Dental Insurance

[Senator]

The VA has a dental plan I am going to get for ~$20 a month. It covers Diagnostic and Preventive with $0 deductible.

The rest at 50% with a $1,000 max benefit.

Plan Comparison | Delta Dental VADIP Dental Program

 

[ziggy29]

For the most part I never found individual dental to be worth it. You may pay $30-35 per person per month, with a $1000-1500 annual max. Sure, if you need crowns and fillings and root canals every year that's worth it, but if that's the case you have other problems.

Once becoming eligible for group insurance through FEDVIP in May I started on it again. For about $26 per month (for me, DW may or may not go on my medical next year pending choices in the next month or so) I get pretty good insurance that pays 100% for all preventative stuff and has a $10,000 annual maximum. As I have a loose front tooth (and have for years) that may need an implant or a bridge fairly soon (paid 50% in network), it seems like a roughly break-even premium if all I have is cleaning, X-rays and exam is worth doing just in case I need that significant work.

But most individual dental policies, for most people, are probably not a great buy, especially with a $1000-1500 maximum annual benefit in most cases.

 

[Dreamer]

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.

Oh my, I would really be in trouble if 1 implant including crown cost $7000.00. I guess my price is not so bad. He told me that 1 implant including crown would be $2700.00.

 

[omni550]

For folks who need expensive dental procedures, there are places for dental tourism.

I once had a roommate who went to Costa Rica for her mouthful of dental work. That practice even offered an inexpensive insurance policy (~$100-150, iirc) that would cover the cost of a return visit for adjustments or if anything more major was required. She did get and use that policy. She had a 'Hollywood smile' when she was done.

The dentists that took care of her were a father and son team who had been educated in the U.S., most everyone in the practice spoke English, they had a small boutique hotel next door for their American patients, and it was all set up so patients could go back to their rooms between various procedures, etc.

Here's an example of a website for one of the dental practices in Cost Rica (that has gotten a lot of U.S. press apparently): http://www.mezadentalcare.com/

omni

 

[nun]

The VA has a dental plan I am going to get for ~$20 a month. It covers Diagnostic and Preventive with $0 deductible.

The rest at 50% with a $1,000 max benefit.

Plan Comparison | Delta Dental VADIP Dental Program

I have a MetLife Dental plan. $29/mth premium for 2 x cleanings, x-rays and check ups and I get a $1250 annual coverage amount.

 

[braumeister]

Oh my, I would really be in trouble if 1 implant including crown cost $7000.00. I guess my price is not so bad. He told me that 1 implant including crown would be $2700.00.

That's a real bargain price. Seriously.

 

[Corporateburnout]

That's a real bargain price. Seriously.

+1

 

[Amethyst]

Wow, I should say so. Implant + crown, including all the follow-up visits, for $2700 would be a bargain with insurance.

That's a real bargain price. Seriously.

 

[Corporateburnout]

For folks who need expensive dental procedures, there are places for dental tourism.

I once had a roommate who went to Costa Rica for her mouthful of dental work. That practice even offered an inexpensive insurance policy (~$100-150, iirc) that would cover the cost of a return visit for adjustments or if anything more major was required. She did get and use that policy. She had a 'Hollywood smile' when she was done.

The dentists that took care of her were a father and son team who had been educated in the U.S., most everyone in the practice spoke English, they had a small boutique hotel next door for their American patients, and it was all set up so patients could go back to their rooms between various procedures, etc.

Here's an example of a website for one of the dental practices in Cost Rica (that has gotten a lot of U.S. press apparently): Dental Implants and Cosmetic Dentistry in Costa Rica, Meza Dental

omni

For an implant it is be impractical to do. I started the process of the implant back in February and so far I've had 5 visits to the surgeon for the extraction, bone graft, implant, X rays and checkups with three more scheduled before completion in January.

I also prefer to be treated by my dentist/surgeon in case of any problems occur in the future.

For me the peace of mine is worth the cost.

 

[athena53]

For an implant it is be impractical to do. I started the process of the implant back in February and so far I've had 5 visits to the surgeon for the extraction, bone graft, implant, X rays and checkups with three more scheduled before completion in January.

I also prefer to be treated by my dentist/surgeon in case of any problems occur in the future.

For me the peace of mind is worth the cost.

I've had 4 implants and the oral surgeon did the extraction, bone graft and placement of the implant at the same time. They still waited 2 months for it to heal before putting on a permanent cap and another 2 months before the prosthetic tooth went on. (To those of you not familiar with the terminology, the "implant" is just the titanium plate with a threaded hole that they embed in the jawbone.) I agree with you, though. I have an oral surgeon who's fantastic and a dentist who works well with him. If I need implants again, I won't mess with what works.

