
If something cannot endure laughter.... it cannot endure.
Patience is the art of concealing your impatience.
Slow and steady wins the race.
pb4uski is offline   Reply With Quote
Old 02-08-2016, 03:57 PM   #5
Moderator
rodi's Avatar
 
Join Date: Apr 2012
Location: San Diego
Posts: 8,817
Is your dentist "balance billing". I remember the first time I got an EOB - I was shocked at the difference between the charge and the reimbursement. But I was never billed for the difference.

This may be a case where having insurance locks in the lower negotiated price.
__________________
Retired June 2014. No longer an enginerd - now I'm just a nerd.
micro pensions 7%, rental income 18%
rodi is offline   Reply With Quote
Old 02-08-2016, 04:38 PM   #6
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
 
Join Date: Nov 2007
Posts: 7,531
Sounds like they aren't treating your dentist as in network. Some of the less expensive dental plans have limited networks.

I was just perusing the dental plans available through the healthcare.gov exchange and decided not to buy any. Even though it's only $22/mo ($270/yr), that's $70 more than I'll pay for 2 cleanings with my dentist's $99 special. If I get a cavity, I'll pay the $100-150 out of pocket. with insurance it would have been ~$100 after deductible, so I would still be better off without insurance unless I get more than 1 cavity.
__________________
Retired in 2013 at age 33. Keeping busy reading, blogging, relaxing, gaming, and enjoying the outdoors with my wife and 3 kids (5, 11, and 12).
FUEGO is offline   Reply With Quote
Old 02-08-2016, 05:02 PM   #7
Recycles dryer sheets
 
Join Date: Dec 2006
Posts: 409
Quote:
Originally Posted by Texas Proud View Post
I know there have been many threads on dental insurance and how it is not really insurance etc. etc.... I know about that etc., but will complain about something else...


I decided to buy dental insurance this year for the 4 of us... cost about $120 per month... it states that it will pay 100% of normal preventative starting when we purchase the insurance.... both in and out of network...

So, kids went in January (their normal time, had been scheduled 6 months earlier).... normal stuff, I do not even believe any X-rays...

I just go my EOB and to my surprise the amount they will pay is only about 40% of the bill... WHAT They agree on the three charges being submitted, but their 'normal' cost is so much lower than what you can get it for around here... they are paying their 'normal' charges....


Now, I have called around and the price my dentist is charging is almost the same as others... I did not call any of those dental mill places as they do not provide the level of care that I think we need....

Will be dropping this insurance pretty quickly....
Had similar experience many years ago. Only good dental insurance is the one provided by employers.

Talked to many dentists, receptionists. They could not recommend one
private dental carrier that was good.
__________________
wolf is offline   Reply With Quote
Old 02-08-2016, 07:40 PM   #8
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
 
Join Date: May 2005
Posts: 13,288
Quote:
Originally Posted by big-papa View Post
Was your dentist "in-network"?
Not surprised - my wife, daughter and myself all go to different dentists. Back when I was looking for private insurance, it was just about impossible to find somebody "in-network" for all 3 of us. Now that I'm w*rking again that just doesn't seem to be problem with the insurance we get through my employer.

Dentist is not in network.... however, I paid more for insurance that also would pay for dentist out of network...


I did change from the company I had two years ago (went without last year) who did pay for all charges... will see if I can go back to them...
__________________
Texas Proud is offline   Reply With Quote
Old 02-08-2016, 07:44 PM   #9
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
 
Join Date: May 2005
Posts: 13,288
Quote:
Originally Posted by rodi View Post
Is your dentist "balance billing". I remember the first time I got an EOB - I was shocked at the difference between the charge and the reimbursement. But I was never billed for the difference.

This may be a case where having insurance locks in the lower negotiated price.

Do not know... just got the EOBs...

I do know that my old dentist billed for fluoride and the insurance would not pay and I did not get a bill... I think this is the same with current dentist... however, I do not see the dentist eating $120 of charges... we will see...

