Dental Insurance

[48Fire]

What have you all done? Is dental insurance a rip off or a good idea?

Even our dentist recommended we drop the insurance. He gave me all possible costs for various issues.

 

[Corporateburnout]

Have you checked other dental practices to see what discount they are offering?

Mr. A. is getting an implant next month. Our insurance covers about 40% of the dental office's "full" cost for surgery, implant, and crown - total, about $3200.00 with insurance. Four hundred dollars of the $3200.00 is for nitrous, which the insurance doesn't cover - but the doctor strongly urged it, because the extraction will be a rough one.

If we didn't have insurance, or if our insurance hadn't started contributing toward implants, we would have received a 25% discount off the surgery, implant and crown. (It seems a little silly to even have a "full" price since apparently, no one pays it. It reminds me of JCPenney "sales.").

Amethyst

Is this $3200 total for the implant including the crown? If so I think it's extremely reasonable. I am currently going through the process of an implant that started back in March with the extraction, bone graft with sedation and last month had the implant. My dentist will install the crown in January. The surgeon's bill is $6500 with my insurance paying only $1500. I expect an additional $1100 bill from my dentist for the crown.

We plan to pay out of pocket when my COBRA coverage terminates in July. I don't think dental insurance is worth it.

 

[Dreamer]

I have been going to a dental school. I have many crowns that are 15-20+ years old that are starting to fail. I was concerned because two times I went and had old crowns removed and they were not able to save the tooth and they were extracted each time. They did a full mouth series x-ray and had 3 or 4 of the instructors look at the x-rays and my mouth and came to the conclusion that it was too difficult for the student dentist. I have an appointment to go to their new location where in resident dentists are learning specialties and have instructors watching them also. They are wanting to take off all of my crowns and see what is under them, instead of just guessing. Unforturnately, I am losing bone also. The resident dentists charge more than the student dentists of course. I have no idea what kind of money I will be looking at after they decide what is needed.

Open season is coming up, so I have been looking at dental insurance. I think that they dental school would be out-of-network, so they would pay less, higher deductible and lower amount paid out for the year. Also, if I was reading it correctly, they would only pay for crowns one per every 60 month period. The real kicker was, if you had a crown within the last 60 months, before you had their coverage and paid for it yourself, it still counted against you in the dental insurance plan. If that is the case, then I have decided not to get it. I think it would probably be next to impossible to get them to help pay for any implants.

 

[scrabbler1]

Back in 2007, when I switched from working 20 hours per week to only 12 hours per week, I had to forgo eligibility for my company's group health plan which included dental. I was able to go on COBRA for the next 18 months which coincided with the last 17 months I worked until I ERed in late 2008.


But in those 17 months, as well as earlier in 2007 when I was planning this strategy but still was working 20 hours per week, I made sure to have some costly dental work I had been postponing for a while. This included getting a crown and having 2 wisdom teeth pulled while I still had dental coverage.


This worked out well because my dental bills starting in 2009 when I was without dental coverage have been very low because I have had nearly no cavities or any other problems. I had figured out that cost of my old dental premiums under COBRA plus deductibles plus coinsurance were about the same as the cost of two annual exams plus one set of X-rays plus 1 or 2 small cavities.


My dentist since 1989 retired in 2013 so I have been going to another dentist he suggested starting in 2014. Besides being cavity-free in 2013 I have been cavity-free in 2014 and earlier this year (I have my next visit tomorrow so let's see if this great streak can continue).

 

[SJ1_]

I never saw a dental plan that was worth anything... JMHO

 

[Danmar]

We tried dental insurance for a year but I never saw the advantage. It had limits on yearly total payouts and didn't cover things that were expensive or complex (like implants).

The total value of the coverage was more than the year premium, but not significantly more, and heavily geared to fillings and crowns. If it doesn't cover the risk of unlikely but costly medical needs it's not really insurance.

Our experience exactly. Most of the procedures we use now(implants,etc) are not covered or restricted to such an extent, not worth it. Paying $100 per month for a $1,500 yearly coverage max seems like a waste of time to me. We dropped our group dental coverage offered by past employer's group plan last year.

