Dental insurance for seniors

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regfman
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Dental insurance for seniors

Post by regfman »

My wife and I have had Kaiser healthcare for many years and for many years my employer covered the typical amount of this Kaiser HMO insurance and also a PPO dental insurance. As we retired we have kept Kaiser and are generally very happy with it for supplental medicare with Kaiser Senior Advantage. To get dental insurance we have Kaiser Senior Advantage Plus which adds about $20 a month for each of us and provides some dental coverage, only through Delta Dental HMO, along with discounted glasses, and a gym membership for us (although the gym is closed down now.)
The dental coverage is not with Dental Dental's PPO plan but instead with Dental Dental's HMO plan. That makes it very hard to select from a very limited amount of dentists,and over the few years that we've had DD HMO the dentists that we have found have been so displeased with their arrangement with Delta Dental that they have dropped out of the plan and left us looking for new dentists.

What sort of dental plans are offered to seniors that provide some decent coverage and a wide range of dentists? It seems the subset of dentists we have to choose within Kaiser's Delta Dental HMO plan are very limiting. On the other hand we both have pretty good teeth. And we have no plans of any major dental work coming up, so maybe we should forgot about dental insurance?
jebmke
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Re: Dental insurance for seniors

Post by jebmke »

regfman wrote: Thu Aug 20, 2020 4:50 pm And we have no plans of any major dental work coming up, so maybe we should forgot about dental insurance?
All my major dental work was unplanned.

I've looked at dental insurance a couple of times (not recently) and I could never make the numbers work. Caps are typically pretty low so going without insurance is normally the best pure financial play. There are a number of discount programs available that help mitigate the cost but you have to make sure the providers you use (and might use) accept them.
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Topic Author
regfman
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Re: Dental insurance for seniors

Post by regfman »

Do most seniors who aren't covered by some former employer's better retirement plans end up buying dental plans? Or is it usually determined that it is cheaper to just pay out of pocket for all dental services? best case it would be just teeth cleaning twice a year.

and I do agree with jebmke's comment that the major dental work is probably going to be unplanned.
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Blake7
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Re: Dental insurance for seniors

Post by Blake7 »

+1 on paying for dental directly vs. buying insurance. Dental and vision insurance are usually worthless (i.e., cost as much or more than paying directly over the long term) in my experience, especially if you have to pay your own premiums. Look for senior programs and ask for discounts for paying cash directly. I have a government HMO that’s almost fully paid, but we only use it for free preventative work. If we need work done, which is rare, the insurance coverage is poor. We just go to a out of network and pay cash. When I retire, I will not purchasing dental insurance.
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JoMoney
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Re: Dental insurance for seniors

Post by JoMoney »

FWIW, I'm not sure how it differs for seniors, but I don't know what "decent coverage" means when it comes to dental plans.
Most of the plans I've seen with my employers cover 2 cleanings and an x-ray each year, and anything beyond that winds up being something like 50% covered with a cap at $1-2k max.

Not that $2,000 isn't a good amount of money, but I wouldn't even buy comprehensive insurance on a car that was worth twice that amount, that's just the kind of unexpected loss I'd be willing/able to suck up and accept the risk.

But when it comes to forgoing dental insurance altogether, If the cost of the dental plan was the same as what paying cash for 2 cleanings and an xray would otherwise amount to, and it looks like that is often the case, then it feels like whatever additional coverage is just a 'bonus'.
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BogleTaxPro
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Re: Dental insurance for seniors

Post by BogleTaxPro »

also +1 on just paying directly. Our dentist office actually suggested we look into the AARP Delta PPO plan. But in comparing what we actually pay each year (I keep medical/dental expenses in a spreadsheet) vs what the premiums would be...it didn't make sense. Plus, they restrict how much they'll pay out the first year (no crowns or implants). You could ask your dentist if they'll give you a cash discount for paying up-front. Ours said no for routine work but they'll negotiate if we need something major.
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GerryL
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Re: Dental insurance for seniors

Post by GerryL »

My long-time dentist hates insurance. He'll work with some insurance companies, but only grudgingly. I pre-pay for a year of preventative care, which includes discounts for other types of dental needs. I penciled out the costs for Delta Dental-type insurance coverage and his offer and it made sense to go with his plan. Fortunately, we did not transact the payment for 2020. That was going to happen on my initial visit of the year, which got canceled as lockdown started.
123
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Re: Dental insurance for seniors

Post by 123 »

https://www.dentalinsurance.com/ can identify possible individual plans for enrollment. They have plans all ages but when you put a date of birth in the search feature will identify premiums with the associated plans. In California Delta Dental is a major provider for group plans and there are individual plans included from them as well. The dental insurance business seems to have it all figured out, many plans have a waiting period for major work and the amount covered can vary based on how long you've had the plan. That said there are some higher cost plans that cover major work earliar.

