Does Aetna offer individual dental plans?

[LostDollar]

@DS4

Not asking you to read any of the previous posts in the thread, but for the benefit of @Patrick Flammia, I wondered if you would consider stopping by and providing your "I don't think an agent should bother with dental insurance" perspective. He is struggling with the issue and I think your comments as an agent to another agent would be good counterbalance to my consumer "dental insurance is hot stuff" comments.

 

[Chazm]

Does he take cash? Manhattan allows the patient to use any dentist. No network required.

Yes, that’s how I use it now. It’s supposed to be easy to upload the receipt and get reimbursed but it’s really a PITA. Half of the time I’m calling and fighting to get it paid. One time I got a second cleaning a week before my 6 months and they denied it. They love to deny. The $100 DED is bad too.

 

[goillini52]

Yes, that’s how I use it now. It’s supposed to be easy to upload the receipt and get reimbursed but it’s really a PITA. Half of the time I’m calling and fighting to get it paid. One time I got a second cleaning a week before my 6 months and they denied it. They love to deny. The $100 DED is bad too.

Yep, they only cover that every 6 months. Didn't your agent cover that with you?

I don't like the deductible either. The Select plan can have it or not. I only sell it with no deductible. It's only $5 more a month to not have it.

 

[LostDollar]

Yes, that’s how I use it now. It’s supposed to be easy to upload the receipt and get reimbursed but it’s really a PITA. Half of the time I’m calling and fighting to get it paid. One time I got a second cleaning a week before my 6 months and they denied it. They love to deny. The $100 DED is bad too.

There's an issue I forget about when making comments out of the blue. Some do 1 cleaning every 6 months, others do 2 cleanings per year. Watch to see the plan you want does 2 per year or you will have that problem again.

Deductibles also have a lot of variation, can't remember where Ameritas falls.
First watch amounts. $50, $75, $100.
Then annual or lifetime.
Then will they exclude preventive services from the deductible.

Then watch placement of Cleaning, Cleaning exams, and cleaning x-rays. (Can't remember codes off the top of my head.)
I'm thinking I saw one or two very inexpensive plans that put the cleaning in preventive, but put the cleaning exam and annual cleaning xray set in basic, so they were subject to the annual deductible. As the plan price goes up, you should see all three going to preventive.

Another thing that is tricky is the dental exam for a visit complaining of pain. the year I started with root canal and crown I had several "pain" visits. I think the right code is D0140. I think UHC paid something on all of them, and I think the code was in preventive. I know BCBSKS paid something on all of them and again I am pretty sure it was preventive. This is where Delta Dental KS would have gotten me. They allow )only) one D0140 charge per (policy) year AND they put it in Basic where it is subject to Deductible. So if I had had Delta that year, and it had been my only Dental insurance, I would have had to pay full charge, with NO network adjustment for 4-5 D0140 pain exams.

Fillings, understand that most plans will not cover white (resin) fillings on posterior teeth, whether the dentist will accept the reimbursement as payment in full is up to them. also watch for restrictions on number of fillings per tooth.

Some plans will not cover a root canal if a filling has been placed on the tooth x months prior to root canal.

Apologies if you have already connected with all those things, they are just "issues" I've run into in the last 2-3 years.

If Ameritas has waiting periods, you will have to check to see if the Manhattan plan will cause them to be waived.

 

[Chazm]

Yep, they only cover that every 6 months. Didn't your agent cover that with you?

I don't like the deductible either. The Select plan can have it or not. I only sell it with no deductible. It's only $5 more a month to not have it.

Nope, because I’ve yet to find a summary of benefits. Lol
We don’t have the select plan option in FL. Two options, $1k or 1.5k both with $100 ded.

 

[goillini52]

Nope, because I’ve yet to find a summary of benefits. Lol
We don’t have the select plan option in FL. Two options, $1k or 1.5k both with $100 ded.

We have a $3,000 option on both plans. The brochure says semi-annual exams, cleanings and x-rays...would be better if they said every 6 months.

On the back of the brochure, it tells to go to: disclosure.manhattanlife.com [EXTERNAL LINK] - Health Insurance Pre-enrollment Disclosures | ManhattanLife for a list of exclusions, limitations and definition of pre-existing conditions for all of their products.

The only time I sell the Select plan is when somebody needs immediate benefits for Major dental work.

 

[Newby]

I see individual dental insurance as sucker bait. I see ZERO value to it. But people who know nothing about health insurance have always used dental as a gauge to whether they have “good” insurance or not.
He has great health insurance at his new job. He even has dental!
If dental can get an agent in the house to review their real coverages then it has done all it’s supposed to do.

 

[LostDollar]

I see individual dental insurance as sucker bait. I see ZERO value to it. But people who know nothing about health insurance have always used dental as a gauge to whether they have “good” insurance or not.
He has great health insurance at his new job. He even has dental!
If dental can get an agent in the house to review their real coverages then it has done all it’s supposed to do.

Perhaps because we have different life circumstances, you and I see the value in dental insurance completely differently.

Using the word "other" rather than "real", I have no problem with the idea of an agent using dental as an opening to review other insurance coverage with a prospect.

 

[rousemark]

Yep, they only cover that every 6 months. Didn't your agent cover that with you?

I don't like the deductible either. The Select plan can have it or not. I only sell it with no deductible. It's only $5 more a month to not have it.

Aetna;s Dental Plus has no waiting periods except for Orthodontics and no deductible for basic care.

 

[goillini52]

Aetna;s Dental Plus has no waiting periods except for Orthodontics and no deductible for basic care.

In Illinois the Plus Plan has $100 deductible on everything but preventive. Also, Manhattan Select pays $200 a year for glasses, Aetna $200 every 2 years. Manhattan pays $750 per ear on hearing aids, Aetna pays $500.

Manhattan's with no deductible is cheaper than Aetna that has the deductible.

Manhattan wins hands down.