Retirees - Dental Insurance vs. Dental Plan

Questions on how we spend our money and our time - consumer goods and services, home and vehicle, leisure and recreational activities
Post Reply
User avatar
Topic Author
fishandgolf
Posts: 794
Joined: Fri Nov 25, 2016 1:50 pm

Retirees - Dental Insurance vs. Dental Plan

Post by fishandgolf »

We currently have neither. Most folks we talked with said Dental Insurance is not a great option.....so we avoided it.

We both started Medicare in June 2020. Since then, I've had a root canal and two crowns; she has had two crowns. So out-of-pocket costs have been
just north of $5K. We each do two cleanings per year which cost about $130/each..... so total of another ~$500.00.

She's somewhat paranoid that this pattern (crowns and root canals) could continue as we age so she has been looking at Dental Insurance (Physicians Mutual), which would cost ~$1200/yr. for both. She recently met a friend who told her about Dental Plan....new to us. We don't have the same dentist so her cost would be ~$150/r. and mine about the same. Her dentist offers Cigna and my Aetna; we live in Wisconsin.

So, we're still in the process of trying to understand the pros and cons of each....... Dental Insurance vs. Dental Plan. If any BH's can offer some insight on this topic, would greatly appreciate it.
eddot98
Posts: 1193
Joined: Wed Jan 01, 2014 10:47 am
Location: The Berkshires

Re: Retirees - Dental Insurance vs. Dental Plan

Post by eddot98 »

When I was working for NY State, we had a Dental Plan included as a benefit through Emblem Health. It wasn’t the greatest, but it was free. If one used a participating dentist, costs were only a $25 deductible yearly each for me and DW. Plan maximum was low, $2300 each. The Emblem Dental clinic that we used wasn’t the best, but they were all right. The plan ended when I retired in 2010 and we were offered to continue basically the same plan for $810 per year. We have continued with this insurance since my retirement. Our participating dental clinic is still the Emblem Health clinic and costs are low. Before Covid-19 we each got 2 cleanings per year and maybe one or two cavities filled a year. We pretty much broke even, but we were covered against major costs, like most insurance. We had one visit in 2020 before Covid-19 hit. We just went back in September 2021 and had a cleaning each at no cost and I went back for 2 fillings for the $25 deductible. Without the insurance they would have cost $280. I’m not sure what a non participating dentist would charge, but I would guess that it would be more than $140 for a 2 surface filling. Going to the Emblem Dental clinic is part of the benefit of the insurance.
User avatar
GerryL
Posts: 3902
Joined: Fri Sep 20, 2013 11:40 pm

Re: Retirees - Dental Insurance vs. Dental Plan

Post by GerryL »

My longtime dentist HATES dental insurance. ("It's not really 'insurance.'") For the past several years he has been offering me a "loyalty program" in which I prepay for my regular cleanings and exams at a set rate, and includes a discount for filings, etc. When he first offered this, I did the math and, given that dental insurance covers a very low annual maximum, it penciled out slightly in favor of his plan.

If you have a regular dentist, you might want to ask what plan he prefers to work with, or whether you can get the negotiated rate if you pay him directly.
mkc
Moderator
Posts: 3226
Joined: Wed Apr 17, 2013 2:59 pm

Re: Retirees - Dental Insurance vs. Dental Plan

Post by mkc »

Can you explain what you mean by "Dental Plan"?

For individual insurance, dental insurance never made sense to us - the annual benefit was barely more than the premium you pay, so if you didn't have a lot of high-dollar services where you needed to take advantage of the negotiated rates, you wouldn't come out ahead.

There are a handful of dental discount plans where you essentially get negotiated rates at dentists who accept the discount plan. Is that the "Dental Plan" you are asking about? If so, you'll need (just as with insurance) to check with your dentist's billing person to make sure they accept that plan.
7eight9
Posts: 2406
Joined: Fri May 17, 2019 7:11 pm

Re: Retirees - Dental Insurance vs. Dental Plan

Post by 7eight9 »

You might want to consider paying for cleanings/xrays domestically and any more serious work (crowns/implants) going abroad/south of the border.
I guess it all could be much worse. | They could be warming up my hearse.
adventure
Posts: 14
Joined: Sat Sep 15, 2018 7:20 pm

Re: Retirees - Dental Insurance vs. Dental Plan

Post by adventure »

I use a Dental Plan instead of buying Dental Insurance. After adding up the annual premium, the annual deductible, the the co-pays, and the low maximum ceiling they would pay per year, for me it did not make financial sense. Additionally, many policies exclude certain things. My dentist wanted to do a gold crown, but when I had insurance, they would not pay for gold.

To me, insurance is for items that would cause catastrophic financial loss, not for a (example) $2,000 maximum ceiling. If you get the insurance free through an employer, it's great, just like vision insurance. But vision insurance does not pay for eye care, that's covered by medical insurance.

If the most a dental plan would pay is $2,000 annually, paying $800 to cover that amount each year in premiums sounds like a very expensive policy premium. Pay them $800, and they will pay you $2,000 after the deductible and any co-pays? Not for me. I think of dental insurance as a Pre-Pay" system instead of real insurance.

Also, some credit unions like Navy Fed and Pen Fed offer discounted dental plans.
Zhuang
Posts: 56
Joined: Sat Jan 09, 2021 12:22 am

Re: Retirees - Dental Insurance vs. Dental Plan

Post by Zhuang »

fishandgolf wrote: Sun Dec 05, 2021 6:57 pm We currently have neither. Most folks we talked with said Dental Insurance is not a great option.....so we avoided it.