 

[Nunthewiser]

We are currently uninsured, having retired just ten months ago and got our teeth as healthy as possible while under megacorps care.

We found a local community college that has a dental hygene program and does serious cleanings for $20 as well as xrays as requested so we will likely just find a dentist when something starts to hurt.

 

[Amethyst]

Nope. It's right there on the estimate. We live in a,high cost area and all services are expensive.

I am sure the $400 charge is for IV sedation, not nitrous. No one has brought up going to a dental school for any extensive, expensive dental work. If you live near a dental school and you have more time than money, I would definitely consider going there for any crown and bridge work, implants, etc.

 

[MRG]

Nope. It's right there on the estimate. We live in a,high cost area and all services are expensive.

I'd bring a case of Redi-whip and self administer.

 

[Alan]

We decided to not do dental insurance when we retired in 2010 as it did appear to be worth it.

Anything serious like root canal and periodontal surgery are covered by health insurance.

Going next week for my first filling in over 6 years

 

[Amethyst]

I believe so. It is $2000 for the procedure (with insurance) and $1200 for the crown. There is no bone graft anticipated with the implant, but he is supposed to get a bone graft for a back tooth and the insurance will not cover that ($1000 for the graft and material, surgery extra).

Is this $3200 total for the implant including the crown? If so I think it's extremely reasonable. I am currently going through the process of an implant that started back in March with the extraction, bone graft with sedation and last month had the implant. My dentist will install the crown in January. The surgeon's bill is $6500 with my insurance paying only $1500. I expect an additional $1100 bill from my dentist for the crown.

We plan to pay out of pocket when my COBRA coverage terminates in July. I don't think dental insurance is worth it.

 

[Corporateburnout]

Anything serious like root canal and periodontal surgery are covered by health insurance.

Root canals covered by health insurance in the US ?

 

[athena53]

I retired abruptly (BS bucket was full) halfway through the work on 2 dental implants. Fortunately, I'd already burned through the annual max on my employer's policy! I looked at dental insurance and decided against it. The 6 month to 1-year waiting period on anything other than routine cleanings really turned me off. It was practically a guaranteed profit for the insurer during that period.


So far I've gotten hit with some small bills for fillings and for the 2 extra cleanings per year they recommend because I have implants (insurance would cover only two but I need 4). I'm perfectly happy to have gone without coverage, knowing that even now it's not going to be of much use if I need anything major- and despite regular care and (they tell me) taking good care of my mouth and gums, my problems tend to be major. I have a lot of old crowns an a bridge that's likely to fail sometime.

 

[Texas Proud]

I retired abruptly (BS bucket was full) halfway through the work on 2 dental implants. Fortunately, I'd already burned through the annual max on my employer's policy! I looked at dental insurance and decided against it. The 6 month to 1-year waiting period on anything other than routine cleanings really turned me off. It was practically a guaranteed profit for the insurer during that period.


So far I've gotten hit with some small bills for fillings and for the 2 extra cleanings per year they recommend because I have implants (insurance would cover only two but I need 4). I'm perfectly happy to have gone without coverage, knowing that even now it's not going to be of much use if I need anything major- and despite regular care and (they tell me) taking good care of my mouth and gums, my problems tend to be major. I have a lot of old crowns an a bridge that's likely to fail sometime.

As an FYI.... I was looking at getting dental insurance for next year and was going through some of the policies offered this year... a couple did have waiting periods, but they were waived if you paid the full year premium up front....

The problem with dental is that there are many things that you can wait on.... so you sign up for dental insurance, get teeth fixed and then cancel policy... they are out then.... and I bet more people do this than do it with health insurance...

 

[big-papa]

When I was between jobs and after Cobra, I also looked into dental insurance. For us with 1 kid, it was just about break even for checkups if paid out of pocket vs. with insurance. However, all it would take would be a root canal, a crown and/or a filling to put it back over the edge to being very worthwhile. But right after I started coverage, I went back to work and had to cancel it.

