Manhattan (CUL) Adds netword to Dental, Hearing, Vision

[CHBS]

I didn't notice that until after I posted.

Back when I was doing all the question stuff about Dental, the particular UHC plan I have was what I thought was the best potential cost/benefit relationship I could come up with.

When I was looking, UHC had 6 plans in their folder. Now they only have 4, so I think they dropped the one I have. (Maybe my 7 fillings in one visit claim ran them over budget.)

Their "senior" plan also seems to be a moving target. A couple of months ago when I went to UHC dental plans to check, when I put in my birthdate, they showed a combination DVH plan. I had to put in an under 65 birthdate to see the matrix I was looking for. Given the discussions in the CUL thread, today I wanted to look at the characteristics of the senior plan and it doesn't show up. All I find is stuff about UHC buying a hearing network last year and now having a great setup for hearing treatment and discounted hearing aids.

Are you appointed (running these in e-Store) or just going to their site?

 

[CHBS]

I didn't notice that until after I posted.

Back when I was doing all the question stuff about Dental, the particular UHC plan I have was what I thought was the best potential cost/benefit relationship I could come up with.

When I was looking, UHC had 6 plans in their folder. Now they only have 4, so I think they dropped the one I have. (Maybe my 7 fillings in one visit claim ran them over budget.)

Their "senior" plan also seems to be a moving target. A couple of months ago when I went to UHC dental plans to check, when I put in my birthdate, they showed a combination DVH plan. I had to put in an under 65 birthdate to see the matrix I was looking for. Given the discussions in the CUL thread, today I wanted to look at the characteristics of the senior plan and it doesn't show up. All I find is stuff about UHC buying a hearing network last year and now having a great setup for hearing treatment and discounted hearing aids.

I see you're in Kansas, I ran 66502 in the agent portal and got 4 Gen (senior) plans and when I did a u65 DOB, I got 6 options.

 

[goillini52]

Didn't know you wanted a quote and were you laughing at me with that emoji?!
If you want more than this email me and I'll send you a benefit summary
No waiting periods on any benefits (including major services), but benefits on basic and major reduced year 1 and 2. preventive paid at 100% day 1. $50 annual deductible on most plans, $100 on some.
The hearing benefit on the senior plans is an indemnity benefit that pays $75 towards hearing exam every 12 months and a building benefit for hearing aids that starts at $100 on day 1 up to $750 after year 3, plus the discount program that the carrier requires their commerical business to use because of how steep the discounts are. Not bad for a free hearing benefit and you don't take away from your dental annual max if you use it. Message me with what states you sell in and I can tell you the comp.

I was laughing at the "low utilizer" comment. Manhattan has a pool of money, so you can use the full annual max on any of the 3 areas of coverage, or split it up.

I'm at 55%/7%.

So, you're saying that UHC will pay $1,900 on a pair of dentures after the 2nd year?

What would they pay on dentures in the 1st year? 2nd year?

 

[CHBS]

I was laughing at the "low utilizer" comment. Manhattan has a pool of money, so you can use the full annual max on any of the 3 areas of coverage, or split it up.

I'm at 55%/7%.

So, you're saying that UHC will pay $1,900 on a pair of dentures after the 2nd year?

What would they pay on dentures in the 1st year? 2nd year?

I know how the Manhattan plan works. I"m appointed with them too I say low utilizer because if you get a pair of glasses and a root canal, you're well beyond $1000 or $1,500. Forget exams, x-rays, etc.

I'm not sure what you mean by 55%/7%. I'm guessing first year and renewal comp? That's not what I meant...

The major benefit is 50% after the 2nd year so if you had the plan with the $2,000 annual max and your dentures were more than $3,800 then yes...they plan would pay $1,900 towards your dentures.

 

[goillini52]

I know how the Manhattan plan works. I"m appointed with them too I say low utilizer because if you get a pair of glasses and a root canal, you're well beyond $1000 or $1,500. Forget exams, x-rays, etc.

I'm not sure what you mean by 55%/7%. I'm guessing first year and renewal comp? That's not what I meant...

The major benefit is 50% after the 2nd year so if you had the plan with the $2,000 annual max and your dentures were more than $3,800 then yes...they plan would pay $1,900 towards your dentures.

That UHC is sounding less impressive. You made it sound like it paid 100% after the deductibe. So, in year 3, the UHC pays 50% on Major up to $2,000 and Manhattan pays 80% up to $1,500. What does UHC pay on Major in Years 1 and 2?

 

[CHBS]

That UHC is sounding less impressive. You made it sound like it paid 100% after the deductible. So, in year 3, the UHC pays 50% on Major up to $2,000 and Manhattan pays 80% up to $1,500. What does UHC pay on Major in Years 1 and 2?

I've never come across a plan like you were thinking.... year 1 and 2 it pays 10% then 30% I think. Can't recall off the top of my head. But it's not excluded for waiting period so you will still get the 30%-40% network discount, which is really where the value comes in with dental.