We both started Medicare in June 2020. Since then, I've had a root canal and two crowns; she has had two crowns. So out-of-pocket costs have been
just north of $5K. We each do two cleanings per year which cost about $130/each..... so total of another ~$500.00.

She's somewhat paranoid that this pattern (crowns and root canals) could continue as we age so she has been looking at Dental Insurance (Physicians Mutual), which would cost ~$1200/yr. for both. She recently met a friend who told her about Dental Plan....new to us. We don't have the same dentist so her cost would be ~$150/r. and mine about the same. Her dentist offers Cigna and my Aetna; we live in Wisconsin.

So, we're still in the process of trying to understand the pros and cons of each....... Dental Insurance vs. Dental Plan. If any BH's can offer some insight on this topic, would greatly appreciate it.
Normally it’s a wash if You buy insurance out of your own pocket or not.
Suggestions:
1. Talk to your dentist office and ask them what insurance they accept. Then you can do the math.
2. Ask your dentist if they have a special discount for paying cash directly.
3. Ask your dentist office if they recommend dental discount programs That you can purchase.
jima
Posts: 37
Joined: Wed Aug 15, 2012 4:40 pm

Re: Retirees - Dental Insurance vs. Dental Plan

Post by jima »

I’ve used a dental plan for years and generally pretty happy with it. Have had both Aetna Dental Access and Ameriplan, they work the same so it comes down to dentist selection and pricing. I believe they both have an online price search feature where you can price shop the negotiated rates (even without being a member). The prices can vary significantly between dentists and even between plans for the same dentist, so worth looking at both and whether another dentist could be worth checking out.

This year for the first time I got dental insurance through work because I expected my wife and I both to get some crowns. I’m not positive but believe it worked out better financially, but the insurance was a real hassle to use. Basically the dentist will bill you for things they are pretty sure the insurance won’t cover, then submit the claim, then bill you again for anything that was denied. It was very difficult to audit the charges for accuracy, and took more time than I want to spend. Decided not to continue it for next year.
User avatar
celia
Posts: 16763
Joined: Sun Mar 09, 2008 6:32 am
Location: SoCal

Re: Retirees - Dental Insurance vs. Dental Plan

Post by celia »

It will be important to see which dentists participate in the "dental plan". I suspect those are the dentists you won't want to see--those that have an assembly line of patients waiting in a crowded waiting room.
Parkinglotracer
Posts: 3915
Joined: Fri Dec 20, 2019 2:49 am
Location: Upstate NY

Re: Retirees - Dental Insurance vs. Dental Plan

Post by Parkinglotracer »

My long term, excellent, no up sell, world class dentist takes no insurance and participates in no dental plans. He does file insurance paperwork if one has insurance. Years back He suggested i save my money and pay cash. He does give a 5% discount for cash.

If i could find a good dentist who participates in any insurance or plan i can get as a military / industry retiree and i could save some money on fillings, crowns, etc I’d consider reluctantly changing dentists.
User avatar
Kagord
Posts: 1670
Joined: Fri Nov 23, 2018 12:28 pm
Location: Peaksville, Ohio

Re: Retirees - Dental Insurance vs. Dental Plan

Post by Kagord »

Can someone please explicitly define Dental Plan?

I'm familiar with dentists that offer their own "plans", as an alternative to dental insurance. Like annually, two cleanings, an exam, XRay (if one needed that year), and 10% off other work, for $200 and change. This saves over published rates, and is probably a good option if your mouth/teeth are healthy. This would be at a particular dentist's office.

But the previous posts seem to imply there can be network of dentists on a plan, is this "Dental Plan" something different?
evelynmanley
Posts: 1022
Joined: Tue Sep 21, 2010 9:13 am

Re: Retirees - Dental Insurance vs. Dental Plan

Post by evelynmanley »

Kagord wrote: Mon Dec 06, 2021 7:56 am Can someone please explicitly define Dental Plan?

I'm familiar with dentists that offer their own "plans", as an alternative to dental insurance. Like annually, two cleanings, an exam, XRay (if one needed that year), and 10% off other work, for $200 and change. This saves over published rates, and is probably a good option if your mouth/teeth are healthy. This would be at a particular dentist's office.

But the previous posts seem to imply there can be network of dentists on a plan, is this "Dental Plan" something different?
This is a good example of the typical dental plan (for which, BTW, Suze Orman is the figurehead):
https://www.dentalplans.com/

I looked at the rates, and they are almost exactly what my dentist already charges with a 5% discount for cash payments.

For Medicare dental plans, Kaiser Advantage for Seniors in Northern California just made DeltaCare USA available to all members at no extra cost. Their rates and benefits are great, but without any exception, the reviews of the dentists who take DeltaCare USA in my area and even within 100 miles of where I live are abysmal. Very unfortunate for seniors who really might need this kind of coverage. https://www1.deltadentalins.com/individ ... e-usa.html
bberris
Posts: 2412
Joined: Sun Feb 20, 2011 8:44 am

Re: Retirees - Dental Insurance vs. Dental Plan

Post by bberris »

I also use a dental plan instead of insurance. But unlike insurance, these plans seem not to pay a commission to the broker, so they are cheaper when you buy from the plan itself. Compare:

https://www.dentalplans.com/
https://www.cignadentalsavings.com/enroll
dbr
Posts: 46137
Joined: Sun Mar 04, 2007 8:50 am

Re: Retirees - Dental Insurance vs. Dental Plan

Post by dbr »

The question is what your dentist, or some dentist you might see, would charge for various services with insurance, with a plan, or with neither plan nor insurance, including the infamous 5% cash discount.