By the way dentist was more than willing to work with me and gave me their shelf prices for all of the common procedures. Really helped me make the decision.

Also, be aware that there are lots of "discount" plans out there that are not insurance. If you have a dentist you like, make sure before you enroll that they'll accept the discount plan or insurance and that you know what your out of pocket will be for common procedures.

Big-Papa

 

[utrecht]

How do you go about negotiating dental rates with a new dentist? Its not like they have a price list on the wall and then you can ask for a discount.

Lets say you find out you need 2 teeth pulled. Do you ask how much and when he tells you its $400, you then ask for a discount? I assume he already knows you are a cash customer when yu filled out all the forms.

Also, whats a decent price just for a routine cleaning / exam with a new dentist (no insurance)?

 

[sengsational]

Also, whats a decent price just for a routine cleaning / exam with a new dentist (no insurance)?

We routinely get $99 new patient special cards in the mail, but they seem to come from the more expensive dentists.

I did the insurance analysis as compared to a discount program (Aetna vital savings). Prices around here are all over the place, and using the price from the discount plan made it easier to run the numbers. The prices vary by what the dentist agrees to, so there's not a "price list", but if you look around, you can find prices, just to give you an idea. Here's one: http://universaldentalplan.com/wp-c...014-4-Page-Members-Fee-Schedule-May-20141.pdf

What put me off of the insurance was that if you DID manage to get into the territory where you were ahead of the cost of the insurance, then it was limited to some fairly low dollars, and you start paying 100% again.

 

[athena53]

As an FYI.... I was looking at getting dental insurance for next year and was going through some of the policies offered this year... a couple did have waiting periods, but they were waived if you paid the full year premium up front....

The problem with dental is that there are many things that you can wait on.... so you sign up for dental insurance, get teeth fixed and then cancel policy... they are out then.... and I bet more people do this than do it with health insurance...

OK, I hadn't thought about the early cancellation issue. I'd had continuous dental insurance and 4X-yearly checkups for years and I figured they were trying to protect against people not buying insurance till they had an expensive problem, and I was clearly not in that category. Yes, I can see people buying coverage and cancelling, especially if they max out their policy limits.

 

[Theseus]

Anything serious like root canal and periodontal surgery are covered by health insurance.

Root canals covered by health insurance in the US ?

Had some recent periodontal surgery and checked the fine print in my HI policy, unless resulting from injury, or to remove tumors/cysts, it is not covered, albeit with some other even finer print detailing exclusions to the exclusions.

I agree in regards to dental insurance not being worth it. Even when I was employed, the subsidized premium cost seemed to be pretty much a wash. In a past discussion on the subject, a point was made regarding the benefit of paying a lower negotiated rate if insurance was in place, but I'm not sure of that being of much value either. I have brought up the possibility of paying a discounted rate as a cash/retired/no insurance customer with the front desk people at two different providers, each returned a blank stare or no response - next time I'll ask that question of the dentist. My guess is since these are both practices involving multiple partners getting one to agree to that will be like--pulling teeth--as they don't want to be seen as taking profits from their cronies.

 

[Texas Proud]

Let's just start by saying that dental insurance is not really insurance... as others have mentioned, if you have a really bad problem and need implants, most of that money (if not all) is coming out of your pocket....


But, I find it interesting how many people say they do not buy it because their premium is higher than the costs... well, heck, that is what usually happens with insurance....

I do not think I have a single year where I got back more money from my health insurance than I paid in...

Only once did I get back more money on my auto insurance than I paid in... but then they jacked my rate up and I have calculated they will get back 50% of what I was paid for my totaled car....

I have submitted one claim for homeowners... and barely got back my premium for that year... (do not know if rates are going to go up as it was this year for the claim)....

We buy insurance for potential losses that we could not afford... we hope to not use that insurance... and are happy when we do not.... (especially life insurance).... I do not see why dental is any different.... (yes, I know that almost everybody here can afford any potential loss... I am just throwing this out as a general comment)...


As I have seen, the amount paid for dental insurance is basically within what I would pay for just normal checkups, the extra they have to pay every once in awhile is icing on the cake for me... yes, I have gotten the $1K max a few times, so I am good with what I get in this agreement....

