Dental Insurance ?
 

I have recently lost my dental insurance from my employer, as I am now retired ! My current Medicare supplemental insurance only provides basic dental services, and I need coverage beyond cleanings and xrays.

Can any Forum members suggest some recommendations for 'dental only' insurance.

Thanks!

My opinion on dental insurance is that unless you are getting from your employer at a relatively cheap rate, it usually does not pay to have the coverage unless you have serious dental issues. The coverage is usually expensive and does not cover much.

The two carriers that I (my company) have had is Delta and Ameritas. I lean slightly towards Ameritas as being slightly better.

I agree with Joey, that unless you are getting it at a reduced rate through your employer or similar or you have severe dental issues, your probably better off paying out of pocket.

Dan

I went to this website.... dentalplans.com as my company does not offer dental insurance.

For $125/yr I basically purchased the rate Cigna pays the dentist. For example, instead of a private pay root canal @ $1200, the cost was $800.

They offer a few different plans.

Woodsy

That’s a great web site! I noticed they offer Delta’s PPO premium plan which covers 100% preventative and a good portion of restorative care with a max payout of $1000.00 per year for $30 per month. That’s really good!

Dan

Oh my, we have another comedian on the forum!
🙄

Dental Insurance ?
 

Until my early teen years I thought everyone’s parents took their teeth out and placed them in a glass of water before bed. Mother, father, grandmother....
Fortunately, I was able to keep mine


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Thanks Woodsy. Great site with an abundance of options. I have a few clients I will pass this along to.

I agree with this too.

Sorry, I don't understand this information concerning payout- whose payout is maxed at $1000.00? If this refers to THE PLAN, that's peanuts. If it refers to the plan BUYER, how does that jibe with $30.00 a month?

With the exception of my confusion, this would seem quite decent

Agree with those who feel it is usually just not worth it. My wife has had a plan with work and after for many years. Even with clearly covered items, such as x2 cleaning a year, it is a pain to get them to pay. Another time, simple tooth filling, they wanted a photo...an X-ray showing the cavity and the dentists notes were not enough.

I guess there are better plans... but my feeling about insurance is if you can pay for it and/or take the loss you are better off in most cases.

From the website....

“Get 100% coverage for preventive dental care such as exams, cleanings and x-rays.
$50 Annual Deductible
$1,000 Annual Maximum”

So if you have a dental procedure that cost $1000.00 and assuming most plans pay around 50% of that cost so $500.00 would be deducted from the annual maximum payable benefit. Preventive care, (cleaning / X-Rays) are covered 100%.

Dan

All kidding aside, but "implants" are now the way to go (or so I have heard).

I have no idea what costs are involved with this, or even if it's an option which is even covered by any dental insurance.

Additionally, I have been told that TUFTS DENTAL SCHOOL in Boston will do Dental work for a fraction of the going rate. Keep in mind that these are Dental students working under supervision of Licensed Dentists, so I guess it can be a good deal.




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Retirement Benefits
 

When I retired, my company has extended Cobra Plan of all benefits. Because the plans are part of the group, there are reduced rates, however I go to Melcher & Prescott and AARP to shop around. Dental plans are all over the map as far as coverage go. Looking at best value for coverage I find AARP Dental is my best bet.

Implants are not covered under dental plans. Cost per tooth around 4K.


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Delta Dental
 

I have Delta Dental. I pay a monthly premium and it covers all preventative care and xrays. For root canals or crowns it covers some of the costs. As mentioned above it depends on which plan you choose. The plan also offers an option for a maximum benefit of $1,000 or $1500.00 annually. Meaning they will not pay more than their maximum coverage. Even my dentist told me that at retirement is is best to self insure, in other words do not pay for coverage. It comes down to a personal choice.

I have met life. It does cover crowns etc but unless you have something like that it doesnt cover the premium

Not true at least for me. My individual Delta plan paid about 40% of the cost of my implant earlier this year.

Ameritas also covers implants, don’t know the percentage but would guess about the same 40-50%

Dan

I went through this in Mass just a few years ago. Due to almost unbelievable price discrimination, Delta Dental is an absolute must. Missing from the comments against dental insurance is that Delta caps the amount that your dentist can charge BEFORE the issue of coverage amount comes up.

Ask your dentist how much he charges for a cleaning, filing, whatever, to a noninsured patient. Then ask how much Delta allows him to charge a covered patient. It's not 10 or 20% less, it's enough to make your head explode. (Sadly, this is another example of how the struggling often pay more than the well off in our society.)

This issue is even highlighted on the Delta website, where you can buy a plan that has zero coverage, but allows you to take advantage of their price caps. It's extortion

I saved enough to pay for the card +$$$ on my first visit. Paying out $125 per year is not much to get the discounted price the insurance companies pay out.

Way cheaper than self-insuring!


Woodsy

What about the network?

The card I bought was for Cigna ($125), and my dentist takes Cigna. So it was easy! Needed a root canal done and saved $250 off the private pay price. Then had the crown base started... currently I have saved $350 off private pay pricing...

Woodsy

This is factually true. Now, instead of getting mad about it, you can turn it to your advantage: simply meet with your dentist and ask for a discount. I did this out of necessity and I pay the same rate as insurance companies pay him. There is no real loss to the dentist. It's much simpler to pay the dentist directly. Some doctors are now using this strategy: instead of dealing with insurance companies, they collect a reduced payment directly from their patients, avoiding the huge expensive of insurance management.

