Author Topic: Wow - Dental Insurance is a HUGE racket and a ripoff!!!  (Read 18055 times)

cdub

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Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« on: March 05, 2014, 11:30:22 AM »
Ok - so my wife is now staying home with the kids so we no longer have Health Insurance or Dental insurance through her work (I'm self employed) and have a pretty affordable plan through the ACA.

But it doesn't have Dental Insurance.

My wife needs to get around $6k in work done if we didn't have insurance.... so I thought I'd look into insurance.

Geesh! The Blue Shield PPO plans only payout a yearly max of $500 per member (the yearly premium is $1,200!!!!).

The United Concordia plan ($90/month) has a $1,500 yearly payout maximum per member but covers ZERO PERCENT of major restorative work like crowns.  ZERO freaking percent. Isn't that why people have insurance? To pay or the big stuff?

There is a plan that covers 60% of major restorative work for $120/month (family of 4) with United Concordia. That would be $1,440 in premium payments and United Concordia would pay $1,500 of the $6k and we'd be on the hook for the rest. Gee thanks for the $60 bucks you're pinching it Mr. Insurance Company.

The only way you'd save any money is if the whole family needed a lot of work done.

What a huge racket.

Thankfully I have a e-fund that'll pay for this if we decide to go without insurance - and unless I'm reading their benefit summary's incorrectly that's a no brainer.

Thoughts?

CommonCents

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Re: Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« Reply #1 on: March 05, 2014, 11:35:43 AM »
Keep in mind another benefit of dental insurance - they negotiate rates with dentists.  My dentist has a fee schedule for various plans.  For my insurance, once I hit the cap ($1050 but a $50 deductible), then I'd have to pay their full rate.  However, I have secondary dental through my husband and that plan has negotiated that I pay the negotiated rate even once their cap is reached (again $1050 but a $50 deductible).

cdub

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Re: Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« Reply #2 on: March 05, 2014, 11:45:15 AM »
Keep in mind another benefit of dental insurance - they negotiate rates with dentists.  My dentist has a fee schedule for various plans.  For my insurance, once I hit the cap ($1050 but a $50 deductible), then I'd have to pay their full rate.  However, I have secondary dental through my husband and that plan has negotiated that I pay the negotiated rate even once their cap is reached (again $1050 but a $50 deductible).

What good is negotiated rates when they cover ZERO percent of major restorative work. This is for plans on the individual market - I've heard that employer plans are better.

CommonCents

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Re: Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« Reply #3 on: March 05, 2014, 11:54:12 AM »
Keep in mind another benefit of dental insurance - they negotiate rates with dentists.  My dentist has a fee schedule for various plans.  For my insurance, once I hit the cap ($1050 but a $50 deductible), then I'd have to pay their full rate.  However, I have secondary dental through my husband and that plan has negotiated that I pay the negotiated rate even once their cap is reached (again $1050 but a $50 deductible).

What good is negotiated rates when they cover ZERO percent of major restorative work. This is for plans on the individual market - I've heard that employer plans are better.
Keep in mind another benefit of dental insurance - they negotiate rates with dentists.  My dentist has a fee schedule for various plans.  For my insurance, once I hit the cap ($1050 but a $50 deductible), then I'd have to pay their full rate.  However, I have secondary dental through my husband and that plan has negotiated that I pay the negotiated rate even once their cap is reached (again $1050 but a $50 deductible).

What good is negotiated rates when they cover ZERO percent of major restorative work. This is for plans on the individual market - I've heard that employer plans are better.

Well let's do the math with fake numbers.
The dentist charges $1000 for a crown.
The plan has negotiated rates of $500.
You need 3 crowns done.
If it costs under $1500 for the plan...you could actually save money, even if the plan covers nothing for what you want done.

