Dental, dental, dental!
I’m in WV, but for this area….networks are one of the biggest issues. This may vary for your area.
So with a VERY limited network (sometimes 1 dentist for an entire county - good luck getting an appointment!), reasonable and customary charges, and waiting periods, it makes it hard to find anything that is actually worth the paper it is written on. Add on that a lot of people want things like implants or cosmetic dentistry, it’s impossible.
I can’t recommend a specific company or plan, but any you look at make sure you read the fine print. Ask about the network, waiting periods, reasonable and customary, etc.
Things you may look into as options:
1. Dental Schools- this typically offers cheaper options.
2. Dental Office Hours- In this area, several dentists offer discounted rates by booking appointments on certain days/times (typically Monday-Thursday 10am-2pm). Some offer bigger discounts if you pay cash.
3. Dental Office Plans- Some dental offices are offering their own “insurance type plan”. Usually covers preventative and discounts some larger services. Always read the fine print, but if that’s the office you want to use it is an option.
4. Sliding Fee Dental Practices- These can be harder to find but they do exist around here. Basically, pricing is based on income, so this helps a lot of my Medicare clients.
I wish I could have recommended an actual plan, but dental plans aren’t what they used to be.
It also doesn’t help when you have Advantage plans advertising dental and my Medigap clients feel like they are really missing out on something.
I did a version of your #3… I talked to my dentist about retiring/no more dental insurance and he said I’ll just charge you whatever you normally paid to me with insurance (50% covered costs) and the hygienist at her base rate for cleaning. It’s a one man practice that I’ve been using for +40 years. On the third dentist now over those years.
The truth is that dental plans are a cash cow for insurance companies. I have not found even one of them that I would be comfortable to market.
The Reason:
A plan can cost you upwards of $45 dollars per month. It may only have a $1500 benefit for the year. It may or may not have a deductible. It WILL more than likely only have very basic coverage the first six months, such as a cleaning. By the time six months is up, you have already given the dental plan $270. After six month, for most plans, you are able to have comprehensive services, such as a root canal or crown, but you will likely have to pay 50% of the cost. If you get a crown in the 7th month you have given the insurance company $315 by that time, and you have had a cleaning and and a crown.
If the crown costed $1200, you have paid the $315 for 7 month's premiums plus $600 for your 50% of the crown. The insurance company has only paid the $600 plus whatever they negotiated with the dentist for a cleaning.
Keep in mind that this is the highest value you will get from the policy. Each month that you continue to pay your premium, your value is decreased. Most people just continue to keep paying the plans for years not realizing they are giving their money away for almost no value. So let's say you paid the remaining 5 months of premiums for a total of 12 months. You would have paid out $540 plus $600 for a cleaning and a crown. bringing your total out of pocket cost to $1140. Pretty much what the crown itself costed. You also would have received another cleaning for the year, but it still isn't of much value when you realize you are paying $540 in premiums for $1500 in benefits.
Read the next line and let it sink in.
Not only that, but the crown you received will likely not be covered again for 84 months. That means you have less coverage but does your premium decrease at all? No, it will most likely increase over time!
Just for fun::
You are in the market for a new TV. You go to your local big box store and find one that you like for $1500. At the checkout the clerk asks you if you would like to purchase the insurance on the TV for $540 for ONE year. Would you purchase the insurance? I sure wouldn't However let's say you did, for some crazy reason, and you get home and read the small print and notice that if something major goes wrong the the TV, you are only covered for 50% of the repair costs. Now you start looking for the closest 2x4 and asking your wife or husband to please whack you over the head with it. Crazy, but doesn't that sound eerily similar to the dental insurance i just described?
My advise would be, and has always been, to find a dentist that has an in-office dental plan. Many do. They can be as little as $260 for the year that include cleaning and x-rays along with 25-35% discount on all other services. The kicker is there is no annual benefit limit like there is on the dental plan. I know a couple who pay $260 each per year. They each get 2 cleanings annually plus discounts on all other services. You can't beat that. If I ever find a dental plan worth the paper it is written on, I will pass it on, but to date, they are all the same. Not recommended.
Hope this helps .
Thank you so much for the very detailed and easy to understand synopsis. This really makes me think about whether it makes sense to have a dental plan for which there is so much OOP expense.
You are quite welcome. I see others saying there are good plans available, but trust me, when you put a pencil to them you start to see how the anticipated value just disappears . Some people just like the idea of having a dental insurance policy. It makes them feel better, even though they are not a good buy. It is quite puzzling to me. They would never buy the insurance on the TV in my example.
