Does anyone know of a good dental insurance plan that actually covers some procedures? most plans I see are cheap, but they have a very small cap as far as how much they pay out. let me know what you folks do for dental and what companies are best. Now I have no dental and everything is out of pocket. thanks
good dental insurance
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Senator
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I do VA dental insurance. If you are a Veteran, you can enroll again as of 11/15/2017.
athena53
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There are previous threads on this. For most of us the answer is "no". The limitation on the most the insurer will pay in a given year (typically $1,500-$2,000) makes it a deal-breaker for many.
YMMV if you're eligible for the VA plan or something else covering union or government retirees.
YMMV if you're eligible for the VA plan or something else covering union or government retirees.
Are you looking for a plan you could pay $500 in premiums and get a $1,000 in benefits? Sounds good, but how does that work for an insurance company?
Sunset
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Best dental insurance I know of is Four Times Per Day.
Brush your teeth after, Breakfast, Lunch, Supper, and before Bedtime.
If you drink well water or have city no-fluoride water, then be sure to use fluoride toothpaste.
I grew up with well water that had no fluoride, and had terrible cavity issues. Once we lived in the city and got fluoride water my cavity issues went down over the years. I have not had a cavity in 10 years or more now.
Brush your teeth after, Breakfast, Lunch, Supper, and before Bedtime.
If you drink well water or have city no-fluoride water, then be sure to use fluoride toothpaste.
I grew up with well water that had no fluoride, and had terrible cavity issues. Once we lived in the city and got fluoride water my cavity issues went down over the years. I have not had a cavity in 10 years or more now.
This year, I am using a Delta Dental PPO plan, which covers some advanced procedures like root canals and crowns.
Annual premium: $478
I have already maxed out my annual benefit of $1,000 for 2017
But I received another $2,500+ in discounts from my dentist for having insurance
So the total benefit so far has been over $3,500 (total billed by dentist: $6,354, total paid out of pocket: $2,723).
Annual premium: $478
I have already maxed out my annual benefit of $1,000 for 2017
But I received another $2,500+ in discounts from my dentist for having insurance
So the total benefit so far has been over $3,500 (total billed by dentist: $6,354, total paid out of pocket: $2,723).
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We didn't get dental insurance, but our dentist is part of a group that offers a member discount program.
So for an annual fee (299 for two?) We get exams covered, cleanings at insurance rates, and crowns/implants with the 50% rate that insurance covers, stuff like that. It's very similar to what I had under employee-dental coverage when working.
If you like your dentist, ask if they have any concierge type plans.
So for an annual fee (299 for two?) We get exams covered, cleanings at insurance rates, and crowns/implants with the 50% rate that insurance covers, stuff like that. It's very similar to what I had under employee-dental coverage when working.
If you like your dentist, ask if they have any concierge type plans.
Sunset
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We signed up with our dentist on their "plan".
$450 per yr, covers
2 exams and 2 cleaning per yr, plus 1 set of bite wing x-rays per year, plus 20% off cost of any work.
This is for 2 people, ( so $225 pp).
I'm pretty unsure of what the costs are for the dental work, so that is a bit of a fuzzy benefit.
$450 per yr, covers
2 exams and 2 cleaning per yr, plus 1 set of bite wing x-rays per year, plus 20% off cost of any work.
This is for 2 people, ( so $225 pp).
I'm pretty unsure of what the costs are for the dental work, so that is a bit of a fuzzy benefit.
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I did massive research on this... and did not like any of the plans offered. Many had windows of limited coverage (no fillings till 12 months coverage... no crowns till 24 months coverage, etc.) And the annual caps...
We pay out of pocket. Our dentist doesn't give us discounts - even for paying cash... and bills us more than the EOB said he was billing my old employee insurance. I've talked with him about it - and talked with his office manager... they seem unwilling to negotiate and just keep recommending I get a PPO plan... which doesn't pencil out. But he's a great dentist and so... we pay as we go.
We pay out of pocket. Our dentist doesn't give us discounts - even for paying cash... and bills us more than the EOB said he was billing my old employee insurance. I've talked with him about it - and talked with his office manager... they seem unwilling to negotiate and just keep recommending I get a PPO plan... which doesn't pencil out. But he's a great dentist and so... we pay as we go.
Sojourner
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Wow, he must be an exceptionally great dentist for you to stick with him, considering his lack of flexibility and seeming disdain for your loyal patronage. I really like my dentist and have been a regular patient of his for over 15 years, but I'd be looking around for someone more considerate and accommodating if he wasn't at all willing to work with me on OOP cash pricing discounts.
aja8888
Moderator Emeritus
Not entirely true.
Many conditions apply for VA care. For instance, I served from 1964 to 1968, was honorably discharged and can't even qualify for the lowest tier due to income limits.
athena53
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That was the deal breaker for me. I understand that the insurance company doesn't want to pay for someone who waits to buy dental insurance till they need major work. but I'd been continuously insured under employer plans for years when I retired. They made no exceptions for that so the coverage you got in the first year was pretty much limited to 2 cleanings.
aja8888
Moderator Emeritus
A couple of us here (maybe three people) have had major dental work done this year. Major being implants, crowns, root canals, dentures, etc and have spent thousands since insurance won't cover 99% of what was done. Luckily, I was able to get 10% off my dental work being a "senior" citizen, so that saved me over $3,000. 