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....

Huge difference. I've never made a Homeowners claim and haven't made an Auto claim for at least 15 years, but the potential amount they'll pay if Something Really Bad happens is more than I want to pay out of pocket. The most that dental insurance pays, no matter how bad things get, is capped at $1,500 per year, more or less. I'll go without the dental coverage.

 

[ziggy29]

Huge difference. I've never made a Homeowners claim and haven't made an Auto claim for at least 15 years, but the potential amount they'll pay of Something Really Bad happens is more than I want to pay out of pocket. The most that dental insurance pays, no matter how bad things get, is capped at $1,500 per year, more or less. I'll go without the dental coverage.

This why I sometimes jokingly call dental insurance "anti-insurance" or the opposite of pure insurance. The main idea behind insurance is to protect you from catastrophic loss, even if you have to eat the first few hundred (or thousand) dollars in deductibles to keep the premiums affordable. Dental is the opposite; it usually pays the first $1,000 or $1,500 (or even $5-10K in some cases), possibly with small deductibles and some copays, and then it pays nothing. Now the good thing is that no one is going to get 6- and 7-figure dentist bills, of course, but still, my usual rule of thumb with dental is that *most* people are better off without it if the premiums aren't subsidized or you get special "group rates" that are subsidized by people who pay them but almost never go to the dentist.

There are a few people of course, who might benefit from an individual dental policy. For example, some folks who have periodontal issues and need perio maintenance in addition to regular cleanings and X-rays may come out ahead, since perio maintenance is usually covered at 80% and sometimes 100% *in addition to* the semiannual checkups and cleanings. Of course, there is some adverse selection in the individual dental market because the people who choose to buy it will usually be the ones most fully utilizing the benefits.

 

[GTFan]

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.

After retiring at end of last year we talked to the office folks at our dentist and they recommended the Aetna Dental Access plan, which costs about $100 a year for our family - this gives us discounted rates instead of paying the full cash rate at dentists that accept the plan. My guess is that it's the same rate that the average insurance pays but I'm not sure (they don't offer a cash discount), the advantage for the dentist being that they don't have to file claims and hassle with getting paid.

I did the math and this plan pays for itself with just routine cleanings vs. paying cash rate, and we're ahead of the game with fillings, x-rays etc.

I used this website to buy the plan, may be cheaper elsewhere. No issues with our dentist accepting it and can be used immediately.

Aetna Dental Access $7.95 - Use Immediately

 

[FUEGO]

After retiring at end of last year we talked to the office folks at our dentist and they recommended the Aetna Dental Access plan, which costs about $100 a year for our family - this gives us discounted rates instead of paying the full cash rate at dentists that accept the plan. My guess is that it's the same rate that the average insurance pays but I'm not sure (they don't offer a cash discount), the advantage for the dentist being that they don't have to file claims and hassle with getting paid.

I did the math and this plan pays for itself with just routine cleanings vs. paying cash rate, and we're ahead of the game with fillings, x-rays etc.

I used this website to buy the plan, may be cheaper elsewhere. No issues with our dentist accepting it and can be used immediately.

Aetna Dental Access $7.95 - Use Immediately

The rates they show at that link look pretty close to the rates our dental insurance pays (Metlife). I'll definitely be looking into this for $100/yr for the family once DW loses her employer provided dental insurance (currently costing $900/yr for a family of 5). Thanks!

 

[Texas Proud]

After retiring at end of last year we talked to the office folks at our dentist and they recommended the Aetna Dental Access plan, which costs about $100 a year for our family - this gives us discounted rates instead of paying the full cash rate at dentists that accept the plan. My guess is that it's the same rate that the average insurance pays but I'm not sure (they don't offer a cash discount), the advantage for the dentist being that they don't have to file claims and hassle with getting paid.

I did the math and this plan pays for itself with just routine cleanings vs. paying cash rate, and we're ahead of the game with fillings, x-rays etc.

I used this website to buy the plan, may be cheaper elsewhere. No issues with our dentist accepting it and can be used immediately.

Aetna Dental Access $7.95 - Use Immediately

Not sure if I would want to go to the dentists listed.... I looked around here and Castle Dentists came up all over the place... by far the largest group....

The lady who used to clean my teeth at my old dentist also worked at Castle... she said that they would run the people in quickly.... she had a total of 15 minutes to clean the teeth... if they were really bad, to bad for the patient... do as much as you can and move on....

Since they are all over the place, someone must be going to them.... anybody care to comment on their experience??

 

[FUEGO]

Not sure if I would want to go to the dentists listed.... I looked around here and Castle Dentists came up all over the place... by far the largest group....