I also highly recommend a Harvard Pilgrim Medicare Advantage plan called Stride Value Rx. It covers most medical procedures, dental and vision benefits, and other perks that add up to make the $40 a month premium worth it. (I mean in addition to Medicare Part A, which is free, and Medicare Part B, which costs $144/month.) The covered dental services for 2020 are: oral exams, cleanings, x-rays, peridontal exam, peridontal cleaning. There is a $35 copay per visit, no deductible, maximum $500 benefit per year.

That doesn't cover fillings, etc., which brings me back to my suggestion above: negotiate with your dentist. I once investigated Delta Dental and decided that the benefits were too low to justify the yearly premium.

My health insurance agent once told me that a viable option is to put the money you would have paid for insurance into a separate account and use it only when you need it. Just think of the hundreds of thousands of dollars you pay over the course of your lifetime for home, car, and health insurance. I've never filed a single home insurance claim. I've been paid about $4000 in car claims over several decades of buying insurance. Insurance companies make a profit because there is a very good chance that you will pay far more for insurance than you will ever collect on claims.

So if I retire and have no coverage, I an pay Delya $125 and get big discounys. I get it so far. But I didn't understand all the details of the network questin. Do I have to go to a dentist in their network ?

The last company I worked for didn’t buy dental coverage for employees. Instead you brought your invoice to the office and the company reimbursed you based on the coverages provided by a good dental plan. The reason: premiums paid by the employer (never mind the employee share) far exceeded the annual amount that was reimbursed or paid out. Think about it, cleaning & check up are about 125, xrays are about 150. Monthly premiums are about 125. You get a cleaning twice a year and xrays once. Who wins there?


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I am in the same place as 'SailinAway', and have 'Harvard Pilgrim Stride Medicare' plan. Been on the plan for 2 yrs now, and find it is a fantastic plan, including dental procedures as described above, eye exams, hearing exams, and extra money called 'Wallet' benefit, which will provide you over $300 annually for out of pocket expenses such as 'Massage therapy, Health Club memberships, Accupuncture, etc. The plan also give you $250 year in over the counter, out of pocket pharmaceuticals not covered under the regular drug plan. It's like getting FREE money ! As you can see, I'm a huge fan of Harvard Pilgrim !

Virtually all of the Dentists in Mass are in the Delta network. You can probably check this on their website--search for your own, then every other dentist you can think of

The Harvard Pilgrim Advantage plans do provide coverage as stated but these are structured as HMOs which can be cost saving but before we get away from the dental discussion, this is a way different kettle of fish from regular Medicare.

Just a caution.

As a new Medicare recipient, before choosing Harvard Pilgrim and the Stride Value Rx Advantage plan I did well over 100 hours of research to understand Medicare and the various types of supplemental plans. It can make you crazy. I looked at every major insurance company and carefully compared all of the supplements on spreadsheets. When I had made a tentative decision I had a long conversation with a very good insurance agent to verify my findings. He agreed that for my specific situation, HP Stride Value Rx offers the most coverage for the least money. You have to carefully assess your needs and do a ton of research. I spoke with five or six insurance agents and found real holes in their knowledge of the baffling senior healthcare system. They would recommend plans without really knowing much about them or about the competition. Finally I found an agent with comprehensive knowledge. But what is right for one person isn't necessarily right for someone else.

Your last sentence is exactly the point.

If you have no objection, it would be helpful if you would give us the name of your knowledgeable agent. We just got a sizable rate increase in our supplemental coverage, and I am not sure we have what’s best for us. Too late to change course right now, but for future planning, the right agent could make a difference. Thanks in advance.

Here is a good website that explains the difference between Medicare supplement & advantage plan.

https://www.ehealthinsurance.com/med...pplement-plans

We ended up going with a BCBS Medicare Advantage Plan that provides medical, dental, vision, prescription coverage & reimburses for up to 100 per year for health club expenses. The premium is $33/mph above the usual Medicare part B premium. Our plan requires that we select providers from a specific list of Drs however, for an additional $90/math premium we could go to anyone we want.


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His name is Todd Reagin, owner of Maine Medicare Options. https://www.mainemedicareoptions.com/
Phone numbers: (207) 370-0143 or (866) 976-9038

Don't be put off by the fact that he's in Maine. In my experience he was very knowledgeable about insurance and healthcare in New Hampshire and Massachusetts. His website says, "I am an independent insurance agent contracted with all the top Medicare health insurance plan companies available in New Hampshire and Maine." That means he has contacts at those companies and can call them directly to straighten out problems for you.

He was very generous with his time and in the end I was confident that I had made the best choice. You can read testimonials about him at https://my.setmore.com/bookingpage/3...e031ce/reviews I agree with all of them.

***Coincidentally, Todd has an excellent article on dental plans at his website: https://www.mainemedicareoptions.com/dental/

Competent Medicare Advisors
 

I found Melcher and Prescott in Laconia pretty competent in explaining Medicare options to me. Make suggestions and go forward from there.
You will also find Servicelink is also helpful, not just Medicare, anything in elderly and disability cases. Even Medicaid. Both services are free!

I opt for Plan N over advantage as I travel a lot, skiing out West, vacationing in the Caribbean, business trips all over N. America etc. Advantage plans won't cover me outside this area.