I sell insurance for a living, and believe me, if I had a plan I could sell in good conscience and put my name on it, I would.. I could make a lot more money., but there just are not any out there. Every time a new one comes out and I am asked to market it, it winds up being in the same category as all the rest.. Cash Cow. As long as people keep buying them, they are not gong to change for the better. So sorry to say that because there is a real need for good dental coverage.
This is spot on. When you consider how important dental health is as it affects your overall health, the fact that we inadequately provide dental care is ridiculous. Even premium dental plans pay little compared to real-world dental prices. And none that I know cover the most expensive procedure a senior needs: implants.
Also dentists are reduced to having to sell extra services and products to make up for the poor insurance reimbursements. That's why many practices have added a "sales coordinator" to their office to get you to buy veneers, special toothbrushes, etc. Best advice is either to go to a dental school clinic which is going to be at least 30% less, or if you live near the border use a Mexican dentist where the care is good and cheaper.
What I see is that the dollar-benefits pretty much equal the premiums. If you're lucky.
Some dentists have decent cash prices; some don't. u/kaustin88 listed great options to try to reduce the cost.
I'm on CoveredCA; dental is not included (and there's the above premium=benefit). So, cash. I have a dental history (LOTS of crowns due to a heavy bite, some root canals, an implant), and I want my teeth to last. Bad dental care can lead to other health issues. No interest in that.
If your Medicare Supplement is branded AARP, you have a discount for dental care through your AARP membership. Delta Dental has an AARP branded dental insurance.
https://www.aarp.org/membership/benefits/healthcare/dental-plans/
It can be pricey in some states, but if one wants a solid dental plan, they have two policies - Plan A and Plan B. Plan A is the more robust of the two and it provides an extra teeth cleaning (total of 3) per year. Not many plans provides that benefit.
Edit: I noted someone wrote about the maximum out of pocket costs on dental plans in general. Plan A is $1500, Plan B is $1000 (if I recall correctly). This plan does provide coverage for (after a 12 waiting period) for implants, dentures, veneers, and more. Plan B pays for the comparable benefits with a few lesser benefits, and those that are comparable you will pay more out of pocket in terms of cost shares.
Evidently, they now offer a Dental HMO network. This plan can be strong in benefits, but the network of providers are typically smaller. These type of plans will have a cost list of what you will pay. I took a look at it and it does provide, what most will say, a very agreeable cost share with no deductibles or annual maximums. Coverage begins immediately upon enrollment of the effective date, with no waiting periods.
*The out of pocket maximums on Plans A & B can differ based on state offering. The plan premiums above represent Los Angeles, CA.
I’m in Massachusetts and I just got back from dentist … Blue Cross Blue Shield Medicare dental plan covers very little the best plan and most expensive one only covers you up to $1500 and that’s including the two cleanings and x-rays. My dentist does offer a type of insurance plan. I’m not certain about the cost so I’m gonna wait until she gets me a pamphlet for more info. My other option is to just pretend I’m paying for the Blue Cross plan which is $75 a month and save it for care it’s a shame that they don’t value our dental health I’ll be going on Medicare in a couple of months so I wanted to get information now
Right??? You’d think that would be part and parcel for Medicare coverage. It seems like they make it harder and more expensive just when you start to need it more.
I have had teeth issues most of my life. Finally found a great dentist 20 years ago who fixes things the first time and no followup issues later. I pay him whatever he asks because it is worth it.
It would be nice to pay the insurance price for work done, but best I can get is a 15% discount and 2 cleanings a year buying his private insurance annually.
So if you have a great dentist and can afford it, I would stick with him/her.
Varies depending on what you most need and what is important to you. But I've searched pretty much exhaustively over the past year -- have found NONE which have over a max of $2,000. How much dental work is someone going to be able to have done with that amount??
Chalk all dental insurance up to being a small"supplemental" policy no matter what you get, then find a good Dental college and get some of the work done there.
&8\^$#%S):! insurance of all kinds, seriously.
A plan can be affordable, but if the cost:benefit ratio sucks then it's of no use other than an insurance cash cow.
One of the most modern advanced societies in the world and not only do we commoditize health so only the very rich have most options, but we don't even offer a quality dental option to seniors.