The lady who used to clean my teeth at my old dentist also worked at Castle... she said that they would run the people in quickly.... she had a total of 15 minutes to clean the teeth... if they were really bad, to bad for the patient... do as much as you can and move on....

Since they are all over the place, someone must be going to them.... anybody care to comment on their experience??

I have no experience with Castle Dentists, but a bad experience with what sounds like the same type of large dental practice here in NC. Very profit oriented, lots of unnecessary stuff recommended. I ended up going back to a previous dentist I used in the next town over. Spoke to a hygienist there and she said to avoid the place. She works extra shifts on weekends at the big dentist chain place and says it's a sweatshop and all the dentists and hygienists work on commission with incentives or something like that.

As for the Aetna Dental Access Plan, I checked and my current dentist is in network. Not too surprising since he also accepts medicaid patients. But we're very happy with the guy, get to spend a lot of time chatting treatment and preventative options, and the hygienists are top notch. Many of his patients aren't well to do, so he's down with offering budget minded solutions that dentists in fancy areas might not (like the $4 high fluoride rx toothpaste and $1 mouthguard from walmart for an improvised fluoride treatment at home).

 

[Buckeye]

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

My mother has a Humana dental discount 'policy.' She just started with a new dentist (since we moved) and her initial visit was originally $266 but came to $122 after the Humana discount was applied. Basically, the discount plan gets her the Humana negotiated rate but the dental office doesn't have to bill because she just self pays at the end of the appointment.

Other than the charges being significantly discounted, it seems to be a good deal for both the patient and the dentist. The patient pays a lot less but the dentist gets paid the day services are provided without having to bill an insurance company.

It's the Humana HI215 dental discount plan and it is $12.99 per month with an extra $35 sign-up fee for the first year. You can do the whole thing online. I just searched to see if the dentist was on the provider list and she is not but there was no issue with them accepting the discount plan. In fact, they asked if mom had a discount plan when I was on the phone making her first appointment and hemming and hawing about what the first visit was going to cost.

The whole concept is odd because none of the cost of the discount plan ever goes to the dentist (you never have to tell them who your dentist is). The card Humana sent doesn't have any expiration date on it and the dentist's office never communicates with Humana regarding any of my mom's charges because she is self-pay. How would the dentist know whether mom re-upped for another year and why would they even care since the dentist never sees any financial benefit from mom's 'membership?' So, basically mom pays Humana $156 so the dentist will bill her using the Humana negotiated rate schedule? Hmmm.

 

[FUEGO]

The whole concept is odd because none of the cost of the discount plan ever goes to the dentist (you never have to tell them who your dentist is). The card Humana sent doesn't have any expiration date on it and the dentist's office never communicates with Humana regarding any of my mom's charges because she is self-pay. How would the dentist know whether mom re-upped for another year and why would they even care since the dentist never sees any financial benefit from mom's 'membership?' So, basically mom pays Humana $156 so the dentist will bill her using the Humana negotiated rate schedule? Hmmm.

This is the part I'm curious about. Could I just sweet talk the lady at the front desk at my dentist into using the info from one of these Humana or Aetna cards and give me the preferred pricing from those plans without actually buying a card each year?

I'll ask my dentist and/or office manager next time I'm in to see how this stuff works. All they have offered so far is 10% off for immediate payment, but we're getting closer to 30-50% off with our insurance's negotiated rates.

 

[Amethyst]

Interesting, because we use Humana as "secondary" dental insurance (our primary is BC/BS) and there are constantly issues with the dental office forgetting to submit the BC/BS EOB to Humana in order to get Humana's reimbursement.

What I find really interesting is how little Humana actually reimburses, over our co-pay. For example, the dental office charges $2000 up-front for a crown. We pay $1200 for the crown, BC/BS pays nothing, and Humana reimburses the practice about $350.00. So why can't the dental office charge everybody $1550?

Amethyst

My mother has a Humana dental discount 'policy.' She just started with a new dentist (since we moved) and her initial visit was originally $266 but came to $122 after the Humana discount was applied. Basically, the discount plan gets her the Humana negotiated rate but the dental office doesn't have to bill because she just self pays at the end of the appointment.

Other than the charges being significantly discounted, it seems to be a good deal for both the patient and the dentist. The patient pays a lot less but the dentist gets paid the day services are provided without having to bill an insurance company.

It's the Humana HI215 dental discount plan and it is $12.99 per month with an extra $35 sign-up fee for the first year. You can do the whole thing online. I just searched to see if the dentist was on the provider list and she is not but there was no issue with them accepting the discount plan. In fact, they asked if mom had a discount plan when I was on the phone making her first appointment and hemming and hawing about what the first visit was going to cost.