I cannot say if I would say the same if it were only me or just me and DW... but I do remember back when I worked it was worth it, but I do not know if I actually paid for 100% of the premium....

 

[Ian S]

I use a discount dental plan here in Arizona that costs $59/yr. I have a dentist that I like but my teeth are in good shape so I'm not sure how good the "discount" prices are for more involved procedures are. Others may wish to comment as the plan posts its charges: Preventative Dental Services, Cosmetic Dentistry Coverage, Extraction Coverage, Restorative Dental Plans

 

[kcowan]

Because dental expenses are a sure thing, I think most plans are just a budgeting process so you pay for everything in the years when you don't make claims. So aside from the profit margin for the company, you are just getting your own money back.

Pharmacy is also a bottomless pit. Most prescribed drugs are not needed long term. A good example is Prilosec, a permanent solution to a temporary problem!

 

[rodi]

How do you go about negotiating dental rates with a new dentist? Its not like they have a price list on the wall and then you can ask for a discount.

Lets say you find out you need 2 teeth pulled. Do you ask how much and when he tells you its $400, you then ask for a discount? I assume he already knows you are a cash customer when yu filled out all the forms.

Also, whats a decent price just for a routine cleaning / exam with a new dentist (no insurance)?

I just got an EOB for my son's teeth cleaning last month.

Cleaning before discount: $70. After discount $48.93. Cost to me, $0.

So I would expect cleaning, without insurance to be in the $70-100 range. (Not including x-rays.)

As far as having teeth pulled - I would ask for a quote prior - even with insurance... Having gone through this with both sons. (Orthodontist wanted some teeth pulled prior to treatment starting to make room in their crowded mouths.) At the time my sons had different dentists - one was a pediatric specialist (the son with the crappy teeth). Prices were similar, but the pediatric dentist had some anesthesia that wasn't covered, so I had to pay extra for that. It was 2 years ago - IIRC it was around $150-200 after insurance paid.

 

[Dreamer]

I had my dental appt with the Prosthodontic Graduate Clinic today. They will have additional dentists looking at things to make a game plan on what they will be doing. The dentist that I saw today gave me rough figures so far. He thinks that if they do partials and the additional things (new crowns, etc) it will cost between $6,000-$10,000. If they do implants and the additional things, it will cost between $15,000-$20,000. Maybe I should not have quit my part-time job 5/15/15. Maybe I need to look at the dental insurance again, but I don't think it will help much, since WVU dental school is out of network. I asked if there was a discount for paying cash and he said there was not.

The good part was that when I told my DH, he told me to do whatever I wanted. He told me not to think about it too much, because I always tend to go the cheaper route. I go back for a 2 hour appt on 10/26/15, which is our 43rd wedding anniversary. DH has a follow-up appt after cataract surgery on that day. Happy Wedding Anniversary to us-we know how to celebrate!

 

[Corporateburnout]

I had my dental appt with the Prosthodontic Graduate Clinic today. They will have additional dentists looking at things to make a game plan on what they will be doing. The dentist that I saw today gave me rough figures so far. He thinks that if they do partials and the additional things (new crowns, etc) it will cost between $6,000-$10,000. If they do implants and the additional things, it will cost between $15,000-$20,000. Maybe I should not have quit my part-time job 5/15/15. Maybe I need to look at the dental insurance again, but I don't think it will help much, since WVU dental school is out of network. I asked if there was a discount for paying cash and he said there was not.

The good part was that when I told my DH, he told me to do whatever I wanted. He told me not to think about it too much, because I always tend to go the cheaper route. I go back for a 2 hour appt on 10/26/15, which is our 43rd wedding anniversary. DH has a follow-up appt after cataract surgery on that day. Happy Wedding Anniversary to us-we know how to celebrate!

Dental insurance won't help you much for this extensive work. Most insurance policies have a $1500 annual benefits. I am in process of an implant of one tooth at a cost of $7000 including the crown with my insurance covering only $1000.