Often there is minor restorative, major restorative and then things like coverage if you need a root canal (forget the name for this category).  Sadly, they often cover most preventative and the final category at 100% and the others at less than that, even with good insurance.

nereo

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Re: Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« Reply #4 on: March 05, 2014, 11:57:54 AM »
People forget that insurance in general is a business, and one that is designed to make money by taking in more than it pays out.  It's a fairly unique business where they have a vested interest in not paying for the very services you are paying them for, and the marketplace is dominated by so few players in most areas that free-market competition doesn't do much.
I find a lot of problems with the current ACA, but the thing I like best about it is that it requires insurance company to spend a certain percentage (usually 80%) on actual care, or refund the difference. 

also - i find it odd that dental services are treated differently from normal health-care (in this country and in Canada).  How is my mouth not one of the most important parts of my body?  I can get treatment for a cut on my little toe but not for a cavity or a basic preventative cleaning?

To add my own experience; i had dental coverage that advertised it covered an annual checkup and cleaning (including xrays) and covered 80% of simple fillings.  What I found out was that they only paid out $15 for x-rays and $25 for a cleaning, and some similarly ungawdly low amount for a simple filling.  I spoke to my friend who is a dentist and he told me no dentist with a license could ever do x-rays and cleanings for that little without loosing money.  As it was I ended up paying over $200 for a cleaning, x-rays and a filling that was supposedly "covered" (except when you read the fine print).

Frankies Girl

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Re: Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« Reply #5 on: March 05, 2014, 12:05:15 PM »
Check into any dental school programs in your area - I have a friend that has gotten crowns and other dental work for really cheap.

Talk to your dentist's office. Tell them you don't have insurance and if they have any discounts for the work needed. I've done that in the past and was given 20% off.


cdub

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Re: Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« Reply #6 on: March 05, 2014, 12:31:51 PM »
I'll see if they have discounts... but geesh.

Also we spent a long time trying to find a dentist that we like. We're not looking for another one.

Makes more sense to just pay us $100/month and just bite the bullet on this one.

LibraTraci

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Re: Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« Reply #7 on: March 06, 2014, 02:35:37 PM »
People forget that insurance in general is a business, and one that is designed to make money by taking in more than it pays out.  It's a fairly unique business where they have a vested interest in not paying for the very services you are paying them for, and the marketplace is dominated by so few players in most areas that free-market competition doesn't do much.

Thanks for saying this!  I find sometimes that health insurance in general (and by extension, dental insurance) is something of a sacred cow, not to be criticized in polite society.  And since you already brought it up, here's my big chance to unload my feelings, right?

So, insurance as a concept is designed to turn the peaks and valleys of my medical (or dental) expenses into one consistent and predictable monthly payment.  This, in theory, sounds good.

In practice, there is an overconsumption problem -- people don't turn down extra tests and procedures when someone else is paying, so medical and dental practices regularly pad their bills with things like "oral cancer screenings" or yearly x-rays.  So, if I were to be asked whether I'd like a screening for oral cancer for $30 dollars (that thing where they grab your tongue with a piece of gauze and look on either side of it for), I'd say "no thanks" -- after all, I'm a non-smoker, non-drinker with little chance of mouth cancer, and am perfectly capable of looking around my own mouth for that amount of money. 

Same with annual x-rays: "Oh we need to see what's going on below the gum line" is the rationale, but is there any indication that there is something going wrong beneath the gum line?  They don't ever give a rationale for what they are looking for under there -- I think they just want that on the bill because that's how dental practices make a little bit of extra money.  (I seriously wonder whether more damage tban good is done by annual x-rays.  After all, radiation is *not* a healthy thing.)  I honestly believe that the accepted standards of practice in this country do not weigh benefits against risks, but simply institute a standard of care that suits the medical/dental field and the insurance industry. 

Another concern I have about health insurance and dental insurance is that in practice, I will not end up paying for *my* lifetime care, averaged out on a monthly basis, but rather:  I'm paying for the lifetime care of a pool of people, averaged out on a monthly basis.  So, people who don't take care of their health or their teeth have higher cost of care, and I get to pay a share of that -- no thank you!

I far prefer to pay for what I use!   

PS -- I know that a lot of dental issues are genetic, and yeah, that's not fun.  I was comparing gum lines with a co-worker last night -- we both need gum grafts (me, about $6,000 worth -- her, probably $9,000 worth, due to needing more areas done in her mouth) which is probably due to both of us having crappy genes, but her being a smoker and me being a non-smoker.  I wouldn't want to pay $7,500 for my gum graft to help cover her more extreme dental work.  Better for each person to play the hand they were dealt!

labrat

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Re: Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« Reply #8 on: March 06, 2014, 04:35:37 PM »
My thoughts EXACTLY LibraTraci! 