I would think the major advantge of dental insurance is that you have service prices negoitiated (?) by the insurance company so you're not stuck paying the dentist's "rack" price. If someone finds they are a regular customer of dental work that is more than cleaning some kind of dental insurance may be of value but over the long haul I don't know that it really saves you that much.
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mrsbetsy
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Re: Dental insurance for seniors

Post by mrsbetsy »

We pay cash and we supposedly get a 20% discount for doing so for regular cleaning.

The handful of times over the past 10 years we've had expensive stuff, we just cross the southern border and get it there for 25% of the price and it's all been perfectly fine. This inlcudes multiple crowns and a front tooth replacement cap for the two of us.

Might look into medical/dental arbitrage.
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mfswatz9
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Re: Dental insurance for seniors

Post by mfswatz9 »

We gave up dental insurance about 15 years ago. Out dentist gives a 5% discount for cash (check).
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Taylor Larimore
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Self Insurance

Post by Taylor Larimore »

regfman:

I do not buy insurance for risks I can afford to pay myself.

This avoids the company profit, the hassle of dealing with the insurance company and also being surprised by the fine print in the policy which always favors the insurance company.

Best wishes.
Taylor
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jabberwockOG
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Re: Dental insurance for seniors

Post by jabberwockOG »

Running the expected results over time for most dental plans showed me that payouts are so limited that the premiums are more like prepaid dental plan payments than insurance.

Since it looked like a financial wash over time we opted to cancel dental insurance policies and pay as we go. Be sure to ask for a discount or for them to match insurance plan prices if you are paying cash.
gtd98765
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Re: Dental insurance for seniors

Post by gtd98765 »

When we had dental insurance with various health plans, we were limited to specific dentists, who always seemed to push special expensive procedures that seemed dubious. Once we found a dentist we liked whom we thought was honest, we decided to stick with him, despite his not participating in any dental plans. We just pay out of pocket for excellent and infrequent care.
mkc
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Re: Dental insurance for seniors

Post by mkc »

We have never found individual dental insurance to work out, cost-wise. There are a few programs out there that will get you the negotiated rate for procedures but you must pay that in full. Look for "dental savings plans" for those. In general, the annual limit for reimbursement/coverage plus the monthly cost (and often limited choice in providers) didn't make the cost of premiums make sense.
toofache32
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Re: Dental insurance for seniors

Post by toofache32 »

Dentist here. I have looked at these HMO plans and to to provide quality care, they do not cover it. They require significant cost cutting on costs and some of my colleagues outsource to cheap Chinese labs to make it work. Lower costs involve cutting corners. Which corners do you want your dentist to cut? There is no such thing as "dental insurance" which I find interesting that patients sign up for without understanding what it actually is. It's a discount card which is rarely worth it unless someone else is buying it such as an employer. It's actually the opposite of insurance...it pays for minor cleanings but not major stuff like crowns or implants. This would be like your auto insurance paying for oil changes but not a major collision.
MathIsMyWayr
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Re: Dental insurance for seniors

Post by MathIsMyWayr »

When you compare the cost and the dollar amount of the expected benefits of an insurance, it is no longer an insurance. Insurance should for the unexpected benefit.
carolinaman
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Re: Dental insurance for seniors

Post by carolinaman »

jebmke wrote: Thu Aug 20, 2020 5:00 pm
regfman wrote: Thu Aug 20, 2020 4:50 pm And we have no plans of any major dental work coming up, so maybe we should forgot about dental insurance?
All my major dental work was unplanned.

I've looked at dental insurance a couple of times (not recently) and I could never make the numbers work. Caps are typically pretty low so going without insurance is normally the best pure financial play. There are a number of discount programs available that help mitigate the cost but you have to make sure the providers you use (and might use) accept them.
+1. The senior dental plans I have seen provide only limited coverage. One major issue would typically exceed what they would pay out. I have never seen a plan that would be worth joining. BTW, you probably are well aware that seniors can be subject to expensive dental procedures to save their teeth.
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Watty
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Re: Dental insurance for seniors

Post by Watty »

A limited selection of dentists in a plan is a big problem. I have had dentists that were bad so I place a high priority in getting a good dentist.

