Dental coverage

[cadylou]

on more thing

To add to that Jen, what are the annual maximums? Many of the plans I sell have annual maximums anywhere from $1000/yr to $1600/yr. I know from my own experience that a root canal & crown can run $1200 in one shot. I'd be interested if your plans have a higher annual max.

 

[sillyroeske]

Hmmzz

I really dont believe the salesmen/women @ being honest here... Dental is a complete rip off. I sell insurance im not going to sit here and try to scam people for the $$. You get some 80/20 plan based on deductible and then some 50/50 of big stuff up to some small amout of $$.
Really its better to fund an HSA. If you have more questions email me @ [email protected]

 

[Crabcake Johnny]

Just fully explain how it works. I believe the PDF file said it's about $70 a month for family coverage. That's $840 a year so you'd better be using it a lot to make it even remotely worth it. I dropped my discount plan and we simply pay the see the dentist out of pocket - he gave us a discount just because I asked. I pay around $70 for teeth cleaning which includes the bitewing Xrays.

There's three of us so that's $240 a year. A dental discount plan was $12 a month. Sounds good? Ok, that's $144 a year and here's the fee schedule: http://careington.com/products_dentalandvision.aspx - just pull up your state.

My state:
Oral exam - $17
Xrays - $22
Adult cleaning - $32
Total - $71

Any discount there? Nope - which is why when clients actually go to use these they're not happy. I had clients calling me saying they actually paid MORE for dental procedures with the discount plans I sold them then when they just paid out of pocket with nothing.

Clients are also confused because they forget to add up the charges. They see "adult cleaning $32" and erroneously think it's $32 to get their teeth cleaned. But no dentist I know of will just clean a new patient's teeth - it's an oral exam and xrays. They also try to up-sell the flouride treatment and it's all a seperate charge.

I have many dentists as clients and we've talked about these plans at great length. They hate them. The only reason they sign up is to attract new clients but they're confusing and 99 times out of 100 the client owes far more than they thought they'd owe.

 

[somarco]

It get's even worse.

The insured dental plans pay 80% of what? Most have a schedule of reasonable & customary charges. Just like the med plans without a network, if your provider charges xs of the schedule you pay the difference.

 

[Crabcake Johnny]

You just have to do money-difference. Dental insurance touts "free preventive" but nothing is free. The monthy rate is high.

How 'bout this offer:

"Free dinner for a family of 4 at Ruth's Chris. Just pay $80 a month for a year."

Well, would you do that?

How 'bout reading the fine print:

*free dinner only includes a chicken entree and salad. Any steak entree will only be reimbursed at 80% of the usual and customary charges set by the USDA."

 

[aufan]

I would say about 80 percent of the buying public think you ought to pay about $80/mo for coverage and it pay for EVERYTHING.

Fact is you'd be better funding your HSA account to pay for your routine dental work with tax deferred and tax advantaged money(s). What most people have a hard time grasping is the concept of insurance is for THE UNEXPECTED not the ROUTINE. I find this my biggest challenge in educating consumers.

Ask them this.....do you buy auto and home coverage and expect for them to pay for the chimney cleaning and oil changes?

 

[J.R.]

Ask them this.....do you buy auto and home coverage and expect for them to pay for the chimney cleaning and oil changes?

Chimney cleaning, I like it.....

 

[MoneyManager]

Discounted dental and MEDICAL plans

I see what John thinks about the discount fee plan... but am confused by his numbers.

The dentist I was going to was charging me over $140 for a visit, which included xrays and cleaning.

You say yours only charged $70. But you are savvy enough to ask upfront for a discount... do you think the average consumer knows, or wants to do that?

I imagine that fees vary anyway from dentist to dentist and from state to state... but is there somewhere a consumer could go to see what the normal and customary fees are for UNINSURED people in their area?

Because of COURSE you have to do the math on these. I had a discount plan years ago... (and now a friend is selling one)... and it saved me about $600 right away becuase I had work I needed to have done. However I dropped it later because for a single person with no ongoing issues... like for John.. the math did not add up.

