dental and vision insurance

[ripper1]

Wife will start medicare in July. We are all set up with regular medicare A and B, part D, and G medigap. I have to decided to forego dental and vision insurance as it looks and from what I can tell not worth it. What do others think here?

 

[ziggy29]

I would look at your own historical usage of dental and vision, estimate how much those services would cost you in a fairly typical year and decide whether the extra premiums are worthwhile.

One caution is that if one is not insured, there may be a tendency to forego an exam or procedure once in a while to "save a few bucks", and that could lead to greater and costlier problems down the road. That would be a "false economy".

That said, a fair number of dentists will give discounts for patients who are not using insurance and are paying in cash up front.

 

[steelyman]

I have both dental and vision through Delta Dental and EyeMed, respectively. These are a benefit from my former employer. Dental premium is $11/mo.

I think a decision should take past and expected costs into account. That’s an individual calculation/estimate.

I’m expecting higher than normal dental bills for upcoming work (2019) and will be happy to get some reimbursement after deductible is met. My experience is that the coverage is not extensive (out-of-pocket is high) but something is better than nothing.

 

[travelover]

When this has been discussed in the past, the consensus was that if the plan is subsidized by an employer it can be a good deal, whereas plans where you paid the full premium cost are generally not useful.

 

[ziggy29]

When this has been discussed in the past, the consensus was that if the plan is subsidized by an employer it can be a good deal, whereas plans where you paid the full premium cost are generally not useful.

Yes, in the average/usual case. Obviously, these will not be cost-effective in the average case because insurance companies are not in business to lose money.

But there are situations where people might have a usage pattern that makes them cost-effective, and when there is (usually) no underwriting involved for those heavier users of the plans, it is still worth doing the exercise of looking at historical and expected future usage of dental/vision plans and what the premiums would cost.

And sometimes, even employer plans which are *not* subsidized can be a decent deal if these premiums can often be paid out pre-tax which means, especially in higher tax brackets and states with a high income tax, the effective cost of the plan can have a different form of subsidy through the tax code. (Note in particular that for those still working, payroll deductions for medical, dental and vision through a cafeteria plan are not only generally pre-tax as far as income goes, but also pre-tax for SS and Medicare purposes.)

 

[Aerides]

I don't have vision or actual dental insurance, but our dentist is part of a group with a discount plan. Basically, I pay $200 per year and that includes 2x exams/cleanings, and then 50% discount on anything else (filling/crown, etc.). Since I about break even on the included stuff, it's a deal for me.

 

[Spock]

Analysis of available dental plans have gone along the lines of:
$40/month = $480 in premiums.
Which covers 2x exams/cleanings per year with a $40 copay. Dentist charges $80 for these, so we pay $560 per year for $80 of benefits.

Annual cap of benefits is $500 and does not cover root canals, crowns, etc.

The only benefit is that these procedures are billed at a negotiated "usual and prevailing rate" which is sometimes less than cash price.


Net: You'll have to do the math for plans available to you and what your dentist charges.

 

[brett]

On retirement I had the option of picking up our prior dental, vision, benefits.

I decided against it. After reviewing the dental plan I noticed that there was a cap on the annual claim amount AND they only picked up 50 percent of the cost up to the annual cap, of big items like root canals, bridges, caps, implants, whatever. Vision had a cap of once every two years.

Looking back over the past seven years......the insurance company would have made out like bandits had we signed up for their plan.

This is really a math problem, a function of your current dental health, etc, and of course the luck of the draw. The math did not work for us.

 

[ziggy29]

Annual cap of benefits is $500 and does not cover root canals, crowns, etc.

Well, where that is actually the case, it makes no sense at all. That's a terrible plan, actually. That's not really even insurance in any meaningful way; it's "prepaid maintenance" at a steep premium.

Not a lot of math needed for that one.

 

[steelyman]

On vision benefits (mine, anyway): they cover routine services (w/co-pay) one would normally get from an optometrist but when an opthamologist is required it falls under medical insurance.

 

[SumDay]

I searched high & low for reasonably priced premiums after I retired, and realized that if I wanted reasonably priced premiums, I shouldn't have retired.

I get my vision needs taken care of at Costco and just pay out of pocket - about $225 a year.

Our dentist has a "plan" - we pay them $150 each year and get greatly reduced cleanings and x-rays, and some % off major work. I figure that's why I'd been socking money in my HSA - I'll use it for dental expenses.

Neighbors who have Medicare Advantage plans tell me this is one of their favorite parts of their plans - they get a vision allowance of $300 each year and free dental cleanings. So, there's that.

 

[Walt34]

I have some dental and vision coverage, but basically it's more of a discount plan than full insurance. We get two dental checkups a year for free and the occasional filling costs about $10 with the rest covered but after that we pay full freight. Still, I'm grateful that I didn't live in an era when dentistry tools consisted of a pint of Jack Daniels and a pair of pliers.

 

[wolf]

When this has been discussed in the past, the consensus was that if the plan is subsidized by an employer it can be a good deal, whereas plans where you paid the full premium cost are generally not useful.

+1. Many years ago, Wife, Me, Children all had different dentist. I asked each dentist/receptionist. What insurer do your patients use who private pay? Answer: None.

When I had root canals, (endodontics), asked same question. Got same answer. Private dental insurance bad. You have to research the "details", ie. Plan covers teeth cleaning. Fine print, "customary charges", which out here in California, are way to low.

So you end up paying the premium, and the difference between what the insurance carrier pays and the dental bill.

For routine vision exam/glasses. You can't beat Costco's service and price.

 

[LakeRat1]

My DW turns 65 next month, we live in FL, she is going with Aetna Advantage Plan, no extra costs and include dental and eye.... $136 will be deducted from her SS and go directly to Aetna..... Does this sound correct ??