That's cool it pays 80%, but that annual max comes fast with one major procedure and then you're wiped out on your hearing and vision benefit from a dental service. Again, that's what I was referring to when I said, "if you're a low utilizer", referring to the consumer.

But we have a different school of thought on it. I know a lot of people that love the Manhattan plan....I just ride a different wave on that one I guess!

 

[CHBS]

Not an agent.

I recently posted this in another thread, I've just hit one tricky thing in the UHC/GoldenRule dental.

I guess states have been passing laws that say dentists don't have to accept any network caps for services that the insurance carrier does not cover.

So UHC splits the mouth into (I think the right terms are) anterior and posterior teeth. So a dentist does a predetermination on three fillings for me. The eob comes back with a K96-UHC only pays for an amalgam filling on posterior teeth, if the dentist does resin there, the patient is liable for the full difference between UHC's allowed amount for amalgam and the dentist's charge for the resin. (plus your deductible if you have not paid that yet.) the old filling just popped out of one of those what were potential needs this spring. So I have a sorta pricey repair coming up.

It's doubly irritating because my old dentist that just retired took the UHC payments, no problem. Also interesting, I've called three dentists and I have a price range that varies by almost $40 for that one filling - i would not have expected that much.

But, as you say, preventive maintenance pays fine (except for flouride varnish).

I have not used the vision yet so that is becoming an expensive add-on. In my town, the UHC vision providers are limited, but there does happen to be one on the short list that I have been to and like. I do need a checkup, so maybe I'll try the benefit out this year. (I must have a slightly different plan than you are talking about because my vision is an extra charge every month. I think I may have an older-what would now be an under 65 plan-that is no longer available.)

I appreciate seeing your comments about UHC.

I'm a broker in Kansas....when I run the Manhattan zip code in the agent portal I see more plans than you are apparently seeing, but if you're not in NE KS then plans might be different. If you want to message me your zip I can see what I get on my end.

I'm not sure why the difference between the allowed amount and billed would be the responsibility on a pre-d if the dentist is in-network...UHC should be indicated that the provider writes that off. Something sounds off

 

[rousemark]

I've never come across a plan like you were thinking.... year 1 and 2 it pays 10% then 30% I think. Can't recall off the top of my head. But it's not excluded for waiting period so you will still get the 30%-40% network discount, which is really where the value comes in with dental.

That's cool it pays 80%, but that annual max comes fast with one major procedure and then you're wiped out on your hearing and vision benefit from a dental service. Again, that's what I was referring to when I said, "if you're a low utilizer", referring to the consumer.

But we have a different school of thought on it. I know a lot of people that love the Manhattan plan....I just ride a different wave on that one I guess!

You do the wave when selling FE not DVH...

 

[LostDollar]

That UHC is sounding less impressive. You made it sound like it paid 100% after the deductibe. So, in year 3, the UHC pays 50% on Major up to $2,000 and Manhattan pays 80% up to $1,500. What does UHC pay on Major in Years 1 and 2?

I had some reservations about the value of CUL (to me) a couple of years ago. My concerns are a little higher now. First there was the switch to reasonable and customary, from full charges, for new enrollees.

And then all of chazm's posts. I don't think he has any reason to lie about his client's experiences and when I read his posts, it is like he is describing an entirely different insurance carrier than how you and rousemark describe CUL.

I just checked my UHC policy and it also is only paying 50% on major services. However, in year one, it only required a 4 month wait, rather than 6 or more to start routine preventive services. MY preventive work each year (unlike some with better dental health) requires an annual bitewing exray set in addition to cleanings and exams. The sales literature suggested, but did not promise, that I might have better network caps with UHC than some other carriers.

When I considered all those items as a whole, in relation to the premium, I thought it would work. Not sure where I came out the first year, but last year I'm pretty sure that I got back my premiums in a combination of amounts paid to the dentist and writeoffs. Not sure how it will work going forward, but I am not yet at the point where I personally would consider CUL a viable alternative to what I have now.

 

[LostDollar]

I've never come across a plan like you were thinking.... year 1 and 2 it pays 10% then 30% I think. Can't recall off the top of my head. But it's not excluded for waiting period so you will still get the 30%-40% network discount, which is really where the value comes in with dental.

That's cool it pays 80%, but that annual max comes fast with one major procedure and then you're wiped out on your hearing and vision benefit from a dental service. Again, that's what I was referring to when I said, "if you're a low utilizer", referring to the consumer.

But we have a different school of thought on it. I know a lot of people that love the Manhattan plan....I just ride a different wave on that one I guess!

I kind of understand what you are saying about low utilizer, maybe from a slightly different direction. A lot of the discussion about CUL coverage, in a thread here, a couple of years ago centered around the cost of hearing aids and the value that CUL coverage would provide for policy holders when the time limits elapsed and the policy would cover a hearing aid. Right now I don't need a hearing aid and so far I have been fortunate not to hit 1k a year in dental expense (with one possible exception some years back on EGHP's). So I sorta objected to the concept of having to pay a premium that would be calculated on combined risks to cover the chance of a claim level I probably would never hit.