But ... as I mentioned.. I have a friend selling these through one of the bigger discount plan companies. She was trying to get me on board, but for me... the math does not work.

I imagine you have to know...

Reasonable and customary fees for the UNINSURED as opposed to the insured ...in order to make a cost analysis to see if it is beneficial.

They are different are they not? I called a new dentist recently and before they booked me for an appointment they wanted to know if I was insured. I asked them why they needed to know.... did they charge me more if I was uninsured... rather than insured?

The girl hesitated, and said no... but was I insured? I said I would rather not say. I asked if they had something they could fax me with their fees on it... so I could check it out. She said they did not. She also was hesitating to give me an appointment without my answering that question... so I just hung up.

Do consumers know that many health care providers charge differently when they are not insured at all? Do all health care providers have a double standard when billing?

How many health care providers will give patients a fee schedule before they come in for a appointment?

What do people think about discount fee for service plans? Are they something that some agents carry ...along with regular insurance plans?

My friend is selling this one ( http://www.dentalandmedicalbenefits4all.com ) which costs about $12 a month and you go to a dentist in the network who simply guarantees a discounted fee for your work... you know the exact amount before you go though... so you are not surprised when you go to pay.

This company also has discount-fee-for-service MEDICAL which is higher (about $50 a month or so).

I would think that real insurance is always better, right?

But do you run into clients that can not qualify for regular insurance, can not afford it, ... or have to have work done faster, that this would be appropriate for?

The differences this seems to have (at least in my eyes) is that it...

has no waiting period
everyone qualifies
lower cost than insurance plans
covers entire household - regardless of number in it
no exclusions for pre-existing conditions
(my nephew has diabetes and can not find any reasonable coverage so is on medicaid)

It DOES only get the patient discounts on services... but they range from 20-80% discounts depending on the service... and you know upfront what the fee is.

One thing that I THINK is a value... is that it locks in rates for the uninsured. There was a big article in the paper recently about a man that had to have a heart operation here in Orlando. If he had been insured... the hospital would only have charged $60,000 or so for the procedure. But because he was not insured... the hospital billed him over $130,000. for the exact same procedure.

Is this as common as the article I read seemed to imply?

Is it because the insurance companies sort of force the hospitals to keep their billing to an amount the company is willing to pay?

I was pretty shocked by that article... but I figure that a discount plan would solve that issue (in most/some cases) for folks that cannot qualify (maybe due to a pre-existing condition) for traditional health or dental insurance.

Anyway... my friend has just started with this product... and I wonder if it would be worth her time to contact independent insurance agents to carry this product (monthly carry cost is about $50 a month to represent product... but it pays on a residual basis).

Please let me know what you think.

MM

 

[Crabcake Johnny]

Once you start selling a lot of these plans you start to see a pattern in client complaints:

*Schedule an appointment with a dentist on the list. Get to appointment, whip out discout card, no one there has ever heard of it.

*Get procedure done, bill doesn't even come close to the schedule of benefits you agreed to.

After after too many of those pissed calls AND my personal experience I simply stopped recommending them.

 

[MoneyManager]

Thanks John!

Good insight.

I will pass that along to my friend.

As I mentioned... I did use the same company she is selling for a while. I did not experience that. I am leary though of errors and miscommunication issues... so I DID tell them when I made the appointment I was part of that discount plan and verified they were familiar with it and still accepted it.

I also took the fee schedule with me when I went (so I could double check). I actually took 2 - in case the office wanted one - but they had one on file already.

I can see though.. where this would be a problem with some plan companies. I do know that the dentist I was seeing... he said he actually accepted about 12 different plans like this. So if it was a smaller one that did not show up often... I am sure that sometimes the staff might not be informed.

Perhaps my friend could nip this issue in the bud by provided to her clients a "how to use the plan" sheet... with instructions on making appointments the right way... so this would not occur (I do not know if the company does that on its own).

Thanks again!

MM