Senior Dental

There's a six month waiting period for type II services, 12 month waiting period for type 3. This plan doesn't pay a percentage split, rather it the client just pays X amount for whatever service, and the insurance pays the rest....

What I don't understand is how there is no network, what if a dentist won't take it?

There is not network with PFFS plans either. I'm not familiar with the plan but I'm guessing it works like a PFFS plan. The doctor can choose to take it or not. If he takes it today he may not take it tomorrow.

The tooth may fall out before finding a dentist that will take it. :D
 
there is no network, what if a dentist won't take it?

This is an indemnity plan. There are a few plans still around that don't have networks.

If your dentist won't file a claim, you file and get direct reimbursement up to the policy limits.
 
The rate of insurance sucks.

I explain it to clients like this.

You buy home owners insurance to pay for repairs or replace your home. Say you have a $160k home and pay $500-800/year that is a great rate of insurance. In any year you can get many times what you paid in for the year's coverage. Have one total home loss claim and the benefit from that coverage pays more back than you've paid in a lifetime of premiums.

Dental: You pay $300-500/year around here for a $1000-1200/year policy. That sucks. At most you can get up to three times what you paid in coverage "IF" you had a horrible dental year. Multiply that limited amount of coverage by 3, 4, or 10 years of premiums and you can see that dental insurance is NEVER a good bet.
 
Gordon,

I agree that dental is not the best sell but people want to buy dental every day. In Pa we've been selling the Assurant DHMO (weak networks, good commission) United Concordia (great networks,horrible commission) and Aetna PPO Dental ( ok networks,ok commission). We only do dental as a courtesy for our current clients. Too much work not enough commission.

Any info on Pa Indemnity dental plans would be helpful.

Cheers
 
The rate of insurance sucks.

I explain it to clients like this.

You buy home owners insurance to pay for repairs or replace your home. Say you have a $160k home and pay $500-800/year that is a great rate of insurance. In any year you can get many times what you paid in for the year's coverage. Have one total home loss claim and the benefit from that coverage pays more back than you've paid in a lifetime of premiums.

Dental: You pay $300-500/year around here for a $1000-1200/year policy. That sucks. At most you can get up to three times what you paid in coverage "IF" you had a horrible dental year. Multiply that limited amount of coverage by 3, 4, or 10 years of premiums and you can see that dental insurance is NEVER a good bet.

I do pretty much the same. I tell them I have been looking for a plan for the last seventeen years and still haven't found one that I felt was worth the premium that they will have to pay. I also tell them that if I find one they will be the first one I notify.

Even if they really "want it" I won't sell it to them because I know that when they discover it is a piece of junk they are going to forget I told them so and now my credibility is on the line with them. It doesn't matter how "good the commission" is.
 
Well, my client still needs three crowns replaced. She doesn't mind waiting six months to do so, if the insurance is as good as it says, she will only pay $260 per crown, and the insurance will cover a maximum of $1600. She just paid $995 for two crowns because Delta wouldn't cover it, and she had to go out of network with Delta, because she couldn't find a dentist. This plan SEEMS to be a good fit for her, but I just feel as if I'm missing some major detail.
 
Well, my client still needs three crowns replaced. She doesn't mind waiting six months to do so, if the insurance is as good as it says, she will only pay $260 per crown, and the insurance will cover a maximum of $1600. She just paid $995 for two crowns because Delta wouldn't cover it, and she had to go out of network with Delta, because she couldn't find a dentist. This plan SEEMS to be a good fit for her, but I just feel as if I'm missing some major detail.

Oh boy . . .

Can't speak for your area but crowns in Atlanta are in the $1300 range, not including a root canal which can easily run another $1000.

Let's see what this senior dental plan might pay since I am familiar with it.

Plan 1 has a 15 month wait for "C" charges, so no crown until March, 2012.

Even then it will pay 50% of what they deem reasonable and customary.

Let's say they decide the average rate for a crown in my area is $500 which is what a dentist in a DHMO would be reimbursed. The plan will pay 50% of $500 or $250 . . . you pay the rest.

Maybe the plan is a bit more liberal and allows $900 for a crown. This is about what they would pay a PPO dentist.

So 50% of $900 = $450.

Run the math and you will see the client (using this senior dental plan) pays $54 x 15 months = $810 for a benefit that is worth maybe $450.

If she only paid $995 for TWO crowns she got a deal.

Of course that assumes the crowns fit and will last. I have had 5 crowns over each of the last 5 years. They ranged from $1150 to $1400. They all fit and have not had issues.

My wife has one crown (different dentist), has had it for years and it has never felt right.
 
Oh boy . . .

Can't speak for your area but crowns in Atlanta are in the $1300 range, not including a root canal which can easily run another $1000.

Let's see what this senior dental plan might pay since I am familiar with it.

Plan 1 has a 15 month wait for "C" charges, so no crown until March, 2012.

Even then it will pay 50% of what they deem reasonable and customary.

Let's say they decide the average rate for a crown in my area is $500 which is what a dentist in a DHMO would be reimbursed. The plan will pay 50% of $500 or $250 . . . you pay the rest.

Maybe the plan is a bit more liberal and allows $900 for a crown. This is about what they would pay a PPO dentist.

So 50% of $900 = $450.

Run the math and you will see the client (using this senior dental plan) pays $54 x 15 months = $810 for a benefit that is worth maybe $450.

If she only paid $995 for TWO crowns she got a deal.

Of course that assumes the crowns fit and will last. I have had 5 crowns over each of the last 5 years. They ranged from $1150 to $1400. They all fit and have not had issues.

My wife has one crown (different dentist), has had it for years and it has never felt right.

That is exactly why I don't sell them and why after seventeen years I'm still looking for one for my senior clients.
 
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