Dental insurance for all practical purposes is prepaid dental care and not insurance but it is important if the coverage includes negotiated rates that are less than the uninsured rates at your dentist. Negotiated rates might be as little as half the gross rate, perhaps.

While dental costs for more serious work such as crowns and root canals or even implants can run in the thousands of dollars, this is not an issue of hundreds of thousands of dollars that might be involved in a major medical problem.
User avatar
quantAndHold
Posts: 10141
Joined: Thu Sep 17, 2015 10:39 pm
Location: West Coast

Re: Retirees - Dental Insurance vs. Dental Plan

Post by quantAndHold »

evelynmanley wrote: Mon Dec 06, 2021 12:55 pm
Kagord wrote: Mon Dec 06, 2021 7:56 am Can someone please explicitly define Dental Plan?

I'm familiar with dentists that offer their own "plans", as an alternative to dental insurance. Like annually, two cleanings, an exam, XRay (if one needed that year), and 10% off other work, for $200 and change. This saves over published rates, and is probably a good option if your mouth/teeth are healthy. This would be at a particular dentist's office.

But the previous posts seem to imply there can be network of dentists on a plan, is this "Dental Plan" something different?
This is a good example of the typical dental plan (for which, BTW, Suze Orman is the figurehead):
https://www.dentalplans.com/

I looked at the rates, and they are almost exactly what my dentist already charges with a 5% discount for cash payments.

For Medicare dental plans, Kaiser Advantage for Seniors in Northern California just made DeltaCare USA available to all members at no extra cost. Their rates and benefits are great, but without any exception, the reviews of the dentists who take DeltaCare USA in my area and even within 100 miles of where I live are abysmal. Very unfortunate for seniors who really might need this kind of coverage. https://www1.deltadentalins.com/individ ... e-usa.html
My wife just got this with her Medicare Advantage as well. We’re looking it over, but I think she’s going to continue just paying cash. Our dentist offers a discount for long term patients. It isn’t a fixed 5%, it’s based more on what the service costs him to provide.
UALflyer
Posts: 1035
Joined: Thu Jan 17, 2013 9:42 am

Re: Retirees - Dental Insurance vs. Dental Plan

Post by UALflyer »

adventure wrote: Sun Dec 05, 2021 9:03 pm To me, insurance is for items that would cause catastrophic financial loss, not for a (example) $2,000 maximum ceiling. If you get the insurance free through an employer, it's great, just like vision insurance. But vision insurance does not pay for eye care, that's covered by medical insurance.
People say this on this forum on the time, but the reality is actually more complicated. If I can pay $100 for an insurance policy that in my situation is virtually certain to pay out $200 without causing me any headaches in the process, it'd be kind of silly of me not to do it. Losing out on his benefit won't cause me any financial hardship, but why forego free money?

People tend to respond to the above by saying that insurance companies are in the business of making money, so their payouts have to be lower than the premiums paid. That's true on average, but has nothing to do with your individual decision. Lots of people, for instance, pay for dental insurance that covers 2 preventive dental services per year at 100%, but fail to use them both, which is one of the ways that an insurance company makes money. It's kind of like the value of cashback credit cards: their issuers make money on average, but lose money on those of us who collect the cashback and pay off the charges every month. Likewise, the value of dental insurance isn't just in the payouts that it makes, but often in the negotiated pricing. If you are comfortable with its network, meaning that you'd get to see the same providers that you'd see anyway, the negotiated insurance pricing can actually represent a fairly significant benefit.

Hence, if insurance can save you money and make your life a little bit easier by eliminating the need to price check various providers, it can make sense to purchase it even if the benefits have nothing to do with foregoing financial hardship. Not all dental insurance fit the above criteria, but my point is that I don't think that your approach to insurance is appropriate for quite a few people out there.
If the most a dental plan would pay is $2,000 annually, paying $800 to cover that amount each year in premiums sounds like a very expensive policy premium. Pay them $800, and they will pay you $2,000 after the deductible and any co-pays? Not for me. I think of dental insurance as a Pre-Pay" system instead of real insurance.
As you know, depending on the service provided, dental insurance has different percentage copays. So, preventive services, for instance, may be covered at 100%, while major services may be covered at 50%. The point is that even if the insurance benefit maximum happens to only be $2,000/person/year, because of the percentage copays, maxing out the annual benefit means that you've incurred several thousand dollars in dental claims. In the meantime, because of the in-network discounts, you're saving money on all those services.

The benefit maximums then reset the following year, and a lot of dental services can and often have to be spread out over more than one year, meaning that you get to take advantage of more than one annual benefit maximum. In other words, a dental insurance policy with a $2K/year cap buys you a lot more than that in services.
I use a Dental Plan instead of buying Dental Insurance.
I obviously don't know anything about your specific plan, but unlike dental insurance, lots of dental discount plans don't work well. For instance, a number of dental plans only provide percentage discounts (something like 40% off certain fees), which are meaningless, as the providers simply inflate their fees and then apply all these percentage discounts to them.

