Dental Insurance for Implants

[fed up]

Wow, that's deep!

 

[jbrspar]

I have been an insurance agent for 47 years and I haven't seen an individual dental plan I would buy for myself. You are basically swapping dollars with the insurance company.

Well then you need to get out more. The UCR on a crown is about $1,400 in Phoenix. The minute you present an insurance card, the dentist now has to lower his rate from the “street” rate to a MAC (maximum allowable charge) rate. That brings the cost of a crown down from $1,400 to about $800 before you even sit down in the chair. Now let’s say you get a policy with 20% coverage on major procedures from day one. So the insurance company pays $160 on your $800 crown and you’re left with the remaining cost of $640. So you’ve given the insurance company one premium payment of $60 (or less) and in return, they’ve reduced the cost of your crown from $1,400 down to $640, saving you $760. So tell me again how you’re “basically swapping dollars with the insurance company”?

 

[ehall2]

You make a good point, but I am in Georgia and it doesn't work that way here. Most dental plans are for preferred providers and there isn't a dentist in my town that is in the network and they don't reduce prices for anyone.

 

[fed up]

Well then you need to get out more. The UCR on a crown is about $1,400 in Phoenix. The minute you present an insurance card, the dentist now has to lower his rate from the “street” rate to a MAC (maximum allowable charge) rate. That brings the cost of a crown down from $1,400 to about $800 before you even sit down in the chair. Now let’s say you get a policy with 20% coverage on major procedures from day one. So the insurance company pays $160 on your $800 crown and you’re left with the remaining cost of $640. So you’ve given the insurance company one premium payment of $60 (or less) and in return, they’ve reduced the cost of your crown from $1,400 down to $640, saving you $760. So tell me again how you’re “basically swapping dollars with the insurance company”?

Because most all dental plans have an annual max payout so in your example $60/month X 12 months = $720 in premium weighed against that max payout.

 

[Chazm]

I had to replace my crown last month. With my insurance it was $700. I asked him what if I cancel my insurance and paid cash. He said I’ll charge you $1400. Not all of them lower the cash price.

 

[LostDollar]

Well then you need to get out more. The UCR on a crown is about $1,400 in Phoenix. The minute you present an insurance card, the dentist now has to lower his rate from the “street” rate to a MAC (maximum allowable charge) rate. That brings the cost of a crown down from $1,400 to about $800 before you even sit down in the chair. Now let’s say you get a policy with 20% coverage on major procedures from day one. So the insurance company pays $160 on your $800 crown and you’re left with the remaining cost of $640. So you’ve given the insurance company one premium payment of $60 (or less) and in return, they’ve reduced the cost of your crown from $1,400 down to $640, saving you $760. So tell me again how you’re “basically swapping dollars with the insurance company”?

Caveat, not an agent.

It seems to me like you are presenting a rather skewed view there.

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How is this:
"The minute you present an insurance card, the dentist now has to lower his rate from the “street” rate to a MAC (maximum allowable charge) rate."
a universal statement of truth?

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You say a person gets a major dental service for one premium payment:

So you’ve given the insurance company one premium payment of $60 (or less) and in return, they’ve reduced the cost of your crown from $1,400 down to $640, saving you $760.

In what world does that happen?

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[Blueback]

You make a good point, but I am in Georgia and it doesn't work that way here. Most dental plans are for preferred providers and there isn't a dentist in my town that is in the network and they don't reduce prices for anyone.

What town are you in (zip code)? I will bet you dollars to donuts I have a solution for you.

 

[Blueback]

Caveat, not an agent.

It seems to me like you are presenting a rather skewed view there.

---------------------------------------------------------------

How is this:
"The minute you present an insurance card, the dentist now has to lower his rate from the “street” rate to a MAC (maximum allowable charge) rate."
a universal statement of truth?

-------------------------------------------------------

You say a person gets a major dental service for one premium payment:

So you’ve given the insurance company one premium payment of $60 (or less) and in return, they’ve reduced the cost of your crown from $1,400 down to $640, saving you $760.

In what world does that happen?

---------------------------------------------------------

There are a number of plans that work that way actually.

 

[adjusterjack]

I had to replace my crown last month. With my insurance it was $700. I asked him what if I cancel my insurance and paid cash. He said I’ll charge you $1400. Not all of them lower the cash price.

The entire medical profession works that way.

 

[Chazm]

The entire medical profession works that way.

Then why did everyone above this mention that you get a discount without insurance? I’m agreeing with you fyi