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Dental insurance
Old 01-13-2016, 12:41 AM   #1
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Dental insurance

Does anyone know of reasonably priced dental insurance for seniors? Mom needs insurance that she can use at the dentist of her choosing and, since she has dental issues, needs very good coverage.


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Old 01-13-2016, 12:46 AM   #2
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First off, dental insurance does not have 'good coverage' no matter what policy you get... period...


They all make you wait 6 months to 12 months to cover different things... and they all have a max out of pocket that is low.... $1K to $2K from what I see....
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Old 01-13-2016, 05:56 AM   #3
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It sounds like you are looking for an insurance company that wants to take in say, $100 dollars in premiums, so they can pay out $200 in benefits. Insurance companies don't really like to do that.
What is commonly referred to as "Dental Insurance" is not really "insurance" at all, but rather, a menu of pre-agreed to "dental benefits"that are paid for in advance. Insurance is used to offset the risk of something happening that probably will not happen, e.g. a fire, a car crash, a flood...but since the only people who would willingly fork over money for a "dental insurance" plan are the people who know they will use it, INSCOs would only lose money offering such a plan to individuals.
When an employer offers a group plan, it pays a price based upon the number of people covered, the degree to which they are covered. It is a built in winner for the INSCO because they know some won't use it all, and even if they do, with waiting periods, deductibles, exclusions, yearly maximums, their profit is guaranteed.
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Old 01-13-2016, 06:09 AM   #4
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If she is a Veteran, the VA has a plan that is about half price of many plans. No major deal, but it does save just a bit.
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Old 01-13-2016, 06:11 AM   #5
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If she is a Veteran, the VA has a plan that is about half price of many plans. No major deal, but it does save just a bit.
Would she be able to use that plan at a dentist of her choosing? The veteran plans I am familiar with, which may not be all of them, have a very restrictive fee schedule, which many dentists choose not to participate with.
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Old 01-13-2016, 07:25 AM   #6
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Would she be able to use that plan at a dentist of her choosing? The veteran plans I am familiar with, which may not be all of them, have a very restrictive fee schedule, which many dentists choose not to participate with.
The plan I am going to sign up for will be by Delta Dental. Met life also is part of the program.

Quote:
VA is implementing a comprehensive national VA Dental Insurance Program (VADIP) to give enrolled Veterans and CHAMPVA beneficiaries the opportunity to purchase dental insurance through Delta Dental and MetLife at a reduced cost. Participation is voluntary. Purchasing a dental plan does not affect Veterans’ eligibility for VA dental services and treatment. VADIP opens November 15 for the purchasing of plans, with coverage beginning January 1, 2014.
http://www.va.gov/healthbenefits/vadip/
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Old 01-13-2016, 08:03 AM   #7
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Senator: I just took a quick glance at the Delta page:
Plan Comparison | Delta Dental VADIP Dental Program

3 plans. Note the yearly maximum benefit of each plan, and compare that with the rates you will pay. I did not go through the exercise of finding the rates, because you have to punch in your zip code. I guess they change the rate depending upon where you live.

Also note that many of the more expensive procedures are NAB (not a benefit), and even in the more expensive plans, the first year they are NAB, even though you will be paying full rate for that year.
Compare your rate with the maximum yearly benefit to see what is the absolute MOST you could save by being in the program, vs. self-insuring.

As for the OP, who stated mom was in need of extensive work, they'd have to do the same calculations, and then weigh the potential cost of delaying needed work while the waiting period expires. I've seen many $150 dollar problems turn into $2500 dollar problems (or worse) while patients delayed treatment waiting for that $75 benefit to kick in.
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Old 01-13-2016, 08:23 AM   #8
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Here's a recent thread on dental insurance: Dental Insurance

Bottom line: as others are saying, there are no good dental insurance policies available for purchase on the open market.
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Old 01-13-2016, 09:32 AM   #9
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For affordable dentistry, she might do better with a dental school. Granted not "her" dentist but affordable and competent.
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Old 01-13-2016, 10:05 AM   #10
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Would she be able to use that plan at a dentist of her choosing? The veteran plans I am familiar with, which may not be all of them, have a very restrictive fee schedule, which many dentists choose not to participate with.

And they also have a 12 month waiting period on major dental work. If you need a crown or root canal NOW, it won't be covered for 12 months!

Mike
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Old 01-13-2016, 10:14 AM   #11
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Some of them don't have an exclusion period if you had continuous coverage up to the point where their plan's coverage started. When I was between jobs, I signed up for Cigna's after doing a spreadsheet analysis of the previous 3 years dental usage (family of 3) vs. the price list my dentist gave me. For the basics, the annual premium cost was almost on-par with what my annual out-of-pocket would have been for self-pay. The true benefit would have been if an unexpected event like root canal would have come into the picture. A couple of them in a year, though, and we would have hit the maximum benefit they pay per year.


But right after the first premium was made, I went back to work, so never got to test it out.


As in all things, your mileage may vary and one should definitely check with your dentist first to find out if they'll accept the coverage.
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Old 01-13-2016, 10:24 AM   #12
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Senator: I just took a quick glance at the Delta page:
Plan Comparison | Delta Dental VADIP Dental Program

3 plans. Note the yearly maximum benefit of each plan, and compare that with the rates you will pay. I did not go through the exercise of finding the rates, because you have to punch in your zip code. I guess they change the rate depending upon where you live.
Yes, most Dental insurance is really a myth. You are pre-paying for services, and creating a cap on some expenses. In my case, I will pay $15.43 a month, or $185.16 annually - plus a $50 deductible. All for a $500 benefit and the privilege of having an insurance company negotiate for me.