The whole concept is odd because none of the cost of the discount plan ever goes to the dentist (you never have to tell them who your dentist is). The card Humana sent doesn't have any expiration date on it and the dentist's office never communicates with Humana regarding any of my mom's charges because she is self-pay. How would the dentist know whether mom re-upped for another year and why would they even care since the dentist never sees any financial benefit from mom's 'membership?' So, basically mom pays Humana $156 so the dentist will bill her using the Humana negotiated rate schedule? Hmmm.

 

[rodi]

This why I sometimes jokingly call dental insurance "anti-insurance" or the opposite of pure insurance. The main idea behind insurance is to protect you from catastrophic loss, even if you have to eat the first few hundred (or thousand) dollars in deductibles to keep the premiums affordable. Dental is the opposite; it usually pays the first $1,000 or $1,500 (or even $5-10K in some cases), possibly with small deductibles and some copays, and then it pays nothing. Now the good thing is that no one is going to get 6- and 7-figure dentist bills, of course, but still, my usual rule of thumb with dental is that *most* people are better off without it if the premiums aren't subsidized or you get special "group rates" that are subsidized by people who pay them but almost never go to the dentist.

There are a few people of course, who might benefit from an individual dental policy. For example, some folks who have periodontal issues and need perio maintenance in addition to regular cleanings and X-rays may come out ahead, since perio maintenance is usually covered at 80% and sometimes 100% *in addition to* the semiannual checkups and cleanings. Of course, there is some adverse selection in the individual dental market because the people who choose to buy it will usually be the ones most fully utilizing the benefits.

While I agree that the low coverage is kind of "anti-insurance" - it still offers the negotiated rates.

I have a HDHP and had a lot of claims this year because my kids managed to break lots of things doing sports... I still had to pay out of pocket 100% - because of the high deductible, but the negotiated rates were MUCH lower than the "full price" rates.

Dental is semi reversed - they cover some up front, but then you're on your own... but the negotiated rates would apply even if you go past that $1500 coverage. And in the case of my dentist - the negotiated rates are between 50-70% of full price... where as cash payments is 95% of full price... So... even if I blow past the annual limit - I still save some money.

 

[rodi]

FWIW - our dentist doesn't take any of the discount cards. Only PPO plans. And the Humana plan listed above doesn't cover my zipcode.

 

[utrecht]

My family has no dental issues. Ive never even had a cavity. Is the consensus that we should skip dental insurance altogether?

 

[ziggy29]

While I agree that the low coverage is kind of "anti-insurance" - it still offers the negotiated rates.

I have a HDHP and had a lot of claims this year because my kids managed to break lots of things doing sports... I still had to pay out of pocket 100% - because of the high deductible, but the negotiated rates were MUCH lower than the "full price" rates.

True. One other point I failed to make is that if one is covering several children, dental insurance can make sense since "family" rates can be the same whether covering one child or 8. If you are covering eight children, it's probably a lot more cost-effective than if you are covering only one.

As for the negotiated rates, that is true but not necessarily a game-changer, especially for self-only coverage or coverage for a couple with no children in the plan. It does tip the scales a bit, though. In that case, even considering negotiated rates it may not be a great buy when bought on the individual market, though it certainly gets closer. Again, employer group plans are usually more worth considering since they are sometimes subsidized, they sometimes have better rates -- probably in part because there is less adverse selection than in the individual market -- and sometimes have lower deductibles and higher maximum benefits.

That all said, everyone should consider their own situations and their own ability to self-insure if, say, a $2,000 dental bill (or worse) might be in their future.

 

[Buckeye]

This is the part I'm curious about. Could I just sweet talk the lady at the front desk at my dentist into using the info from one of these Humana or Aetna cards and give me the preferred pricing from those plans without actually buying a card each year?

I'll ask my dentist and/or office manager next time I'm in to see how this stuff works. All they have offered so far is 10% off for immediate payment, but we're getting closer to 30-50% off with our insurance's negotiated rates.

Buy one year to get the discount loaded into your profile at the dentist. There will be no expiration push back from the insurance company because they are not in your billing loop.

 

[FUEGO]

Buy one year to get the discount loaded into your profile at the dentist. There will be no expiration push back from the insurance company because they are not in your billing loop.

I thought about that. I could just buy a month and cancel. Pay the $12-15 fee for a month plus the $35 application fee or whatever.

I also signed up for the free WellcareRX card online a couple hours ago. I'll see if my dentist takes it (they're listed in the online providers search) when we visit with the kids in December.

 

[Car-Guy]

I've never thought our dental insurance was a very good deal. Premiums were pretty low but so are the payouts. When I first got it, it was free from the company I worked for so "why not keep it". After a few years they started charging a few dollars a month. Now it's up to about 25 per person but the max payout has never changed. Am thinking about dropping it.