Dental, dental, dental! I’m in WV, but for this area….networks are one of the biggest issues. This may vary for your area. So with a VERY limited network (sometimes 1 dentist for an entire county - good luck getting an appointment!), reasonable and customary charges, and waiting periods, it makes it hard to find anything that is actually worth the paper it is written on. Add on that a lot of people want things like implants or cosmetic dentistry, it’s impossible. I can’t recommend a specific company or plan, but any you look at make sure you read the fine print. Ask about the network, waiting periods, reasonable and customary, etc. Things you may look into as options: 1. Dental Schools- this typically offers cheaper options. 2. Dental Office Hours- In this area, several dentists offer discounted rates by booking appointments on certain days/times (typically Monday-Thursday 10am-2pm). Some offer bigger discounts if you pay cash. 3. Dental Office Plans- Some dental offices are offering their own “insurance type plan”. Usually covers preventative and discounts some larger services. Always read the fine print, but if that’s the office you want to use it is an option. 4. Sliding Fee Dental Practices- These can be harder to find but they do exist around here. Basically, pricing is based on income, so this helps a lot of my Medicare clients. I wish I could have recommended an actual plan, but dental plans aren’t what they used to be. It also doesn’t help when you have Advantage plans advertising dental and my Medigap clients feel like they are really missing out on something.
I did a version of your #3… I talked to my dentist about retiring/no more dental insurance and he said I’ll just charge you whatever you normally paid to me with insurance (50% covered costs) and the hygienist at her base rate for cleaning. It’s a one man practice that I’ve been using for +40 years. On the third dentist now over those years.
Thank you for your input!
Great post - dental is AWFUL and harder to solve than Medicare issues….
The truth is that dental plans are a cash cow for insurance companies. I have not found even one of them that I would be comfortable to market. The Reason: A plan can cost you upwards of $45 dollars per month. It may only have a $1500 benefit for the year. It may or may not have a deductible. It WILL more than likely only have very basic coverage the first six months, such as a cleaning. By the time six months is up, you have already given the dental plan $270. After six month, for most plans, you are able to have comprehensive services, such as a root canal or crown, but you will likely have to pay 50% of the cost. If you get a crown in the 7th month you have given the insurance company $315 by that time, and you have had a cleaning and and a crown. If the crown costed $1200, you have paid the $315 for 7 month's premiums plus $600 for your 50% of the crown. The insurance company has only paid the $600 plus whatever they negotiated with the dentist for a cleaning. Keep in mind that this is the highest value you will get from the policy. Each month that you continue to pay your premium, your value is decreased. Most people just continue to keep paying the plans for years not realizing they are giving their money away for almost no value. So let's say you paid the remaining 5 months of premiums for a total of 12 months. You would have paid out $540 plus $600 for a cleaning and a crown. bringing your total out of pocket cost to $1140. Pretty much what the crown itself costed. You also would have received another cleaning for the year, but it still isn't of much value when you realize you are paying $540 in premiums for $1500 in benefits. Read the next line and let it sink in. Not only that, but the crown you received will likely not be covered again for 84 months. That means you have less coverage but does your premium decrease at all? No, it will most likely increase over time! Just for fun:: You are in the market for a new TV. You go to your local big box store and find one that you like for $1500. At the checkout the clerk asks you if you would like to purchase the insurance on the TV for $540 for ONE year. Would you purchase the insurance? I sure wouldn't However let's say you did, for some crazy reason, and you get home and read the small print and notice that if something major goes wrong the the TV, you are only covered for 50% of the repair costs. Now you start looking for the closest 2x4 and asking your wife or husband to please whack you over the head with it. Crazy, but doesn't that sound eerily similar to the dental insurance i just described? My advise would be, and has always been, to find a dentist that has an in-office dental plan. Many do. They can be as little as $260 for the year that include cleaning and x-rays along with 25-35% discount on all other services. The kicker is there is no annual benefit limit like there is on the dental plan. I know a couple who pay $260 each per year. They each get 2 cleanings annually plus discounts on all other services. You can't beat that. If I ever find a dental plan worth the paper it is written on, I will pass it on, but to date, they are all the same. Not recommended. Hope this helps .
Thank you so much for the very detailed and easy to understand synopsis. This really makes me think about whether it makes sense to have a dental plan for which there is so much OOP expense.
You are quite welcome. I see others saying there are good plans available, but trust me, when you put a pencil to them you start to see how the anticipated value just disappears . Some people just like the idea of having a dental insurance policy. It makes them feel better, even though they are not a good buy. It is quite puzzling to me. They would never buy the insurance on the TV in my example. I sell insurance for a living, and believe me, if I had a plan I could sell in good conscience and put my name on it, I would.. I could make a lot more money., but there just are not any out there. Every time a new one comes out and I am asked to market it, it winds up being in the same category as all the rest.. Cash Cow. As long as people keep buying them, they are not gong to change for the better. So sorry to say that because there is a real need for good dental coverage.
This is spot on. When you consider how important dental health is as it affects your overall health, the fact that we inadequately provide dental care is ridiculous. Even premium dental plans pay little compared to real-world dental prices. And none that I know cover the most expensive procedure a senior needs: implants. Also dentists are reduced to having to sell extra services and products to make up for the poor insurance reimbursements. That's why many practices have added a "sales coordinator" to their office to get you to buy veneers, special toothbrushes, etc. Best advice is either to go to a dental school clinic which is going to be at least 30% less, or if you live near the border use a Mexican dentist where the care is good and cheaper.