Likewise, the fact that there are no dental claims means that the dental provider is the one that gets to interpret the terms, which creates various opportunities for the dental provider to play games. So, they can charge you separately for various things that an insurance company reviewing a claim wouldn't allow them to charge you for, etc... Hence, from a patient's perspective, there are a lot of concerns with dental plans that don't exist with dental insurance.
Last edited by UALflyer on Mon Dec 06, 2021 4:23 pm, edited 2 times in total.
UALflyer
Posts: 1035
Joined: Thu Jan 17, 2013 9:42 am

Re: Retirees - Dental Insurance vs. Dental Plan

Post by UALflyer »

GerryL wrote: Sun Dec 05, 2021 8:15 pm My longtime dentist HATES dental insurance. ("It's not really 'insurance.'") For the past several years he has been offering me a "loyalty program" in which I prepay for my regular cleanings and exams at a set rate, and includes a discount for filings, etc. When he first offered this, I did the math and, given that dental insurance covers a very low annual maximum, it penciled out slightly in favor of his plan.

If you have a regular dentist, you might want to ask what plan he prefers to work with, or whether you can get the negotiated rate if you pay him directly.
I totally get the reason that dental providers (I don't just say "dentists," as the same is true for all dental specialists out there as well) out there hate dental insurance. The policies are all different, have different coverage requirements, effectively dictate how much providers can charge for every procedure, force the provider to pay a billing coordinator/assistant to submit and track all the claims, etc... The providers also say that with dental insurance, there's no financial incentive for them to focus on quality work, as insurance pays exactly the same regardless.

The above is all true, but it's virtually impossible for consumers to assess their providers' clinical skills, so people's assessments and reviews tend to focus on things like the provider's bedside manner, how nice the office is, etc.., which doesn't have anything to do with the person's skill and quality. Likewise, whether a dental provider takes insurance or not tends to have very little correlation with the provider's competence and quality.

Hence, the reason that as I mentioned above, if the dental policy that you're considering has the same in-network providers that you'd want to see anyway, and it looks like the policy will save you money (because of both the actual coverage, but also the in-network pricing), such a policy can be quite worthwhile.

As for the general dentists offering their own "discount plans" where you prepay a certain amount up front and, in exchange, get your regular cleanings and exams at a set rate, plus a "discount" on fillings, etc. It's fine if you want to stay with this dentist anyway and it saves a tiny bit of money over what you'd pay him/her anyway, but it won't save you much money and won't address the types of concerns that the OP has. In the situation that you've described, the so-called "discount" is based on the dentist's made up fees. Again, if you would've paid those made up fees anyway, this can save you money, but it's not really a discount.

Likewise, this obviously only works at your dentist. The OP has mentioned a root canal, and while lots of general dentists offer to do them to make more money, getting an endodontist to do it would generally be a much better idea. Your dentist's "discount" won't work there. The same is true for lots and lots of other things.
Carguy85
Posts: 1227
Joined: Thu Mar 19, 2020 6:26 pm

Re: Retirees - Dental Insurance vs. Dental Plan

Post by Carguy85 »

You are very likely FAR better off money wise in the long run going to a dentist that you trust...one that doesn’t have high pressure sales tactics or other nonsense they are trying to make up for accepting plans that pay poorly. You plant corn, you get corn. Being in the dental field, I see instances of this daily.
User avatar
Topic Author
fishandgolf
Posts: 794
Joined: Fri Nov 25, 2016 1:50 pm

Re: Retirees - Dental Insurance vs. Dental Plan

Post by fishandgolf »

Please accept my apologies......I have not been able to respond to any questions ( Thanks BH"s for providing details about a Dental Plan). Our internet has been out since early AM. There is a great deal of construction going on in our area and one of the contractors, while digging, tore open the provider's cable connection and it just got repaired.

I have reviewed all comments....thank you for your input! I'm still in a quandary about this subject. We have not spent much time doing the research about either.....Dental Insurance or Dental Plan. This is a very busy time for our business so hopefully after the holiday season is over, we'll be able to spend more time to research.

Frankly, my wife is the one pushing this stuff....so I'll let her do the leg work, then she can decide what to do. For me, I have had the same dentist for more than 35 years and really like him; however, he's planning to retire soon so it sorta throws me into the ring as well.

Happy Holidays to you and your family!
Alkali Ike
Posts: 68
Joined: Wed Jan 16, 2019 12:49 pm

Re: Retirees - Dental Insurance vs. Dental Plan

Post by Alkali Ike »

When I retired at age 60, my dental office recommended a dental plan called New Dental Choice. Their website is https://www.newdentalchoice.com/

I don't know if they have participating dentists in Wisconsin, but you can figure that out by visiting their site. They have saved me a lot of money on crowns and root canals versus what I would have spent out of pocket without their help. Oddly enough, they seem to have about the same coverage that I had with Delta Dental when I was 'fully insured' at my workplace. I heartily endorse them.
dbr
Posts: 46137
Joined: Sun Mar 04, 2007 8:50 am

Re: Retirees - Dental Insurance vs. Dental Plan

Post by dbr »

I imagine the significant choice is between a plan or insurance and doing neither. Doing neither will result in higher costs for dental care than doing something.
User avatar
TexasPE
Posts: 686
Joined: Sat Feb 17, 2018 7:41 pm
Location: Southeast Texas

Re: Retirees - Dental Insurance vs. Dental Plan

Post by TexasPE »

fishandgolf wrote: Mon Dec 06, 2021 5:49 pm . For me, I have had the same dentist for more than 35 years and really like him; however, he's planning to retire soon so it sorta throws me into the ring as well.
Be sure to get your retiring dentists' recommendation for another dentist (I asked my retiring dentist who HE went to).

