80% of the Usual and Customary charges.. They used to pay 80% of the actual charge but apparently they were getting hosed on that deal.. Here is the brochure (BTW, street is 40%)
Dropbox - Dental Vision brochure.pdf - Simplify your life
Dental Plans - who has good deals for Seniors?
- Thread starter myinsurebiz
- Start date
Dropbox - Dental Vision brochure.pdf - Simplify your life
- 6,965
Dental insurance plans
Under 65, see link above.
If you are looking for your family, that might be of use. If you are looking for something to sell, I don't know if UHC sells through agents. They do have a senior plan too, I don't know how it compares to other senior age priced dental plans.
I think I got the under 65 plan before they had developed the senior plan, at any rate they have let me keep that (under 65) coverage and the related rate.
4 things I have experienced so far,
The network is somewhat restrictive. I don't think it is as restrictive as, say Ameritas in my area, but much more restrictive than coverage like Delta or BX.
When you go away from general dentists to specialties, the networks appear to be even more restricted.
In regard to fillings, the one issue that has come up for me is that UHC will only pay for amalgam fillings on posterior teeth. So I had a dentist that would only do resin fillings. So I was going to be liable for the full charge, less their payment for amalgam fillings. No network repricing. (I think if the tooth would have been an anterior tooth, the dentist would have accepted UHC repricing and charged me only the difference between UHC allowance less their payment. My old dentist (retiring) just accepted UHC payments and allowed amounts, regardless of tooth position.)
I have a $1,000 plan, which has been fine up to now, but that might not be enough if one needs some fillings and major services in a given year. One just has to make a guess about care levels needed in relation to premiums they will have to pay.
Under 65, see link above.
If you are looking for your family, that might be of use. If you are looking for something to sell, I don't know if UHC sells through agents. They do have a senior plan too, I don't know how it compares to other senior age priced dental plans.
I think I got the under 65 plan before they had developed the senior plan, at any rate they have let me keep that (under 65) coverage and the related rate.
4 things I have experienced so far,
The network is somewhat restrictive. I don't think it is as restrictive as, say Ameritas in my area, but much more restrictive than coverage like Delta or BX.
When you go away from general dentists to specialties, the networks appear to be even more restricted.
In regard to fillings, the one issue that has come up for me is that UHC will only pay for amalgam fillings on posterior teeth. So I had a dentist that would only do resin fillings. So I was going to be liable for the full charge, less their payment for amalgam fillings. No network repricing. (I think if the tooth would have been an anterior tooth, the dentist would have accepted UHC repricing and charged me only the difference between UHC allowance less their payment. My old dentist (retiring) just accepted UHC payments and allowed amounts, regardless of tooth position.)
I have a $1,000 plan, which has been fine up to now, but that might not be enough if one needs some fillings and major services in a given year. One just has to make a guess about care levels needed in relation to premiums they will have to pay.
ive had UHC dental for many years and have had several resin based fillings, just had one done in the back 2 months ago
- 6,965
All I can tell you is what the dentist's office told me and how they computed what my copay would be after they got the coverage estimates back from UHC.
Just thinking about having dental coverage for $30-$35 a month, whatever the actual price is, and dealing with network restrictions and contract fine print make the UHC policy (in my market anyway) not quite so nice as one might think going in.
Just thinking about having dental coverage for $30-$35 a month, whatever the actual price is, and dealing with network restrictions and contract fine print make the UHC policy (in my market anyway) not quite so nice as one might think going in.
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- 6,965
I reread my post and see the confusion.
The essence of what the dentist said is that
UHC will pay for resin fillings on anterior teeth.
On posterior teeth UHC will only pay for an amalgam filling.
My old dentist did resin fillings everywhere in my mouth, took the UHC payment and wrote off 100 percent of the amount the UHC eob said I did not owe.
The dentist he sold his practice to was not going to do that. That dentist was going to do resin fillings on the posterior teeth, receive the UHC payment for an amalgam filling and then balance bill me for the practice's full retail charge for the resin filling less the UHC payment for their share of an amalgam filling.
I did not have any fillings done at that practice, so I do not know if they would have accepted UHC's in-network anterior resin filling rate as the full charge or whether they would have balance billed me an amount to get to their full retail charge for those fillings too.
I had the fillings done at a third dental practice that did accept the UHC in-network rates. That may not have been a good decision because I have had ongoing pain issues in those teeth. It is an open question as to whether the decay was too extensive to avoid filling and root contact or whether the dentist did not do a proper job.
The essence of what the dentist said is that
UHC will pay for resin fillings on anterior teeth.
On posterior teeth UHC will only pay for an amalgam filling.
My old dentist did resin fillings everywhere in my mouth, took the UHC payment and wrote off 100 percent of the amount the UHC eob said I did not owe.
The dentist he sold his practice to was not going to do that. That dentist was going to do resin fillings on the posterior teeth, receive the UHC payment for an amalgam filling and then balance bill me for the practice's full retail charge for the resin filling less the UHC payment for their share of an amalgam filling.
I did not have any fillings done at that practice, so I do not know if they would have accepted UHC's in-network anterior resin filling rate as the full charge or whether they would have balance billed me an amount to get to their full retail charge for those fillings too.
I had the fillings done at a third dental practice that did accept the UHC in-network rates. That may not have been a good decision because I have had ongoing pain issues in those teeth. It is an open question as to whether the decay was too extensive to avoid filling and root contact or whether the dentist did not do a proper job.
- Thread starter
- #16
- 5,993
Uni-Sex rates?
If this is FL When I used to work in the FL market I suggested the MetLife HMO, Have had few client on it and loved it, No limits but it is a network
that specific plan was only in FL I never looked into contracting just sent them there
Outside Of FL or NY I do use Manhatten life it pays well enough has the out of network and uses a pool of money for glasses dental and hearing you can use whatever % you want
Beyond that, i am not going to make dental a project, It has to be something easy to explain without hard networks and a take it or leave it way about it
I don't push it I don't chase them I don't want to spend a lot of time checking dentist after initial conversation finding dentist not in-network and that baloney
And certainly not for less than what Manhatten pays, its not enough even what manhattan pays
Marketers call me sometimes with something like a commission of 8% of $35 or $40
That's not worth the initial call never the less the maintenance
that specific plan was only in FL I never looked into contracting just sent them there
Outside Of FL or NY I do use Manhatten life it pays well enough has the out of network and uses a pool of money for glasses dental and hearing you can use whatever % you want
Beyond that, i am not going to make dental a project, It has to be something easy to explain without hard networks and a take it or leave it way about it
I don't push it I don't chase them I don't want to spend a lot of time checking dentist after initial conversation finding dentist not in-network and that baloney
And certainly not for less than what Manhatten pays, its not enough even what manhattan pays
Marketers call me sometimes with something like a commission of 8% of $35 or $40
That's not worth the initial call never the less the maintenance
Jude Ancis
New Member
- 2
If you have Medicare, then there's a plan that includes dental services.
Not unless you want to go with an advantage plan and lose control of you healthcare choices..