If people ever figure out that it's cheaper to pay just for what you use, insurance and medicine would definitely change for the better. It's one thing if you are too poor to afford basic care, but most people even with a modest income can afford a few doc visits a year and some minor dental work.  For what I pay for premiums just on our HSA plan, I could pay for about $2200 in medical/dental expenses.  I wish I could just contribute that premium money tax-free (~$2800) into the account every year.  Oh, but my premiums get me a "negotiated rate" (that is higher than the cash rate btw), and a shiny HSA debit card to use...

Heart of Tin

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Re: Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« Reply #9 on: March 06, 2014, 04:37:19 PM »
@cdub - It looks like you priced a family policy, but you're only considering your wife's utilization. Can you put her on a separate individual policy for dental only?

The problem with the way in which you are describing the situation is that you are only considering your known liabilities which is a misapplication of insurance. Why should United Concordia (or any insurance company) pay you to have a policy with them? Insurance is designed to transfer unknown risk from the insured to the insurer who can pool you risk with others like you and charge you what should be a nominal premium in comparison to the worst case risk scenario. Maybe the dental policies in your area are priced in such a way to disincentivize all but the highest risk or highest utilization individuals from purchasing insurance in which case you will probably be better off self-insuring if possible.

People forget that insurance in general is a business, and one that is designed to make money by taking in more than it pays out.  It's a fairly unique business where they have a vested interest in not paying for the very services you are paying them for, and the marketplace is dominated by so few players in most areas that free-market competition doesn't do much.

I think most people distrust insurance companies for this very reason, and while insurance companies can be pretty slimy in some of their practices, insurance can still be a mutually beneficial tool for both the insurer and the insured. The insured reduce their risk of catastrophic loss while the insurer makes money off of pooling the premiums and claims of a large group. Overall, the law of averages favors the insurer, but on an individual basis the insured may avoid very large liabilities.

Another concern I have about health insurance and dental insurance is that in practice, I will not end up paying for *my* lifetime care, averaged out on a monthly basis, but rather:  I'm paying for the lifetime care of a pool of people, averaged out on a monthly basis.  So, people who don't take care of their health or their teeth have higher cost of care, and I get to pay a share of that -- no thank you!

If I may quote the estimable Dr. Cox from 'Scrubs', "Statistics mean nothing to the individual." You probably won't end up paying for your lifetime care, but that might end up saving you from medical bankruptcy. Simply taking care of yourself does not ensure that you won't end up with catastrophic medical costs. Some of the most expensive individual health claims in my experience working for a health insurer are from accidents. It doesn't matter that you aren't predisposed to liver cancer or diabetes; if you fall off a ladder and require three months in the ICU, then you will beat your health insurer, even in the long run. I wholeheartedly agree that insurance is overused and oversold in the United States (just look at how many people buy whole life policies when term life or no life insurance would be better for their situation), but a high deductible health insurance policy is generally indispensable for a healthy, low risk individual who is not among the super-rich, because of the ever present low risk of catastrophic medical costs. Dental insurance is less useful since the risks that dental insurance covers are pretty limited in scope, especially with yearly benefit caps like cdub describes.

cdub

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Re: Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« Reply #10 on: March 06, 2014, 11:21:59 PM »
@cdub - It looks like you priced a family policy, but you're only considering your wife's utilization. Can you put her on a separate individual policy for dental only?

I'm not sure the math would work out... especially since they don't cover major restorative work - so it's all moot.

sol

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Re: Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« Reply #11 on: March 07, 2014, 12:11:39 AM »
We have partial dental as part of our regular health insurance, which reduces the bill for our annual cleanings down to just the $25 copay.  It doesn't cover anything other than preventative care.

We have the option of buying explicit dental insurance from the federal government, my employer.  Every year I look at the plans and every year I come to the same conclusion the OP did: it's hard to envision a scenario in which we would use as much dental insurance as you pay for the premiums.  In several cases you are guaranteed to lose money, like it costs $2400/year and they pay a max of $2000/year in benefits, and yet many of my coworkers continue to sign up because they "can't be without" dental insurance.