Insurance does not lock in the lower rate since our dentist is not in any network....
__________________
Texas Proud is offline   Reply With Quote
Old 02-08-2016, 08:02 PM   #10
Moderator
rodi's Avatar
 
Join Date: Apr 2012
Location: San Diego
Posts: 8,817
If all you have is an EOB - you don't know what your bill will be. I'd wait and see.
__________________
Retired June 2014. No longer an enginerd - now I'm just a nerd.
micro pensions 7%, rental income 18%
rodi is offline   Reply With Quote
Old 02-09-2016, 03:38 AM   #11
Thinks s/he gets paid by the post
bUU's Avatar
 
Join Date: Dec 2012
Location: Georgia
Posts: 1,914
Quote:
Originally Posted by Texas Proud View Post
Dentist is not in network.... however, I paid more for insurance that also would pay for dentist out of network...
We also have insurance that would pay for a dentist out of network, but not at the same level of reimbursement as dentists in-network.
__________________
bUU is offline   Reply With Quote
Old 02-09-2016, 07:30 AM   #12
Thinks s/he gets paid by the post
 
Join Date: Dec 2015
Posts: 1,088
Quote:
Originally Posted by bUU View Post
We also have insurance that would pay for a dentist out of network, but not at the same level of reimbursement as dentists in-network.
I will ask you the same question I asked the OP:
Are they paying out more in benefits than you are paying them in premiums?
__________________
HadEnuff is offline   Reply With Quote
Old 02-09-2016, 08:25 AM   #13
Thinks s/he gets paid by the post
bUU's Avatar
 
Join Date: Dec 2012
Location: Georgia
Posts: 1,914
Quote:
Originally Posted by HadEnuff View Post
I will ask you the same question I asked the OP:
Are they paying out more in benefits than you are paying them in premiums?
Why would anyone think they would do that?
__________________
bUU is offline   Reply With Quote
Old 02-09-2016, 08:48 AM   #14
Thinks s/he gets paid by the post
 
Join Date: May 2014
Posts: 3,002
Quote:
Originally Posted by HadEnuff View Post
I will ask you the same question I asked the OP:
Are they paying out more in benefits than you are paying them in premiums?
DH and I actually beat the system on this. Last November, after 18 months of premiums (I estimate $700 total) and no claims except for a couple of cleanings a year, we decided to cancel the policy. Near the end of November, DH thought he might be developing problems in one molar. I was able to reinstate coverage by paying the premium before the end of the month. It turned into a nasty problem that required a root canal and so far the insurer has forked over about $1,000. (That excludes nitrous oxide at $50 a pop, which makes the experience far more bearable for DH but is not covered for those treatments.)

Now I'm wondering whether to cancel again since the work is done and all is well!
__________________
athena53 is offline   Reply With Quote
Old 02-09-2016, 01:10 PM   #15
Confused about dryer sheets
Stillninetofivin's Avatar
 
Join Date: Jan 2010
Location: East Coast
Posts: 9
Our marketplace plan coverage goes up each year. I've got an upper molar that's about to be replaced and I'm happy to see a bump in what they're covering even though the premium is the same as last year.
__________________
Stillninetofivin is offline   Reply With Quote
Old 02-09-2016, 01:17 PM   #16
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
mickeyd's Avatar
 
Join Date: Apr 2004
Location: South Texas~29N/98W
Posts: 5,884
Quote:

Will be dropping this insurance pretty quickly....
As has been mentioned here many times, "dental insurance" is more like pre-paid coverage than real "insurance". A lot of money has to be paid out prior to any claims (agent commission, management fees, insurance company take etc) which only leaves only so much for the dentist.