I value a seasoned, trustworthy dentist - I pay my current one cash - his prices are very reasonable (in fact, the local dental organization has been pushing him to raise his prices).
At 20: I cared what everyone thought about me | At 40: I didn't give a damn what anyone thought of me | Now that I'm 60: I realize that no one was really thinking about me at all | Winston Churchill (?)
michaelingp
Posts: 932
Joined: Tue Jan 17, 2017 7:46 pm

Re: Retirees - Dental Insurance vs. Dental Plan

Post by michaelingp »

For Federal retirees (doesn't sound like it applies to OP), I think dental insurance can be a good deal if your dentist accepts it. We have come ahead every year since we signed up (sometimes way ahead), with the major savings being the negotiated prices, not the actual payments. People say it's impossible to come out ahead since the insurance companies have to make a profit, but in fact, the policy holders can come out ahead because the dentists are discounting their normal fees. Why do dentists accept this? I think it's because some of them need the extra business that participating in the insurance brings in. I believe my dentist is extremely skilled and up on the latest technology, but he's young and started his practice not that many years ago. We have not had any problem finding skilled dentists in network. I haven't seen any indication that less skilled dentists are more likely to accept insurance, but then my sample size is extremely small and we've used the same dentist as before we had insurance.
Chris K Jones
Posts: 441
Joined: Sat Jan 20, 2018 5:54 pm

Re: Retirees - Dental Insurance vs. Dental Plan

Post by Chris K Jones »

I have used Aetna Vital Savings for dental for almost 3 years now. I am happy with it. It is basically a discount plan and coverage is about $100 for my family per year. It is important to make sure that your dentist participates. Mine does and I go to a peridontist. She takes it too. I actually turned down a fairly inexpensive dental insurance plan at work for this plan. This has worked very well for me. Best wishes.
adventure
Posts: 14
Joined: Sat Sep 15, 2018 7:20 pm

Re: Retirees - Dental Insurance vs. Dental Plan

Post by adventure »

UALflyer wrote:
For instance, a number of dental plans only provide percentage discounts (something like 40% off certain fees), which are meaningless, as the providers simply inflate their fees and then apply all these percentage discounts to them.
Really? I'm glad I have an honest dentist who doesn't inflate his prices to take advantage of patients. If anyone has such a crook for a dentist, sounds like time to find a new doctor fast.

I see people mention that you need to ensure a dentist accepts your dental plan. The same applies to dental insurance.

Another benefit of a dental plan is there are no time limits on services in a calendar year. With a dental plan, if you choose to have more than two cleanings per year, no problem. Using the plan, If the cleanings every six months don't fit your schedule, no problem. This came in handy when going on a month long overseas trip, and I wanted the next cleaning before the six month mark.

It's really a coin toss which is better, dental insurance or a discounted plan. I like the plan as there is no ceiling, no co-pays, no annual deductibles, and no dental services that are not covered. If I need three crowns in one year, no problem.

I pay about $100 a year, and every year upon renewal, the company mails me a voucher to return to them with the first paid dental bill (discounted). When they receive the bill and voucher, they send me a check for $25 for renewing. I have received the check for several years from them. So the plan costs me about $75 a year. Your mileage may vary.
Leesbro63
Posts: 10581
Joined: Mon Nov 08, 2010 3:36 pm

Re: Retirees - Dental Insurance vs. Dental Plan

Post by Leesbro63 »

I have DeltaDental thru AARP for $61/month. In the 3 years I’ve had it, I didn’t more on the coverage than I would have paid for 2x/year cleaning, exam and once a year X-rays. I’m 62 and while my teeth are fairly good, I have lots of 40 year old fillings and two crowns. I could need a lot of work or not.

My concern is having a fee schedule to limit the cost of crowns, root canals and other potential such costly care. I don’t like the risk of being charged whatever the specialist feels like charging, even if my regular dentist is trustworthy with regard to fees.

I probably should go to a good dental “plan” and drop the $732/yr dental insurance. Basically paying just a small amount for just a fee schedule. But I’m not sure who offers such a good “plan”. I’ll continue following this for possible plan choices.
Leesbro63
Posts: 10581
Joined: Mon Nov 08, 2010 3:36 pm

Re: Retirees - Dental Insurance vs. Dental Plan

Post by Leesbro63 »

adventure wrote: Tue Dec 07, 2021 3:59 pm
UALflyer wrote:
For instance, a number of dental plans only provide percentage discounts (something like 40% off certain fees), which are meaningless, as the providers simply inflate their fees and then apply all these percentage discounts to them.
Really? I'm glad I have an honest dentist who doesn't inflate his prices to take advantage of patients. If anyone has such a crook for a dentist, sounds like time to find a new doctor fast.

I see people mention that you need to ensure a dentist accepts your dental plan. The same applies to dental insurance.

Another benefit of a dental plan is there are no time limits on services in a calendar year. With a dental plan, if you choose to have more than two cleanings per year, no problem. Using the plan, If the cleanings every six months don't fit your schedule, no problem. This came in handy when going on a month long overseas trip, and I wanted the next cleaning before the six month mark.

It's really a coin toss which is better, dental insurance or a discounted plan. I like the plan as there is no ceiling, no co-pays, no annual deductibles, and no dental services that are not covered. If I need three crowns in one year, no problem.