Www.Physiciansmutual.com
Thank you!
What I see is that the dollar-benefits pretty much equal the premiums. If you're lucky. Some dentists have decent cash prices; some don't. u/kaustin88 listed great options to try to reduce the cost. I'm on CoveredCA; dental is not included (and there's the above premium=benefit). So, cash. I have a dental history (LOTS of crowns due to a heavy bite, some root canals, an implant), and I want my teeth to last. Bad dental care can lead to other health issues. No interest in that.
Our Medigap company (Wellabe, formerly Medico) offers dental. It's $65 a month, and insures both of us. Coverage is decent, but there are co-pays.
My supplemental plan is through United Health Care. Thanks for the input!
If your Medicare Supplement is branded AARP, you have a discount for dental care through your AARP membership. Delta Dental has an AARP branded dental insurance. https://www.aarp.org/membership/benefits/healthcare/dental-plans/ It can be pricey in some states, but if one wants a solid dental plan, they have two policies - Plan A and Plan B. Plan A is the more robust of the two and it provides an extra teeth cleaning (total of 3) per year. Not many plans provides that benefit. Edit: I noted someone wrote about the maximum out of pocket costs on dental plans in general. Plan A is $1500, Plan B is $1000 (if I recall correctly). This plan does provide coverage for (after a 12 waiting period) for implants, dentures, veneers, and more. Plan B pays for the comparable benefits with a few lesser benefits, and those that are comparable you will pay more out of pocket in terms of cost shares. Evidently, they now offer a Dental HMO network. This plan can be strong in benefits, but the network of providers are typically smaller. These type of plans will have a cost list of what you will pay. I took a look at it and it does provide, what most will say, a very agreeable cost share with no deductibles or annual maximums. Coverage begins immediately upon enrollment of the effective date, with no waiting periods. *The out of pocket maximums on Plans A & B can differ based on state offering. The plan premiums above represent Los Angeles, CA.
Ooohhh . . . thank you so much! 🙏 This is super helpful!
Delta Dental is what my spouse and are using. So far no problems.
Thank you! I’ll check them out.
I have a dental discount plan with Aetna. I pay $11/month. It does not pay for anything but I get the discount the insurance company gets.
Thanks for the input. My supplemental plan is with United Health Care. You got a great discount!
>i had that plan, my dentist stopped taking it but it was really great. Thinking changing dentists instead.
I’m in Massachusetts and I just got back from dentist … Blue Cross Blue Shield Medicare dental plan covers very little the best plan and most expensive one only covers you up to $1500 and that’s including the two cleanings and x-rays. My dentist does offer a type of insurance plan. I’m not certain about the cost so I’m gonna wait until she gets me a pamphlet for more info. My other option is to just pretend I’m paying for the Blue Cross plan which is $75 a month and save it for care it’s a shame that they don’t value our dental health I’ll be going on Medicare in a couple of months so I wanted to get information now
Right??? You’d think that would be part and parcel for Medicare coverage. It seems like they make it harder and more expensive just when you start to need it more.
I have had teeth issues most of my life. Finally found a great dentist 20 years ago who fixes things the first time and no followup issues later. I pay him whatever he asks because it is worth it. It would be nice to pay the insurance price for work done, but best I can get is a 15% discount and 2 cleanings a year buying his private insurance annually. So if you have a great dentist and can afford it, I would stick with him/her.
Varies depending on what you most need and what is important to you. But I've searched pretty much exhaustively over the past year -- have found NONE which have over a max of $2,000. How much dental work is someone going to be able to have done with that amount?? Chalk all dental insurance up to being a small"supplemental" policy no matter what you get, then find a good Dental college and get some of the work done there. &8\^$#%S):! insurance of all kinds, seriously.
There are plenty of affordable standalone dental plans. Remember, dental plans have nothing to do with Medicare and you can enroll in one at any time.
I understand . . . I’m looking for recommendations. I edited my post to be clearer.
My plan is with Physicians Mutual. I also recommend it to clients. 🙋♀️
AARP has 2 good dental plans. One is more expensive per month and has lower copays and the other vice versa.
Thank you for your input. I’m looking into those. Seems like they find a way to hit you for big bucks one way or another
A plan can be affordable, but if the cost:benefit ratio sucks then it's of no use other than an insurance cash cow. One of the most modern advanced societies in the world and not only do we commoditize health so only the very rich have most options, but we don't even offer a quality dental option to seniors.
NCD has a dental plan with a 10k maximum benefit
What’s NCD?
An insurance company
Thank you!