straightnochaser
Guru
- 560
Why? 1 filling per tooth every 2 years does not mean you can only get a single filling every two years, it means you can get 1 filling on that particular tooth every 2 years.
Some good dental plans for family’s ?
- Thread starter DonP
- Start date
Why? 1 filling per tooth every 2 years does not mean you can only get a single filling every two years, it means you can get 1 filling on that particular tooth every 2 years.
- 6,473
That's one a person does not really understand until they experience the situation.
A tooth has 5 exposed surfaces, any one of which can develop a cavity at any time.
and, if a person (adult or child) has receding gumlines, there can be newly exposed areas which can either develop new cavities or weaken old fillings.
On molars, I think it could be relatively common for a person to need a filling on the biting surface and another on at least one of the sides.
- 6,473
If you use a provider in-network for your dental insurance coverage, you obtain the reduction to contracted price in addition to the cash payments to the dentist. (And I would think, in that situation, you would have 100% insurance coverage of your preventive service visits.)
- 6,473
If I was an agent,
I think what I would strongly consider offering for Dental Coverage is UHC policies. I would have to look again at features and costs, but I think I would prefer UHC plan selections over Ameritas plan selections. (I WOULD HAVE TO CAUTION THAT, IN MY AREA, THE UHC NETWORK IS LIMITED FOR PROVIDERS.)
I think I would try to understand that thing or process where agents get a page that lists policy features and lets prospects sign up automatically with the agent getting the credit. I know Ameritas has something like that, don't know about UHC.
If a KS resident wanted a policy that made higher payments to the providers (up to the $1K policy limit) and were willing to pay more premium, I would recommend BCBSKS dental coverage.
If I was an agent, and wanted to sell or recommend dental beyond those two options, I would take a look at the features and costs of Sam's dental plan to see if that is something I would want to recommend for those who are willing to sign up for higher premiums.
Many agents here will recommend Manhattan. This is just a personal idiosyncracy, when I was looking more carefully at coverage 3-4 years ago, I didn't want to consider Manhattan because they base their premiums on age bands. Doesn't mean the product might not be a good fit for others.
the Humana Extend series is a good plan, its a little pricey, but good covereage as far as dental goes
- 6,473
Persons with more severe dental service needs may find the following two provisions to be more restrictive than what might be available with alternate coverage.
• Limited oral examination (limit one every calendar year
• Restorations – fillings (limit one per tooth per two years,
composites covered on front teeth only 2 )
straightnochaser
Guru
- 560
Feel free to share a dental plan without limitations, I would love to offer it to my clients.
- 6,473
As you well know, there is no such thing.
However, I have needed, and had, dental coverage that did not have those two restrictions.
Those are some of the evaluation criteria I have, others may use different ones and find these plans acceptable.
Based on my experience with 2 years of serious dental problems, those are not plans I would recommend or sell (if I was an agent). But that's me.
This is just like any other line of insurance, different agents are going to make different choices about what they offer and help clients with. (if they even choose to offer dental coverage because of the agent's opinion of the value of the coverage and the potential amount of customer service involved.)
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thats probably true, as no dental plan is perfect, but Caveat, your also not an agent
- 6,473
That is also true,thats probably true, as no dental plan is perfect, but Caveat, your also not an agent
However, here I do speak from some experience.
Normal preventive services, fillings, root canals, and crowns only.
In 2020 I maxed out one dental plan, and in ONE month came up $100-$200 shy of maxing out a second one.
In 2021 I maxed out two dental plans and had a cleaning visit on a third.
(And administrative issues in coping with 3 dental plan claims were one of the reasons my dentist fired me.)
Getting the 2nd and 3rd policies, I had to look at stuff like waivers of waiting periods, co-ordination of benefits (Ameritas and Met-Life don't as I recall, deductibles (amounts and types of services they applied to and whether they were lifetime or annual), what service category some "preventive" services fell into (some of the "cheap cost" plans moved some services from preventive to basic where they would be subject to a deductible and co-insurance), and other stuff I don't remember now.
I am not going to take the time to go back and look, but I think in 2020 or 2021 I had at least 3 D0140 visits which both my policies paid on. I am also pretty sure in 2019,2020, & 2021 I had at least 2 instances of having multiple fillings on one tooth within a 2 year period. (I may have 1 or 2 teeth which are silver, amalgam, and resin materials held together by enamel.)
The payment for "only amalgam fillings" on back teeth is a bit trickier. My long term dentist who retired in 2018 would do resin fillings on all my teeth and take my UHC payment in full - regardless of whether the payment was for resin or amalgam rates. In the 2019-2021 time period, I had one dentist that did the same and another that basically charged me full retail price for resin fillings on back teeth, subtracted the amalgam based payment and forced me to pay the full difference. (i.e. I got no network price adjustment on those fillings at that dentist.)
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