I pay about $100 a year, and every year upon renewal, the company mails me a voucher to return to them with the first paid dental bill (discounted). When they receive the bill and voucher, they send me a check for $25 for renewing. I have received the check for several years from them. So the plan costs me about $75 a year. Your mileage may vary.
What is your plan? Can I get that?
Starfish
Posts: 2996
Joined: Wed Aug 15, 2018 6:33 pm

Re: Retirees - Dental Insurance vs. Dental Plan

Post by Starfish »

adventure wrote: Tue Dec 07, 2021 3:59 pm
UALflyer wrote:
For instance, a number of dental plans only provide percentage discounts (something like 40% off certain fees), which are meaningless, as the providers simply inflate their fees and then apply all these percentage discounts to them.
Really? I'm glad I have an honest dentist who doesn't inflate his prices to take advantage of patients.
You see this the wrong way.
It is not the dentist that inflates prices, it is the insurance/plan that underpays. For dentists to make this profitable they have to take shortcuts that are never in patient's interest. Patient's with basic delta etc will usually get a lower standard of care. The difference ion cost for far superior care can be sometimes only 10-20%, but the insurance does not allow it.
It's very similar when collect bids for construction, or renovation. If you are not in the business and you don't know and list in detail what to ask, you get lower bids at the price of very different quality or lifetime. Sometimes a 200$ addition in a 10k$ could make a large difference in the lifetime of the finished result.
User avatar
dratkinson
Posts: 6108
Joined: Thu Jul 26, 2007 6:23 pm
Location: Centennial CO

Re: Retirees - Dental Insurance vs. Dental Plan

Post by dratkinson »

When I retired (DoD) and was offered $100/mo dental coverage, I declined. That was 20yrs ago so I've saved ~$24K (=$100/mo x 12mos/yr x 20yrs) out of pocket during that time, all of which has been invested in the market, meaning I should have ~$52K (n=20x12, i=7%/12, pv=0, pmt=-$100, mode=0) set aside for dental expenses... and growing.

During that time I've used a cashback CC to pay for: annual cleanings, 2x root canal, 3x crowns, 1x implant. My current dentist offers a 10% courtesy discount for cash payment (including CC payment).

Since 7% growth on above growing $52K is ~$3600 this year, I could pay for annual cleanings and an annual 1x root canal/crown and still come out ahead.

Since I don't expect to have many annual dental problems, I believe I've come out ahead by being self-insured for dental.
d.r.a., not dr.a. | I'm a novice investor; you are forewarned.
trichebacher
Posts: 12
Joined: Wed Jan 20, 2021 1:49 pm

Re: Retirees - Dental Insurance vs. Dental Plan

Post by trichebacher »

My Medicare Advantage SecureHorizons Plan 2 (HMO) pays for two teeth cleanings per year without extra premium.
andypanda
Posts: 1992
Joined: Sun Nov 12, 2017 8:11 pm
Location: Richmond, Virginia

Re: Retirees - Dental Insurance vs. Dental Plan

Post by andypanda »

The negotiated plan price has been mentioned already, but here's my one example.

I'm a retired state employee with both Medicare and the state retiree Anthem health plan that includes some dental and vision, etc. After having two root canals and crowns some years back I thought I knew what the third one would cost. Wrong.

When I got the bill it was much more expensive. The answer was, "Oh, the state Anthem plan now only pays 5% for the root canal, etc." Well, that's dumb. Why bother.

If Anthem paid 0% I would not have gotten the plan's negotiated price of roughly half the cash price.
adventure
Posts: 14
Joined: Sat Sep 15, 2018 7:20 pm

Re: Retirees - Dental Insurance vs. Dental Plan

Post by adventure »

Leesbro63 wrote:
What is your plan? Can I get that?
My plan is with Benefit Services. If you are a member of one of the partner financial institutions of theirs listed, and join using a link from your credit union, you will get a discount off the annual fee. https://benefitservices.com/
adventure
Posts: 14
Joined: Sat Sep 15, 2018 7:20 pm

Re: Retirees - Dental Insurance vs. Dental Plan

Post by adventure »

Starfish wrote:
You see this the wrong way.
It is not the dentist that inflates prices, it is the insurance/plan that underpays.
It is you who sees it wrong, not me. The plan does not underpay. The plan pays nothing.

In the literature from the dental plan, they include a list of most average dental costs charged by dentists nationwide. They show the average cost for an X-ray or filling, for example. The chart also shows the average negotiated price you would pay. This gives you a guideline of average prices, every dentist is different.

But if you think the prices your dentist charges are inflated, you can compare and get a good idea if he jacked up his prices to compensate for accepting the plan. Seems to me that would be unethical. I don't believe most doctors are deceitful that way.
Cubs Fan
Posts: 150
Joined: Wed Nov 11, 2020 11:22 am

Re: Retirees - Dental Insurance vs. Dental Plan

Post by Cubs Fan »

We are retired and live in AZ. We do not have dental insurance nor a dental plan. Instead, we go to a dental hygiene college twice a year. They provide free x rays. The treatment is absolutely free. The treatments are done by students under the supervision of a dental hygiene instructor. After the x rays have been completed a dentist exams your teeth. If any problems are evident they provide a copy of your x rays on a flash drive so that you can go to the AZ School of Dentistry to have the corrective procedures done. The only drawback is that a normal visit requires 3 to 4 hours of your time.