Self insure this one.
__________________
Part-Owner of Texas

Outside of a dog, a book is man's best friend. Inside of a dog, it's too dark to read. Groucho Marx

In dire need of: faster horses, younger woman, older whiskey, more money.
mickeyd is offline   Reply With Quote
Old 02-09-2016, 05:49 PM   #17
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
 
Join Date: May 2005
Posts: 13,288
Quote:
Originally Posted by bUU View Post
We also have insurance that would pay for a dentist out of network, but not at the same level of reimbursement as dentists in-network.
They are supposed to pay necessary and reasonable.... not from a different payment schedule...

Quote:
Originally Posted by HadEnuff View Post
I will ask you the same question I asked the OP:
Are they paying out more in benefits than you are paying them in premiums?
I had calculated that my premiums for the year would be more than what they would pay out if nothing happened.... but something almost always happens with DW... she had bad teeth... went to have 4 pulled today and will be having implants...

Total premiums would be in the $250 range over cleanings etc... But, if they are going to be pay half of what they are supposed to, that goes up to $1100... might as well not have insurance...
__________________
Texas Proud is offline   Reply With Quote
Old 02-10-2016, 03:07 AM   #18
Thinks s/he gets paid by the post
bUU's Avatar
 
Join Date: Dec 2012
Location: Georgia
Posts: 1,914
Quote:
Originally Posted by Texas Proud View Post
Quote:
Originally Posted by bUU View Post
We also have insurance that would pay for a dentist out of network, but not at the same level of reimbursement as dentists in-network.
They are supposed to pay necessary and reasonable....
The coverage is based on reasonable and customary, but not necessarily 100% coverage, not even in-network.
Quote:
Originally Posted by Texas Proud View Post
not from a different payment schedule...
I don't know what kind of dental insurance you have; I am talking about my dental insurance. Out-of-network, preventive services are subject to balance billing; basic services are covered at 80%; and major services are covered at 50%. A $50 pp deductible applies.
__________________
bUU is offline   Reply With Quote
Old 02-10-2016, 10:14 AM   #19
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
 
Join Date: May 2005
Posts: 13,288
Quote:
Originally Posted by bUU View Post
The coverage is based on reasonable and customary, but not necessarily 100% coverage, not even in-network. I don't know what kind of dental insurance you have; I am talking about my dental insurance. Out-of-network, preventive services are subject to balance billing; basic services are covered at 80%; and major services are covered at 50%. A $50 pp deductible applies.


My current insurance does have $50 deductible, but not on routine cleanings etc.... and they say they pay 100% in or out of network for preventive care... (as I said before, their coverage is the same in network and out of network... the only thing that I can see for in network is that the dentist has agreed to their price schedule so you cannot be balance billed).. yes, reasonable and customary.... but what their prices the EOB showed is not even close to any dentist that I called around me... my dentist said they check more than I do to make sure they are charging close to what others charge...
__________________
Texas Proud is offline   Reply With Quote
Old 02-11-2016, 04:53 AM   #20
Thinks s/he gets paid by the post
bUU's Avatar
 
Join Date: Dec 2012
Location: Georgia
Posts: 1,914
Check the dentists who service mostly lower-income areas, or who operate out of dental schools. Their prices tend to be much lower, and account for the difference between R&C and the price list of preferred dentists.
__________________

__________________
bUU is offline   Reply With Quote
Reply


Currently Active Users Viewing This Thread: 1 (0 members and 1 guests)
 
Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off


Similar Threads
Thread Thread Starter Forum Replies Last Post
Dental implant and dental coverage fh2000 Health and Early Retirement 31 08-30-2014 01:49 PM
Negotiated dental rates without insurance free4now FIRE and Money 5 10-16-2007 08:34 AM
Are root canals worth the dental insurance? Nords FIRE and Money 41 09-11-2006 08:11 PM
Dental Insurance? jj Life after FIRE 19 11-22-2005 01:08 PM
October shaping up to be pretty crappy soupcxan FIRE and Money 14 10-16-2005 09:00 PM

 

 
All times are GMT -6. The time now is 02:27 AM.
 
Powered by vBulletin® Version 3.8.8 Beta 1
Copyright ©2000 - 2017, vBulletin Solutions, Inc.