For most folks, the big dental costs are braces, wisdom teeth, and accidental damage (e.g. hockey pucks).  Dental insurance doesn't normally cover any of those.  Regular health insurance usually covers dental work due to accidental damage and sometimes covers wisdom teeth under outpatient surgery.  Orthodontia is still a giant ball of suck, I've never found a way to effectively insure against that.

chasesfish

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Re: Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« Reply #12 on: March 07, 2014, 04:10:03 AM »
Just food for thought - the only reason I have dental insurance is the premiums are taken from pre-tax dollars.  I've done the analysis as well and I'm paying around $600 pp for a $1000 yearly cap. 

SnackDog

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Re: Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« Reply #13 on: March 07, 2014, 05:22:37 AM »
Dental work can be done cheaply and safely in other countries. We routinely visit dentists in southeast Asia and Latin America.

Weedy Acres

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Re: Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« Reply #14 on: March 07, 2014, 08:57:40 AM »
It sounds like you are expecting insurance to take on responsibility for payment for a known pre-existing condition, and to accept less from you than they (or you) know it will cost.  That makes zero economic or business sense.

I urge you to instead think of insurance as something you only purchase for catastrophes that would be ruinous.  Think about how you would feel if you never had to make a claim (because your house never burned down or because you didn't die prematurely or because you didn't get cancer).  If that makes you happy then it's a good thing to insure.  If instead you feel ripped off because you didn't "make" money on your purchase, then you should be self-insuring.

DizzyDaisies

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Re: Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« Reply #15 on: March 07, 2014, 10:51:54 AM »
I'm a Dental Hygienist.  I would suggest checking with your dental office to see if they participate with any discount plans.  Our office participates with Delta Direct and Cigna Preferred.  The Delta plan is approximately $100/yr for your whole family.  You end up paying the office directly, but you get the Delta fee schedule contracted rates.  There are no maximums.  Delta pays nothing and there are no claims.  Hypothetically, if each crown is $1200, you'll end up paying $850ish.  The fees vary by region.  It would more than pay for itself in your case.  If you were a single person and got 2 cleanings a year and 1 set of bitewing X-rays, it would probably not be worth it. 

cdub

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Re: Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« Reply #16 on: March 07, 2014, 02:27:08 PM »
I'm a Dental Hygienist.  I would suggest checking with your dental office to see if they participate with any discount plans.  Our office participates with Delta Direct and Cigna Preferred.  The Delta plan is approximately $100/yr for your whole family.  You end up paying the office directly, but you get the Delta fee schedule contracted rates.  There are no maximums.  Delta pays nothing and there are no claims.  Hypothetically, if each crown is $1200, you'll end up paying $850ish.  The fees vary by region.  It would more than pay for itself in your case.  If you were a single person and got 2 cleanings a year and 1 set of bitewing X-rays, it would probably not be worth it.

Unfortunately our dentist doesn't participate in any discount plans. :( I was hopeful.

tipster350

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Re: Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« Reply #17 on: March 07, 2014, 02:30:59 PM »
As someone who has professional experience in this area, most dental insurance plans are not worth it. If you are going to spend the money, it is much wiser to roll the amount you are paying for dental insurance to a more robust health insurance plan.

Bärtle

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Re: Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« Reply #18 on: March 07, 2014, 04:48:39 PM »
I'm a Dental Hygienist.  I would suggest checking with your dental office to see if they participate with any discount plans.  Our office participates with Delta Direct and Cigna Preferred.  The Delta plan is approximately $100/yr for your whole family.  You end up paying the office directly, but you get the Delta fee schedule contracted rates.  There are no maximums.  Delta pays nothing and there are no claims.  Hypothetically, if each crown is $1200, you'll end up paying $850ish.  The fees vary by region.  It would more than pay for itself in your case.  If you were a single person and got 2 cleanings a year and 1 set of bitewing X-rays, it would probably not be worth it.