Once you arrive at the School of Dentistry they will assign a 3rd or 4th year student dentist to complete the required work. All procedures at both institutions are supervised by experienced hygienists and dentists. While the teeth cleaning and x rays are free, the dental work is extremely low cost. Again, you must allow for 3 hours or more at the Dental College. Our dental expenses have been next to nothing along with excellent care for the past 7 years in retirement. I highly recommend this to anyone who has the time and wants to save money.
wait until next year!
michaelingp
Posts: 932
Joined: Tue Jan 17, 2017 7:46 pm

Re: Retirees - Dental Insurance vs. Dental Plan

Post by michaelingp »

Starfish wrote: Tue Dec 07, 2021 8:20 pm Patient's with basic delta etc will usually get a lower standard of care.
Are there any reliable studies on this? I am certain my dentist would never change to a lower standard of care for a particular patient based on re-imbursement, but I only have a sample size of one. Wouldn't you know if the standard of care was inadequate and just find a different dentist? Well, actually, I have a sample size of two, one dentist who took insurance and one who didn't. The standard of care seemed identical, but how would I know? But if there's no way for me to know, why would I care? Also, my insurance only pays for two cleanings a year, but I get three. If what you say is true, wouldn't the standard of care of my third cleaning be lower than the first two?
Starfish
Posts: 2996
Joined: Wed Aug 15, 2018 6:33 pm

Re: Retirees - Dental Insurance vs. Dental Plan

Post by Starfish »

michaelingp wrote: Wed Dec 08, 2021 5:28 pm
Starfish wrote: Tue Dec 07, 2021 8:20 pm Patient's with basic delta etc will usually get a lower standard of care.
Are there any reliable studies on this? I am certain my dentist would never change to a lower standard of care for a particular patient based on re-imbursement, but I only have a sample size of one. Wouldn't you know if the standard of care was inadequate and just find a different dentist? Well, actually, I have a sample size of two, one dentist who took insurance and one who didn't. The standard of care seemed identical, but how would I know? But if there's no way for me to know, why would I care? Also, my insurance only pays for two cleanings a year, but I get three. If what you say is true, wouldn't the standard of care of my third cleaning be lower than the first two?
First let me clarify: it is not the work that is lower quality, no honest dentist would do that. But the material, the lab etc. are cheaper.
Insurance pays for the cheapest and most basic treatment, for example the cheapest type of crown or cheapest type of operation. Many times it is actually under or barely at cost. And sometimes it forces the dentist to perform suboptimal work.

I agree, there is no simple way for you to know, this is why the insurance can get away with it. The results show up on long term, statistically speaking, but even then how do you know that was not normal?
Last edited by Starfish on Thu Dec 09, 2021 12:04 am, edited 1 time in total.
adventure
Posts: 14
Joined: Sat Sep 15, 2018 7:20 pm

Re: Retirees - Dental Insurance vs. Dental Plan

Post by adventure »

That's why a dental plan is a good option. There are no limits, if you want a gold crown, you can have it. Many insurance policies will not cover gold crowns or inlays.

My sister fell on a patch of ice and hit her jaw on her car bumper, requiring extensive dental work. With a dental insurance policy, in this case what do you do, get a couple teeth fixed, and wait until following years to fix the rest because there is a $2,000 annual cap on the insurance policy?
dbr
Posts: 46137
Joined: Sun Mar 04, 2007 8:50 am

Re: Retirees - Dental Insurance vs. Dental Plan

Post by dbr »

Unfortunately, in practice dental costs are an expense that needs planning for rather than a risk that can be insured.

When one is fortunate enough to not need a lot of dental care this tends to be relatively negligible. For older people or when accidents happen costs in the thousands can come along. This is not fun for sure, but it is real.

It should still be true that a plan or insurance that results in negotiated costs would help.
UALflyer
Posts: 1035
Joined: Thu Jan 17, 2013 9:42 am

Re: Retirees - Dental Insurance vs. Dental Plan

Post by UALflyer »

Starfish wrote: Tue Dec 07, 2021 8:20 pm
adventure wrote: Tue Dec 07, 2021 3:59 pm
UALflyer wrote:
For instance, a number of dental plans only provide percentage discounts (something like 40% off certain fees), which are meaningless, as the providers simply inflate their fees and then apply all these percentage discounts to them.
Really? I'm glad I have an honest dentist who doesn't inflate his prices to take advantage of patients.
You see this the wrong way.
It is not the dentist that inflates prices, it is the insurance/plan that underpays. For dentists to make this profitable they have to take shortcuts that are never in patient's interest. Patient's with basic delta etc will usually get a lower standard of care. The difference ion cost for far superior care can be sometimes only 10-20%, but the insurance does not allow it.
It's very similar when collect bids for construction, or renovation. If you are not in the business and you don't know and list in detail what to ask, you get lower bids at the price of very different quality or lifetime. Sometimes a 200$ addition in a 10k$ could make a large difference in the lifetime of the finished result.
Again, the issue is in differentiating between paying more for higher quality, versus just being charged more for the same or lower quality.

As I mentioned above, it's virtually impossible for consumers to assess their providers' clinical skills, so people's assessments and reviews tend to focus on things like the provider's bedside manner, how nice the office is, etc.., which doesn't have anything to do with the person's skill and quality.

From a dental provider's standpoint, accepting dental insurance increases the overall patient volume and decreases the amount of marketing that the dental provider has to do to get patients in the door. Hence, also the reason that if a general dentist is older and has been around a long time in the same location, there's just a higher likelihood that he/she has more established patients some/many of whom already don't have dental insurance, such that the dentist can go out of network without losing a substantial revenue stream. This is also the reason that orthodontists, for instance, usually can't do that, as the very nature of their practice means that their patients are always changing and that they constantly need to attract new ones, which makes it much more difficult for them to stop being in-network with all insurance policies.

