Manhattan Life CUL Dental Plan

[Chazm]

Thank you. I can't remember who, but somebody awhile back was fussing at me about my reading comprehension. Once again I have screwed up. I totally misunderstood what you were saying-I thought you were comparing 2 CUL individual policies to family rates of another company.

The brochure also clarifies Scott's comments, reminds me of my concerns and highlights, and emphasizes the need which another agent expressed in another thread-to determine what "good" means to you (the policy user).

The thing I don't think goillini's and your comments clarified for me is that when I pay my premium and get an option on a 1K bucket of cash, I cannot withdraw 100 percent of my expenditure for a particular dental, vision or hearing service. CUL also does not provide a reduction from dental list price to dental network price. (and the dental networks in my location may be somewhat more extensive than the networks in locations referenced in some other threads.) My family unit does not require hearing services at this time.

I have to try to find some EOBs and do some actual cost reviews over the next week.

If you are referring to what CUL will pay based on normal and customary rates, they do not. They pay on Actual rates.

 

[LostDollar]

But to me the network is key. I'm tired of answering phone calls about a horrible dental network while I make $2/month.

In regard to time cost and financial return, would you think differently on this product if you were "brick and mortar" and had an assistant?

 

[sshafran]

I can't find many Dentist in FL that take Ameritas.

And what I look at is major work. Where most plans will only cover 50%. With CUL it's 60%, 70%, 80% after year 3 and you can't beat that. That's where the bigger Out of pocket expenses come.

But to me the network is key. I'm tired of answering phone calls about a horrible dental network while I make $2/month.

It could just be the areas - most of the time when I look up the dentist they are in network.

Also - for whatever reason - CUL only goes up to 70% in Ohio - but OH pays the same premium as every other state. So, while everyone gets 60/70/80, Ohio gets 60/70. This makes it a little less attractive.

 

[LostDollar]

If you are referring to what CUL will pay based on normal and customary rates, they do not. They pay on Actual rates.

With CUL, two individual policies are cheaper than a Family policy... There are no netwrok reductions as there is no network.. Use any dentist.. Pool of money concept, you can use all are a portion for dental and/or vision and/or hearing.. My hearing aids cost $5K.. would have been nice to get $1500 reimbursed..

One of my starting ideas of "good" dental coverage would be to have the semi annual cleanings and annual xrays covered at 100% (of a network controlled charge) without a waiting period or reduction for an annual deductible. CUL does not appear to offer that, so I need to do comparison with other plans.

rousemark, I am in no way wanting to deny how CUL would be, or have been, beneficial to you. All I am saying is that I believe my family unit needs to be different than your family unit needs; and as a result I think CUL will not be the wisest choice for us. That may or may not be correct, I don't know yet.

 

[LostDollar]

It came to mind, but then it left. I may check it out.

Im starting to think maybe the biggest problem with dental is us agents. We want bigger commissions. It seems the Delta plans seem to work well, and the dentists all like it, but the commission is pretty small, so nobody talks about it.

I think the discussions between chazm and sshafran are presenting an excellent contrast of the agent perspectives of selling dental (and vision,hearing) and its financial returns.

 

[LostDollar]

Can the CUL plan be used in combination with a dental discount plan?

If that answer is yes, which price would the CUL discounting run against?
The provider's list price for the service (with reimbursement to the plan holder not to exceed payment to the provider), or the actual discounted payment made to the provider?

 

[GoPokes]

Can the CUL plan be used in combination with a dental discount plan?

If that answer is yes, which price would the CUL discounting run against?
The provider's list price for the service (with reimbursement to the plan holder not to exceed payment to the provider), or the actual discounted payment made to the provider?

My guess is whichever is less expensive for CUL. They are a business, not a charity. They'll follow the agreements in contract, to their own best interest.

I believe you can use an indemnity plan in addition to an insurance plan.

 

[LostDollar]

My guess is whichever is less expensive for CUL. They are a business, not a charity. They'll follow the agreements in contract, to their own best interest.

I believe you can use an indemnity plan in addition to an insurance plan.

Hi,
I undeerstand they are not a charity. I am not trying to devise a plan to "make money" from insurance like you used to be able to do.

I am talkiling about a situation in which I would pay premiums to two companies for services and am wanting to know if there is any coordination of benefits? To my mind, the discount plan would always apply first, because that determines what the discount plan holder pays the dentist.

So my question becomes, If one also holds a CUL insurance plan, would CUL coordinate with the discount plan, taking their discount from the dentist's full price; or would CUL ignore the discount plan and look only at the out of pocket cash payment as the starting point for their computation?

 

[rousemark]

Hi,
I undeerstand they are not a charity. I am not trying to devise a plan to "make money" from insurance like you used to be able to do.

I am talkiling about a situation in which I would pay premiums to two companies for services and am wanting to know if there is any coordination of benefits? To my mind, the discount plan would always apply first, because that determines what the discount plan holder pays the dentist.

So my question becomes, If one also holds a CUL insurance plan, would CUL coordinate with the discount plan, taking their discount from the dentist's full price; or would CUL ignore the discount plan and look only at the out of pocket cash payment as the starting point for their computation?

The Central United plan pays "The actual amount charged or billed for covered medical services by a Physician or supplier." which will be the amount the insured is actually required to pay.. Therefore, If the provider discounts their regular bill, the discounted amount is what will be covered.

 

[LostDollar]

The Central United plan pays "The actual amount charged or billed for covered medical services by a Physician or supplier." which will be the amount the insured is actually required to pay.. Therefore, If the provider discounts their regular bill, the discounted amount is what will be covered.

Hi rousemark,
Thanks for taking the time to give me an answer. I appreciate the courtesy.

I want to see if I can find some of my old eobs and consider an estimate of dental benefits I would receive under two scenarios for self +1 (and I may substitute other companies in the comparison later):

Option A: A Delta Dental KS silver family plan + VSP ($70/mo + VSP)
Option B: A dental discount plan such as Denta Card + CUL ($130/yr + CUL)

I realize that "self + 1" may equal "family" with some companies.
For my personal situation, I am ignoring the need for a hearing benefit.