Some good dental plans for family’s ?

[LostDollar]

No annual max? There has to be a catch?

I am not an insurance agent so I am not sure if my understandings are correct.

I am going to use the word "detail", rather than "catch".

I see at least 5 details a person looking at this plan might want to consider:

--In order to obtain network pricing discounts, the policyholder must go to a provider in the Ameritas network.

--There are four plan levels with gradually increasing premiums. The percentage discount in the top level is based on Ameritas allowed amounts.

--There are four plan levels with gradually increasing premiums. The provider reimbursements in the lower three levels appear to me to be defined cash payments rather than percents of anything.

--There are restrictions on implant related payments.

--I don't know codes for orthodontics, so I don't know if the plan(s) make any payments for those services.

 

[straightnochaser]

I am not an insurance agent so I am not sure if my understandings are correct.

I am going to use the word "detail", rather than "catch".

I see at least 5 details a person looking at this plan might want to consider:

--In order to obtain network pricing discounts, the policyholder must go to a provider in the Ameritas network.

--There are four plan levels with gradually increasing premiums. The percentage discount in the top level is based on Ameritas allowed amounts.

--There are four plan levels with gradually increasing premiums. The provider reimbursements in the lower three levels appear to me to be defined cash payments rather than percents of anything.

--There are restrictions on implant related payments.

--I don't know codes for orthodontics, so I don't know if the plan(s) make any payments for those services.

It's dental insurance man, restrictions are par of the course for everyone (except you who has THREE policies).

Of course there are restrictions on implants, they are expensive and if there were no restrictions in place dental insurance would be unaffordable or just plain not offered.

 

[LostDollar]

It's dental insurance man, restrictions are par of the course for everyone (except you who has THREE policies).

Of course there are restrictions on implants, they are expensive and if there were no restrictions in place dental insurance would be unaffordable or just plain not offered.

I HAD three dental policies for a short time. I do not HAVE three dental policies.

Are you suggesting that it is inappropriate for agents and consumers to be aware of details about an insurance product (dental or otherwise) before its sale or purchase?

Several times a year there are questions that come up about how to obtain dental insurance that covers implants. Not too long ago there was a rather desperately toned post about obtaining dental insurance coverage for orthodontics. Are you suggesting that it is ok to ignore specific details about whether, or how, this dental insurance covers implants or orthodontics prior to its purchase?

 

[Jim Wright]

Are you suggesting that it is inappropriate for agents and consumers to be aware of details about an insurance product (dental or otherwise) before its sale or purchase?

No one is saying that. We are aware of the details and that's why most of us think they are trash. Maybe there are some unicorns out there but we all deal with the major carriers and products and know that there are so many restrictions and unknown costs that they aren't worth it.

 

[straightnochaser]

I HAD three dental policies for a short time. I do not HAVE three dental policies.

Are you suggesting that it is inappropriate for agents and consumers to be aware of details about an insurance product (dental or otherwise) before its sale or purchase?

Several times a year there are questions that come up about how to obtain dental insurance that covers implants. Not too long ago there was a rather desperately toned post about obtaining dental insurance coverage for orthodontics. Are you suggesting that it is ok to ignore specific details about whether, or how, this dental insurance covers implants or orthodontics prior to its purchase?

Yup, that's exactly what I said.....

 

[Midlevel]

Obviously most of my clients don’t have a stand along dental plan bc they have the $1300.00 - $1600.00/year with their MAPD. Some who have had it all their life through the State or whatever think they need more so I use Ameritas. Tell them upfront it’s not going to be life changing savings. You’re gonna pay 500.00/year for premiums and best case scenario you get up to 2000.00 benefit after the 1st 12 months. It does work well running it through their Ameritas and then their Aeta/Medica MA plan reimburses them for what ever they pay out of pocket.

Some of my under 65’s do chose to take the dental until they get on Medicare.

 

[LostDollar]

No annual max? There has to be a catch?

I am not an insurance agent so I am not sure if my understandings are correct.

I am going to use the word "detail", rather than "catch".

I see at least 5 details a person looking at this plan might want to consider:

--In order to obtain network pricing discounts, the policyholder must go to a provider in the Ameritas network.

--There are four plan levels with gradually increasing premiums. The percentage discount in the top level is based on Ameritas allowed amounts.

--There are four plan levels with gradually increasing premiums. The provider reimbursements in the lower three levels appear to me to be defined cash payments rather than percents of anything.

--There are restrictions on implant related payments.

--I don't know codes for orthodontics, so I don't know if the plan(s) make any payments for those services.

additional comments
I see restrictions on payments for code D0140. this could probably result in out of pocket payments for evaluations for pain or root canals.

Scanning quickly, I can't find coverage for D0460. This could represent out of pocket costs for plan holders seeking evaluation for dental pain.

Scanning quickly, I can't find coverage for D0367. If it has no coverage, this could result in a noticeable out of pocket cost for someone having a preevaluation for a root canal.

Caveat, I am not an agent. Speaking as a consumer, I am not sure this plan would provide any more useful level of benefit than a UHC or Ameritas plan in a similar price range.

 

[straightnochaser]

additional comments
I see restrictions on payments for code D0140. this could probably result in out of pocket payments for evaluations for pain or root canals.

Scanning quickly, I can't find coverage for D0460. This could represent out of pocket costs for plan holders seeking evaluation for dental pain.

Scanning quickly, I can't find coverage for D0367. If it has no coverage, this could result in a noticeable out of pocket cost for someone having a preevaluation for a root canal.

Caveat, I am not an agent. Speaking as a consumer, I am not sure this plan would provide any more useful level of benefit than a UHC or Ameritas plan in a similar price range.

a CT scan is not usual for someone needing a root canal, you're looking for a perfect dental plan, it doesn't exist.

 

[LostDollar]

a CT scan is not usual for someone needing a root canal, you're looking for a perfect dental plan, it doesn't exist.

That statement contains one untruth and one possible untruth.

The codes I cited were taken directly from an endodontist’s eob.

The endodontists can decide what’s usual and what’s not.

YOU do NOT get to tell MY endodontist what x-rays he gets to take. If a guy is firing up a long evil looking drill bit that could go into my sinus cavities and he needs that type of x-ray to help prevent damage from the drill, I think he gets to have it. ( and both my policies did make payments for it.)

Definition of a perfect dental plan is going to vary from patient to patient depending on their particular needs. I am not looking for a perfect plan, I am attempting to see characteristics of. Ones that exist.

The business of presenting this plan as paying percents of some amount is inaccurate and misleading, until or unless you carefully read fine print.

As far as the codes I cited, both my plans cover D0140 in preventive, rather than basic. And both my plans made payments to my endodontist for all the services I listed above.

In addition, one of my plans puts root canals in basic services with no waitin period.

I know Ronvand is an experienced Medicare agent, but given that I have seen @Yagents and @Fisher recommending discount plans, I think a person would be better off looking at a straight dental discount plan or a straight dental insurance plan rather than this hybrid thingy. That is not looking for a perfect plan, that is just considering characteristics of existing plans, personal experience, and comments from agents I trust.

You are coming across to me as being awfully defensive of a plan in a whole category of insurance you don’t really seem to approve of.

 

[LostDollar]

Part of my insurance forums education for dental insurance has been:

When people start bandying about the term “percents”, one should ALWAYS ask, “percent of what?”.

Looking at physicians mutual product advertising suggests one might also want to ask:

“Is it even a percent?”.