Hence, whether a dental provider takes insurance or not tends to have very little correlation with the provider's competence and quality.
Starfish wrote: Wed Dec 08, 2021 8:46 pm Insurance pays for the cheapest and most basic treatment, for example the cheapest type of crown or cheapest type of operation.
What dental insurance covers and does not cover varies widely, so that insurance plan particulars matter. I don't think that people are suggesting that every single dental insurance policy out there is cost effective, worthwhile, etc...

The point that many of us are making is that for the reasons that have been mentioned in this thread, which extend far beyond the actual annual coverage caps, there are a lot of dental insurance policies out there that are cost effective and worthwhile.
Last edited by UALflyer on Thu Dec 09, 2021 10:00 am, edited 1 time in total.
UALflyer
Posts: 1035
Joined: Thu Jan 17, 2013 9:42 am

Re: Retirees - Dental Insurance vs. Dental Plan

Post by UALflyer »

adventure wrote: Wed Dec 08, 2021 10:08 pmMy sister fell on a patch of ice and hit her jaw on her car bumper, requiring extensive dental work. With a dental insurance policy, in this case what do you do, get a couple teeth fixed, and wait until following years to fix the rest because there is a $2,000 annual cap on the insurance policy?
In this situation, a ton of medical insurance plans would cover the cost.
michaelingp
Posts: 932
Joined: Tue Jan 17, 2017 7:46 pm

Re: Retirees - Dental Insurance vs. Dental Plan

Post by michaelingp »

UALflyer wrote: Thu Dec 09, 2021 9:39 am
adventure wrote: Wed Dec 08, 2021 10:08 pmMy sister fell on a patch of ice and hit her jaw on her car bumper, requiring extensive dental work. With a dental insurance policy, in this case what do you do, get a couple teeth fixed, and wait until following years to fix the rest because there is a $2,000 annual cap on the insurance policy?
In this situation, a ton of medical insurance plans would cover the cost.
That, plus barring a catastrophic accident like this, many (if not most) dental procedures actually can wait for the next year. I had a tooth extracted and didn't have it replaced for a decade or so. When I finally did, I had two to replace, so I had one done one year and one done the next.
UALflyer
Posts: 1035
Joined: Thu Jan 17, 2013 9:42 am

Re: Retirees - Dental Insurance vs. Dental Plan

Post by UALflyer »

adventure wrote: Tue Dec 07, 2021 3:59 pm Really? I'm glad I have an honest dentist who doesn't inflate his prices to take advantage of patients. If anyone has such a crook for a dentist, sounds like time to find a new doctor fast.
With a dental plan, how would you know, as the dentist is the one interpreting the plan terms without any oversight.

I am not casting aspersions on your particular dentist, as I obviously don't know him/her. I am just explaining the reason that most dental discount plans just don't work well. With a dental discount plan, there's no specific fee schedule that the dentist has to abide by and the provider can use multiple line items to come up with a fee. A discount dental plan that shows you an "average" fee per line item doesn't tell you a whole lot, as each provider isn't required to accept that fee, and the patient has no way of knowing what line items can be used together or not.
Another benefit of a dental plan is there are no time limits on services in a calendar year. With a dental plan, if you choose to have more than two cleanings per year, no problem. Using the plan, If the cleanings every six months don't fit your schedule, no problem. This came in handy when going on a month long overseas trip, and I wanted the next cleaning before the six month mark.
A ton of dental insurance policies provide for dental cleanings twice a year rather than every 6 months, so what you're describing isn't an issue.
It's really a coin toss which is better, dental insurance or a discounted plan. I like the plan as there is no ceiling, no co-pays, no annual deductibles, and no dental services that are not covered. If I need three crowns in one year, no problem.
With most dental insurance policies, even if you exceed the policy maximums for the year, the dentist still has to abide by the fee schedule, so you still benefit from the in-network discounts.
Last edited by UALflyer on Thu Dec 09, 2021 11:33 am, edited 1 time in total.
rsgdmd
Posts: 30
Joined: Sun Dec 30, 2012 12:59 pm

Re: Retirees - Dental Insurance vs. Dental Plan

Post by rsgdmd »

As a recently retired Dentist, I thought I'd weigh in. Dental insurance / dental plan - both are ways to get more patients coming to the office. In areas with lots of dentists, getting new patients can be difficult. Taking insurance/plans helps, esp. for Dentist just starting out.
But these plans mean working for less money. You hope patients with these plans will refer patients who pay out of pocket, but often not the case. So, Dentists with heavy insurance participation need to work more quickly to make up for lower fees. If you want personalized attention, having a discount plan may not be for you. Often will use less expensive labs for patients with poor reimbursement rates. Some insurance companies own low cost dental labs, who usually offshore their work, often to China.
As some have mentioned, many dental insurance plans are not financially beneficial, esp. if buying as individual, as opposed to thru employer. Even plans with AARP rarely work out, due to waiting periods, maximums, etc. If cost is an issue, see if your present dentist participates with any plans and then check those plans out. If you're looking for a Dentist, compile a list of nearby Dentists who either are recommended to you or get good reviews.
Then look for them on lists of providers from different plans. If a plan won't send you their list of providers (or have it online), walk away. Also, make sure the list shows those who aren't accepting any new plan patients.
You are essentially paying a yearly fee (usually around $100) for a list of Dentists willing to accept the plan's fee schedule. That's it. Don't bother comparing their "average dental fee" with the plans' fee. Those average fees are generally very inflated to make the plan look better. Don't go with a plan that says you get X% off; you want to know the fee. Don't expect the best when you're paying a discount. Dental Insurance/Plans pay for Chevys, not Cadillacs.
Post Reply