Schwetna PPO and Dental Reimbursement...

[Chazm]

If I've learned anything in the seven years I have sold advantage plans it's this. Never sell the dental products of the plan. They are always bad and hard to find dentist.

I had an appointment today where the guy was just stuck on dental. I stopped him and said look ,do not get these plans based off the dental they are not made for that, get it based off the medical coverage. Since I've started doing that I stopped getting complaints about dental.

 

[WCMason]

If I've learned anything in the seven years I have sold advantage plans it's this. Never sell the dental products of the plan. They are always bad and hard to find dentist. I had an appointment today where the guy was just stuck on dental. I stopped him and said look ,do not get these plans based off the dental they are not made for that, get it based off the medical coverage. Since I've started doing that I stopped getting complaints about dental.

In the case of the Aetna plan it isn't a rider with an additional monthly premium and network but a no cost reimbursement fund that allows them to go to any licensed dentist. As MAPD extra benefits go this is one of the better ones I've seen

 

[sman]

If I've learned anything in the seven years I have sold advantage plans it's this. Never sell the dental products of the plan. They are always bad and hard to find dentist.

I had an appointment today where the guy was just stuck on dental. I stopped him and said look ,do not get these plans based off the dental they are not made for that, get it based off the medical coverage. Since I've started doing that I stopped getting complaints about dental.

This^^^!

I tell anyone who asks about dental insurance (whether on Medicare or not) that in my opinion there is no dental plan worth the premium. And when they ask whether or not a MAPD plan offers dental coverage, I explain that it's a very small benefit and that I wouldn't make a decision based on that particular benefit as it's almost worthless.

More power to folks selling stand-alone dental plans, but it just isn't my cup of tea. It's a complaint waiting to happen. And for what, a few dollars per month of commission? No thank you.

 

[FLM2]

The member can go to any licensed dentist and then submit the claim to them for reimbursement.

Sometimes the annual benefit is split into preventive and comprehensive maximums but that is spelled out in the enrollment book in the plans I have seen

It depends on the state, in Florida it is definitely network-based (from the Evidence of Coverage):
Maximum Benefit:
·
$2,000 every year for non-Medicare covered comprehensive dental services from in-network and out-of-network providers.

Medicare-covered dental services: 30% coinsurance.
Preventive dental services 50% coinsurance*
Non-Medicare covered comprehensive dental services 50% coinsurance*

I suppose if someone was having $4K of work done under covered services the $2K reimbursement would be nice but it's never as easy as that.

Just like Sman, I tell my clients to ignore the dental part of any plan and focus on the medical, I don't like writing stand alone dental because of the ever changing networks and don't want to deal with the aggravation (plus I don't think any plan is decent value)

 

[Chazm]

In the case of the Aetna plan it isn't a rider with an additional monthly premium and network but a no cost reimbursement fund that allows them to go to any licensed dentist. As MAPD extra benefits go this is one of the better ones I've seen

In FL we have a Coventry plan that includes dental at no extra premium is isn't a reimbursement. It's the best I've seen included in a plan and hell, it's better than most stand alone dental plans.
Even though, when someone is thinking of choosing Coventry over a big network plan like UHC, I make sure they know that they shouldn't base their decision on the dental. It shouldn't factor in, it'll probably be a narrow network and be gone soon

 

[wehotex]

Quick rant - why is a plan that costs $68 a month so difficult to use? Yet, still has a 4.5 star rating???

First year for the client on Aetna.. because it's a PPO and the 1k dental reimbursement, but there's not a bit of information on how the plan pays, how it works, how she goes about reimbursement. Called customer service and they don't know polka-dotted sheets either...

What gives?

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quick note to GreenSky... thank you in advance for your kind words and for taking time to share your wealth of knowledge, in that awesomely supportive way that you do...
Thanks Buddy!

Lol. I asked this question to the local San Antonio Aetna broker rep during AEP. He told me that it would appear in the EOC. When I told him that it was not, he said that a quick call to Mb Services by the customer would suffice. So, that doesn't work? Ill try to ask him for some more detailed info and share it with you.

 

[Mrs.A.Mann]

Lol. I asked this question to the local San Antonio Aetna broker rep during AEP. He told me that it would appear in the EOC. When I told him that it was not, he said that a quick call to Mb Services by the customer would suffice. So, that doesn't work? Ill try to ask him for some more detailed info and share it with you.

Thanks for responding!! I had done the same thing, calling cs, asking more upline folk, then here and then finally my rep came back from vacay and responded with flying colors. The plan is good and the benefit is good (just as previously described). Coverage is for a crown with no wait :0) Eat that, know-it-all's... *blowing kiss*

Note to KIA's - I am sensitive and have little tolerance for critical folks who don't know what-for and then ride me thinkin' they do. Rethink the whole rookie ribbin' game or shove off. I have a business to run and this site makes me a better agent ;0)

 

[Norwayguy]

Lol. I asked this question to the local San Antonio Aetna broker rep during AEP. He told me that it would appear in the EOC. When I told him that it was not, he said that a quick call to Mb Services by the customer would suffice. So, that doesn't work? Ill try to ask him for some more detailed info and share it with you.

He obviously doesn't know or wouldn't have tried to pawn you off twice.