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Message

Is Dental Insurance More of a Mess than Health Insurance?
Posted on 1/18/23 at 1:34 pm
Posted on 1/18/23 at 1:34 pm
We are on my wife's policy and have been for years. Been going to the same dentist for almost a decade. Great people.
About 5 years ago, the insurance changed and they went from in network in that plan to out of network in the other plan. However, the reimbursement rates even for out of network was apparently still very strong, so they basically acted as if they were "in-network" by only charging the co-pays they would charge if they were in-network, and between the co-pay and the reimbirsement they got, they were good and woudl write of any balance.
As of Jan 1, the insurance changed again. They are still out of network on this new plan, however, the out of network rates are supposedly way down. I talked to the insurance person at the dentist and she said for example, the old insurer would pay about $300 for a cleaning, the new one it's $120 if you are out of network. They can't eat this and they have decided they are going to start charging patients with that new plan a $150 co pay.
My wife is a teacher and a lot of people here are on this plan, so many people are impacted.
So we started looking around for another dentist.
This is so frusrtrating. Either we find a new dentist, or we forego an important employment benefit at significant cost to us.
This is so stupid. Who really thought tying health / dental / vision etc coverage to employment was a good idea?
We need to change the tax laws to allow people to write off 100 percent of cost of insurance, without limiation, just like employers can do. Maybe then we can get rid of the stupidity of employer coverage, they can pay that cost in salary instead, and we can all just get our own coverage.
About 5 years ago, the insurance changed and they went from in network in that plan to out of network in the other plan. However, the reimbursement rates even for out of network was apparently still very strong, so they basically acted as if they were "in-network" by only charging the co-pays they would charge if they were in-network, and between the co-pay and the reimbirsement they got, they were good and woudl write of any balance.
As of Jan 1, the insurance changed again. They are still out of network on this new plan, however, the out of network rates are supposedly way down. I talked to the insurance person at the dentist and she said for example, the old insurer would pay about $300 for a cleaning, the new one it's $120 if you are out of network. They can't eat this and they have decided they are going to start charging patients with that new plan a $150 co pay.
My wife is a teacher and a lot of people here are on this plan, so many people are impacted.
So we started looking around for another dentist.
This is so frusrtrating. Either we find a new dentist, or we forego an important employment benefit at significant cost to us.
This is so stupid. Who really thought tying health / dental / vision etc coverage to employment was a good idea?
We need to change the tax laws to allow people to write off 100 percent of cost of insurance, without limiation, just like employers can do. Maybe then we can get rid of the stupidity of employer coverage, they can pay that cost in salary instead, and we can all just get our own coverage.
Posted on 1/18/23 at 1:36 pm to LSUFanHouston
I've heard insurance is confusing purposefully.
Posted on 1/18/23 at 1:39 pm to sodcutterjones
90 % of the dental insurance out there is really shitty. Most companies don't spring for the other 10% when making decisions on what to offer employees in benefit packages either.
Posted on 1/18/23 at 1:39 pm to LSUFanHouston
Dental insurance is a shitshow. They need to standardize these policies across the board so there is not so much variation in coverage. It’s a game of bait and switch, delay and denial of coverage for every little technicality. Basically a scam.
Posted on 1/18/23 at 1:40 pm to genuineLSUtiger
I had to get some major dental work done and it was cheaper for me to do it while I was in between jobs with no insurance
If that doesn't tell you how worthless it is I don't know what will
And I mean A LOT cheaper
If that doesn't tell you how worthless it is I don't know what will
And I mean A LOT cheaper
Posted on 1/18/23 at 1:42 pm to LSUFanHouston
You're better off finding a new dentist that is in network.
Semi-related, I went to pick up a prescription for my wife at CVS that is normally $10 and it was $250. They said that our insurer (BCBS) is no longer in their network. We never got that memo but I guess they are constantly renegotiating deals.