Two cleanings and exams will likely run about that, and if I need a filling or something more, it will pay for itself.

Certainly the OP should look close at what the needs are, and the timliness of having the work. If my teeth hurt, I would not wait a day.
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Old 01-13-2016, 11:43 AM   #13
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We've been using Delta Dental through AARP. $1K max coverage per person per year. This was (believe it or not) the best option I could find. Other alternatives were a local dental chain's "plan" with reduced fees for procedures according to a published schedule. Also, our County has a program where you can pay (IMMIC) $100 and get reduced fees when you present your card to the dentist.

IMHO, dental coverage and eyecare coverage are woefully inadequate out there.
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Old 01-13-2016, 11:50 AM   #14
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We've been using Delta Dental through AARP. $1K max coverage per person per year. This was (believe it or not) the best option I could find. Other alternatives were a local dental chain's "plan" with reduced fees for procedures according to a published schedule. Also, our County has a program where you can pay (IMMIC) $100 and get reduced fees when you present your card to the dentist.

IMHO, dental coverage and eyecare coverage are woefully inadequate out there.
Have you done the math to see how much your yearly premiums are really saving you?
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Old 01-13-2016, 12:57 PM   #15
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Yes, most Dental insurance is really a myth. You are pre-paying for services, and creating a cap on some expenses. In my case, I will pay $15.43 a month, or $185.16 annually - plus a $50 deductible. All for a $500 benefit and the privilege of having an insurance company negotiate for me.

Two cleanings and exams will likely run about that, and if I need a filling or something more, it will pay for itself.

Certainly the OP should look close at what the needs are, and the timliness of having the work. If my teeth hurt, I would not wait a day.
If you are in a good employer group dental plan -- sometimes but not always subsidized by the employer -- a dental plan can be a good buy. I've not seen an individual one on the open market that is a good buy. In a group plan you can benefit from a lot of people participating in the plan who don't use their benefits (i.e. rarely if ever go to the dentist) so the math can work for those who do. An individual plan, on the other hand, is going to be purchased by people who will likely be fully using their preventative services, at least, so you don't have the idle participants subsidizing your premiums.

Our dental plan costs us $47 a month for both of us, and fully covers preventative care and has a $10,000 annual maximum benefit. That's a pretty good value, especially since I have a couple of ancient fillings which will probably need to be replaced with crowns within the next few years, but it's an employer group plan and you could not get pricing like that (let alone a $10K annual benefit) in the individual/open market. Not to mention that you can usually pay for employer group coverage with pretax dollars, whereas with an individual plan you'd only be able to deduct the premiums to the extent you exceeded 10% of your AGI in medical expenses.
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Old 01-13-2016, 05:28 PM   #16
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As the OP of the thread REWahoo linked I can tell you what I found.

There's no good solution.

If she knows she'll need major work - but it can be put off - perhaps one of the plans that has a 6 month or 12 month exclusion. All of the plans I looked at had "networks" - so there is still the issue as to whether her dentist is in the network. My dentist (who I'm very happy with) only takes PPO plans - and only some of those...

We opted to self insure - but I may put my older son and my husband on a plan - because they have much crappier teeth than my younger son and me.

The other thing to look at - some dentists offer a discount for cash payment... but only if you ask. (Unfortunately, my dentist only offers a 5% off list price). Some might even let you pay the negotiated rate that an insurance company would pay - in my dentists case that's closer to 20% off the list price. That's the real benefit of insurance - getting that negotiated rate.
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Old 01-13-2016, 06:14 PM   #17
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That's the real benefit of insurance - getting that negotiated rate.
That's my sense too.
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Old 01-13-2016, 06:43 PM   #18
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We are very lucky to have a subsidized plan through DW's former employer.

We have both patronized the same excellent independent dental practice for over 20 years, and we love them. They don't participate in any insurance plans, so they bill whatever, take what the insurance sends them, and bill us directly for 100% of the difference.

Unfortunately, DW has had some major problems in the last couple of years, and the total billing was close to $5,000 for that time frame. Here are our numbers for 2014 and 2015 combined:

Insurance paid: $1,584
Cost of insurance: $720
Obviously, we paid the difference up to the nearly $5K billing.

I seriously doubt you could find anything remotely similar on the open market, but my point is just that if you have a subsidized dental plan where you w*rk, then it is definitely to your advantage to enroll in it and continue it as a retiree (if you have that option).
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Old 01-15-2016, 02:19 PM   #19
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I had bookmarked these sites for when my COBRA coverage ends later this year:

http://coast2coastrx.com/index.php/dental-locator

https://www.deltadentalins.com/plans/

I've yet to research the Coast2Coast option. For my area in Los Angeles, the Denta Dental plan I found at $80/year seemed reasonable with fairly good coverage.
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Old 01-16-2016, 09:18 AM   #20
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We've been using Delta Dental through AARP. $1K max coverage per person per year. This was (believe it or not) the best option I could find.
Wow, cheapest plan I saw there was $85.22 a month for two with max $1k per year benefit and $100 deductible. You've got to be kidding, that's an utter ripoff.

https://www.deltadentalins.com/indEn...ssuerCode=AARP

I got the Aetna Dental Access card for $100, gives me discounted rates on all stuff at my dentist (who isn't a part of any Dental HMO plan). Pays for itself just with cleanings and X-rays and I pay less for fillings and crowns. It was recommended to me as a cash payer by the dentist's front office folks.

http://www.consumerbenefits.net/dental-plans.htm

There's no good dental insurance on the open market unless you can find a good dentist that takes HMO plans, and then you'll probably be hit with upselling because those plans don't pay the dentist enough. PPO plans are way too expensive and way too limited in what they pay.
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