Gotadimple
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I've been researching this, as insurance coverage has changed. Most standalone dental plans that sell to individuals will have a $0 deductible and $1,000 maximum limit (at least in Washington state). Coverage is 2 exams, 2 cleanings, limited x-rays, periodontal procedures, anesthesia, fillings, bridges - but you pay 50% for most procedures. At $30-40 (for most plans) that's $360-$480 for $2000 worth of coverage.
At 50% coinsurance, the maximum out of pocket is $1,000 plus the premium. So by having insurance, you get a 32% discount on procedures ($1000+360=1360/2000). The insurance companies negotiate a fee schedule for procedures - which is proprietary. Without insurance the dentist can charge the usual and customary, which is a lot more (like half as much in some cases) than the fee schedule.
So, the question becomes, how much are you willing to pay for a 30-50% discount on the cost of dental services? That is why a dentist will encourage signing up for a PPO plan. They'll give up 40-50% of their usual and customary, because they are assured some payment for the services from both the insurer and you. It's the risk you take when you go without insurance: loss of a negotiated rate plus some reimbursement from the insurer.
Hope that's clear,
Rita
At 50% coinsurance, the maximum out of pocket is $1,000 plus the premium. So by having insurance, you get a 32% discount on procedures ($1000+360=1360/2000). The insurance companies negotiate a fee schedule for procedures - which is proprietary. Without insurance the dentist can charge the usual and customary, which is a lot more (like half as much in some cases) than the fee schedule.
So, the question becomes, how much are you willing to pay for a 30-50% discount on the cost of dental services? That is why a dentist will encourage signing up for a PPO plan. They'll give up 40-50% of their usual and customary, because they are assured some payment for the services from both the insurer and you. It's the risk you take when you go without insurance: loss of a negotiated rate plus some reimbursement from the insurer.
Hope that's clear,
Rita
Bamaman
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My BCBS policy is $33 a month with a $1500 max per year.
I am waiting right now for my appointment for an implant. Had to leave town as our local dentists want a fortune per tooth. And insurance won't pay for implants.
I am waiting right now for my appointment for an implant. Had to leave town as our local dentists want a fortune per tooth. And insurance won't pay for implants.
It's clear when you dentist does that. Mine doesn't. Anything not covered by insurance is billed at non-negotiated rates, although they do give a small discount!
Some insurance will pay for implants. DH's did although with a $2K per year maximum, it was still a lot of $. He was able to schedule the work over a 2 year period so did get $4K benefit.
travelover
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My DW's retirement insurance covers dental insurance. I was delighted to find out that she could add me to her plan for $5 a month. The former employer's portion is $25 / month / person.
Beyond those plans with subsidies, I've never seen a plan worth the premiums.
Beyond those plans with subsidies, I've never seen a plan worth the premiums.
We also looked at plans after we retired and decided to do without insurance.
W2R
Moderator Emeritus
Same here. I pay in cash at the time of treatment, and my dentist gives me a discount of around 15%-20% (I forget which). Also he sometimes does not charge me at all. This year he did three root canals and some fillings without charging me, and replaced a broken filling last week without charging me. He is not the cheapest dentist in town, though, so I still pay him a lot.
Senator
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It is true, because the dental care is not through the VA it is through Delta Dental. I believe any veteran can apply, as long as they are enrolled in the VA Health care program. Disabled or not.
Sometimes you have to search for programs, and jump through a few hoops, to be eligible for them. I get 100% of my healthcare from the VA, and make a 6-figure income as I am a disabled Vet. Anyone that is a Veteran can sign up for VA Care, and you may be in a very low priority tier, and you can then get the dental insurance.
It is a private dental insurance offered at a group discount.
Here is the link
https://feds.deltadentalins.com/vadip/
Here is the premium schedule
https://feds.deltadentalins.com/vadip/downloads/plan-brochure.pdf
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To get the benefit of the "negotiated rate", you will likely have choose a dentist who takes the plan. This may or may not be the dentist you'd most like to see.
The simple fact is that the more a plan discounts from the "usual and customary", the more the dentist is relying on volume to make up the difference. Also, these offices tend to know what procedures are the most lucrative, per unit of time and effort and overhead, and often steer their treatment plans accordingly.
Having treatment recommendations influenced by what the insurance company will or will not cover, or what they will cover more generously, is not, IMO, the ideal way to treat or be treated.
Many of these offices will systematically steer a patient away from what is a "covered" procedure, to what is not, and then can charge what they want, trying to get away from the payment constraints of the contract.
So, be careful.
The simple fact is that the more a plan discounts from the "usual and customary", the more the dentist is relying on volume to make up the difference. Also, these offices tend to know what procedures are the most lucrative, per unit of time and effort and overhead, and often steer their treatment plans accordingly.
Having treatment recommendations influenced by what the insurance company will or will not cover, or what they will cover more generously, is not, IMO, the ideal way to treat or be treated.
Many of these offices will systematically steer a patient away from what is a "covered" procedure, to what is not, and then can charge what they want, trying to get away from the payment constraints of the contract.
So, be careful.
GTFan
Thinks s/he gets paid by the post
In other words if you know you'll need substantial work done, insurance might benefit you. If all you need are cleanings and the occasional filling then no, it won't. And that's most folks which is why insurance is usually not worth it.
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