Semi-related, I went to pick up a prescription for my wife at CVS that is normally $10 and it was $250. They said that our insurer (BCBS) is no longer in their network. We never got that memo but I guess they are constantly renegotiating deals.
Posted on 1/18/23 at 1:42 pm to LSUFanHouston
This is why I bought insurance insurance.
Posted on 1/18/23 at 1:44 pm to LSUFanHouston
The entire dental industry is a scam. Did cavemen have dentists? We created a job for something that was never a problem until we decided it was. I've never been big into the fluoride conspiracies but look back when it first got introduced and see how much the dental industry has grown.
Posted on 1/18/23 at 1:47 pm to LSUFanHouston
I thought dental insurance was always basically worthless anyway. I didn't go to a dentist for a long time but I'm back on he wagon and I just use a plan my dentist offers that is cheaper than insurance premiums.
Posted on 1/18/23 at 1:49 pm to OysterPoBoy
quote:
The entire dental industry is a scam. Did cavemen have dentists? We created a job for something that was never a problem until we decided it was. I've never been big into the fluoride conspiracies but look back when it first got introduced and see how much the dental industry has grown.
Dental issues have been a problem for many years.
However, the increase in sugar consumption has been the biggest issue with our teeth.
Cut out sugar and you will have significantly fewer dentists in existence.
Posted on 1/18/23 at 1:51 pm to sodcutterjones
This.
In my experience, a lot of the idea is to bury you in paperwork so that you either can’t get your benefits OR keep billing you for shite you don’t owe then never give you a refund if you overpay something.
Want to know why people stiff medical offices? shite like this.
In my experience, a lot of the idea is to bury you in paperwork so that you either can’t get your benefits OR keep billing you for shite you don’t owe then never give you a refund if you overpay something.
Want to know why people stiff medical offices? shite like this.
Posted on 1/18/23 at 1:52 pm to LSUFanHouston
Not in my experience so far at least. Transitioning from Blue Cross to Cigna for medical though already has me paying nearly $20 more on the meds I’m currently on.
This post was edited on 1/18/23 at 1:53 pm
Posted on 1/18/23 at 1:54 pm to TigerBlood62
quote:
Thanks, Obama.
Thanks, FDR.
Posted on 1/18/23 at 1:55 pm to Sao
quote:
Delta Dental?
No, The Standard
Posted on 1/18/23 at 2:00 pm to SlowFlowPro
quote:
I thought dental insurance was always basically worthless anyway. I didn't go to a dentist for a long time but I'm back on he wagon and I just use a plan my dentist offers that is cheaper than insurance premiums.
Our family premium is $50/month so $600/yr (I don't know how much the school board kicks in).
If they are going to charge me $150 for a cleaning and the reimbursement rate is $120, then assume $270 is the cost for one cleaning (I know it's not that simple, of course).
There's four of us and two cleanings a year so $270 x 8 = $2,160 a year in cleaning costs vs $600 for insurance plus $80 in co pays under the old plan.
Posted on 1/18/23 at 2:01 pm to LSUFanHouston
Our pediatric dentist is now out of network. Just got the EOB from my son’s last checkup saying the patients responsibility is…..$1. If they send me a bill for that so help me God.
Posted on 1/18/23 at 2:04 pm to LSUFanHouston
quote:
start charging patients with that new plan a $150 co pay.
My dentist has a "self insurance" option offered by his practice that is $350/ year and includes 2 cleanings, xrays, fluoride, and 10% off of major work.
Its basically equal or better then any other insurance I've ever had because I pay him directly and he doesn't have to do shite to collect.
If you are paying more than this, I'd look around for a new dentist. He's making bank, so it must work. They take insurance too, but I'm just saying this seems to work well.
Posted on 1/18/23 at 2:05 pm to whiskey over ice
Meanwhile every dentist office is state of the art with flat screen and headphones. Have better X ray equipment than hospitals.
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