They can be bad in two ways,

1) Low quality work either because of lack of skill or using lower quality materials or equipment to save money.

2) Wanting to do all sorts of expensive work that is not necessary.

Often times dentists will be both.

Right now we have a good dentist that has an annual plan for a discount for basic care and a discount for other care that is needed.
testing321
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Re: Dental insurance for seniors

Post by testing321 »

We have had insurance from Delta Dental since I retired. I keep a spreadsheet of our claims, and like medical insurance, the provider discounts are much greater than the insurance payments. Overall, we have saved a lot with the insurance, but of course, it depends on how much work is done. Our plan covers implants and crowns. Almost all the dentists in our area are in-network.
friar1610
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Re: Dental insurance for seniors

Post by friar1610 »

For years I've been in the pay your own way; don't buy dental insurance camp. But a year or so ago TRICARE (for retired military) dropped a terrible Delta Dental Plan as an option and we became eligible for the retired civil-service plans. I looked at the numbers and determined that if either my wife or I had just one visit (between the two of us) in addition to the two normal annual check-ups/cleanings it would be worth the premiums. Thinking that in spite of healthy teeth and good dental hygiene habits these teeth aren't getting any younger, I signed us up for the basic GEHA plan (that our dentist participates in). So far it has paid off and we have been ahead of the game. I have an extraction and a likely new crown in my immediate future and even at 50% reimbursement I'm well ahead of the game. That said, if we were 20 years younger I probably wouldn't have signed up.
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brajalle
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Re: Dental insurance for seniors

Post by brajalle »

You may want to look around at discount card options. For example, Delta Dental offers a Delta Dental Patient Direct discount card - https://www.deltadental.com/us/en/dental-insurance.html

Unfortunately, it's not available in all states, but it has been expanding. The last time I checked, it was $80/yr for the entire household. What it does is give you the Delta Dental PPO rates - if a Dentist accepts Delta Dental Insurance, he has to take the discount card. The Delta Dental PPO rate was a bit less than what my employer's dental insurance negotiated prices are. The math I did suggests the discount card is a better value (I'm looking at pre-tax and post-tax premium/card costs, deductibles, co-pays) until we have the equivalent of about 2 fillings - then it flips to the insurance. Given that I have a few tax credits/deductions that have AGI limits I try to keep under, I have kept the insurance the last 3 years (I was on the card for about 3 years). For the full cost of my employer dental insurance in retirement - I'd use the discount card for sure though.

One poster mentioned going south of the border for expensive dental work. If that isn't an option, look for Dental schools nearby - they often will do expensive work for cost. My parents do this - they get a 10% cash discount at our dentist (sadly, they won't ever bother with the Delta Dental card) and if they've ever needed more expensive work they go to a Dental school that is about 40 min away.
westie
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Re: Dental insurance for seniors

Post by westie »

I have a federal dental plan (retired) offered through Aetna. Cost spouse and I about $100 a month total. We have been satisfied with it. In network it has zero deductible, covers all cleanings and xrays, 70% for fillings/extractions, 40% for root canals, crowns and dentures, 50% for orthodontics/braces. It has a $30,000 per year maximum benefit. One root canal and crown pretty much pays for the plan for an entire year. If you're paying $20 a month for a supplemental plan you can't expect it to cover much.
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TomatoTomahto
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Re: Dental insurance for seniors

Post by TomatoTomahto »

toofache32 wrote: Thu Aug 20, 2020 10:58 pm It's actually the opposite of insurance...it pays for minor cleanings but not major stuff like crowns or implants. This would be like your auto insurance paying for oil changes but not a major collision.
That’s been my take on it also, but one time I was shocked that they actually paid for an extraction; it must have been a fat finger mistake. :D . Our “insurance” is employer subsidized, so we use it with eyes wide open.

One thing that won’t apply to OP, but others might benefit from, is a “restricted use FSA” (or some similar phrase) that we use. It will allow pre-tax payments/reimbursement for dental and vision. In our case, it is in addition to an HSA, and accounted for separately by the same HSA administrator. Unlike the HSA but like “normal” FSAs, you must use it or lose it each calendar year.
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toofache32
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Re: Dental insurance for seniors

Post by toofache32 »

brajalle wrote: Sat Aug 22, 2020 2:41 am
One poster mentioned going south of the border for expensive dental work. If that isn't an option, look for Dental schools nearby - they often will do expensive work for cost. My parents do this - they get a 10% cash discount at our dentist (sadly, they won't ever bother with the Delta Dental card) and if they've ever needed more expensive work they go to a Dental school that is about 40 min away.
This is because Delta Dental is notorious for sending the doctor's payments to the patient instead of the doctor. They do not honor assignment of benefits. While many out of network dentists will collect only your share and bill the rest to insurance, the smart ones will not do this with Delta because you would be amazed at the number of patients who keep the insurance check instead of giving it to their dentist. But I'm sure no Boglehead would ever do that...
brajalle
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Re: Dental insurance for seniors

Post by brajalle »

toofache32 wrote: Sat Aug 22, 2020 6:30 pm
brajalle wrote: Sat Aug 22, 2020 2:41 am
One poster mentioned going south of the border for expensive dental work. If that isn't an option, look for Dental schools nearby - they often will do expensive work for cost. My parents do this - they get a 10% cash discount at our dentist (sadly, they won't ever bother with the Delta Dental card) and if they've ever needed more expensive work they go to a Dental school that is about 40 min away.
This is because Delta Dental is notorious for sending the doctor's payments to the patient instead of the doctor. They do not honor assignment of benefits. While many out of network dentists will collect only your share and bill the rest to insurance, the smart ones will not do this with Delta because you would be amazed at the number of patients who keep the insurance check instead of giving it to their dentist. But I'm sure no Boglehead would ever do that...
Actually, I was referring to my parents not wanting to mess with buying the discount card each year. Our dentist (same dentist) takes Delta Dental - but complains about it (reason given was not the one you mentioned).
willyd123
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Re: Dental insurance for seniors

Post by willyd123 »

Over the long term and assuming you take reasonably good care of your teeth and you have assets in case of an expensive issue, dental insurance is unnecessary. We talked with our dentist's administrator and she suggested the same. Just make sure to confirm the costs of services before they are performed.
Bcdkgf
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Re: Dental insurance for seniors

Post by Bcdkgf »

My husband and I will extend our Cobra Dental Benefits with Metropolitan for $69 for the two of us. $2000 yearly limit, $50 Deductible and will cover implants. 70% for small things, 50% for major restoratives and such like. Free cleaning twice a year. X-rays annually. The coverage will last 18 months, and then we are on our own again. Met will not extend the policy.

Implant coverage is important to us. My husband has four implants and many old crowns. I have a 40 year old bridge on the upper front, that is end of life, plus many crowns. This is a result of poor dental care while we grew up.

I failed to find dental policies that matched this price and coverage. We will not use a network dentist, tried two and their service was not good and harmful. Our current dentist is 65 years old, reasonably priced and does not push procedures.

This is a tip for having the insurance help pay for the implants: Have the first part of the procedure (post installed) by the oral surgeon in December and the following Spring have the crown placed on the post by the dentist.
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RudyS
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Re: Dental insurance for seniors

Post by RudyS »

Watty wrote: Fri Aug 21, 2020 10:05 am A limited selection of dentists in a plan is a big problem. I have had dentists that were bad so I place a high priority in getting a good dentist.

They can be bad in two ways,

1) Low quality work either because of lack of skill or using lower quality materials or equipment to save money.

2) Wanting to do all sorts of expensive work that is not necessary.

Often times dentists will be both.

Right now we have a good dentist that has an annual plan for a discount for basic care and a discount for other care that is needed.
100% agree!
dbr
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Re: Dental insurance for seniors

Post by dbr »

I have the impression dental insurance is most helpful for getting a negotiated fee schedule. Otherwise it is just payment in advance. We have used enough dental care that the insurance payments max out the plan and recover the cost. Just about every dentist and specialist in our area is in plan. It also helps to set up care with insurance in place rather than being asked to pay in advance. Anyway, dental insurance is certainly not insurance and we have experienced situations (injury) where over plan dental costs were major. Sometimes a dental cost may end up being an insured medical cost. Part of the injury situation was.
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Sheepdog
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Re: Dental insurance for seniors

Post by Sheepdog »

I have Anthem Blue Cross Blue Shield Medicare Advantage plan within which I receive Dental, Vision and Hearing coverage for extra premiums. The dental, thru Liberty Dental, covers twice a year cleaning and examinations plus considerable discounts for major dental work. For me, this insurance has saved me much
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