So if I needed a whole mouth restoration,this plan would cover all 28 teeth and give me the discounted price?

mm1970

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Re: Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« Reply #19 on: March 09, 2014, 09:51:39 PM »
I have found that mostly you are correct on the dental insurance.  Until my most recent company, my dental premiums have been covered by the company.  My current company has a very basic plan (only 5 dentists in town) that is covered.  There is a slightly more expensive plan with 20 dentists, and a PPO type plan with anyone you want (but the coverage is lower).

All of my math showed that it was not worth paying for the premium dental - it was, in fact, cheaper to pay out of pocket for our cleanings than pay $1200/ year for the premiums.

Until I needed a crown.  And my husband needed a crown.  In the same year.

Now there are 4 of us and 3 going to the dentist regularly.  At 6 regular visits a year, at $200-250 a pop (covered at 80%), that's $1040 covered automatically.  We waited for my husband's most recent crown until the new year.  Boom, got our money back.

But it really wasn't until 2 years ago when we had 3 at the dentist and we both were in our 40's (when our fillings from our teens/20's started failing) that it became worth the money.

nereo

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Re: Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« Reply #20 on: September 15, 2015, 05:44:23 AM »
dental tourisme is working if you use a good company
I do not understand what you are trying to say - please elaborate.

2Birds1Stone

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Re: Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« Reply #21 on: September 15, 2015, 06:02:31 AM »
He is a troll, look at the thread he started and his sig.
dental tourisme is working if you use a good company
I do not understand what you are trying to say - please elaborate.

nereo

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Re: Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« Reply #22 on: September 15, 2015, 06:17:57 AM »
He is a troll, look at the thread he started and his sig.
dental tourisme is working if you use a good company
I do not understand what you are trying to say - please elaborate.

ah, got it.  thanks.

ShoulderThingThatGoesUp

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Re: Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« Reply #23 on: September 15, 2015, 06:31:24 AM »
Haven't had it for years. Ask your dentist if there's a cash discount - they're small businesses, usually, and have no desire to deal with insurance.

Jags4186

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Re: Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« Reply #24 on: September 15, 2015, 07:50:28 AM »
Dental insurance, for the most part, is never good for the insured because otherwise people would sign up when they need major work, then drop it.

My insurance at work will pay up to $1500/yr.  Also, they will only pay X amount for Y procedure.  For example my dentist charges $200 for a cleaning, they will only pay $165, so I pay $35 every time I go.  I pay $6 and change/week pretax for this plan.  For me it works because I'm essentially paying $312 in pretax premiums for $330 of post tax cleanings.  Also if I need a cavity filled or something I'll get at least some sort of support.

Bob W

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Re: Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« Reply #25 on: September 15, 2015, 07:59:17 AM »
Look for new dentists that are advertising heavily in your area.   Then negotiate the best rates.  Read a few things on negotiating.   You should be able to save at least 50%.   Bring cash up front.

GizmoTX

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Re: Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« Reply #26 on: September 15, 2015, 08:04:18 AM »
We've deliberately never had dental or vision insurance. Pay as we go has worked out much better.

FIRE me

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Re: Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« Reply #27 on: September 15, 2015, 08:08:24 AM »
Ok - so my wife is now staying home with the kids so we no longer have Health Insurance or Dental insurance through her work (I'm self employed) and have a pretty affordable plan through the ACA.

But it doesn't have Dental Insurance.

Thoughts?

Ask your Dentist if you can continue paying the same prices that your former insurance plan allowed. You can look at your old statements to see what the plan allowed, versus what the Dentist billed. The difference is likely very substantial.

For procedures you had not previously had done in his office, you'd have to trust him (or her), assuming said Dentist would agree at all.

It might help if you were willing to convince him of your financial solvency and presumably high (you're a Mustachian!) credit rating.

jimmyshutter

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Re: Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« Reply #28 on: January 13, 2019, 05:03:39 AM »
I just thought I'd share my recent experience. I hadn't been to a dentist in almost 15 years so I went to a new one. I sat down with the cleaning person and she said I had very little plaque and made a comment on how well I must take care of my teeth.

What a joke. Cleanings, check ups, and x-rays are a scam.

Brush and floss regularly folks, the rest is just a money grab by dentists and insurance companies.
« Last Edit: January 13, 2019, 05:09:57 AM by jimmyshutter »

WhiteTrashCash

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Re: Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« Reply #29 on: January 13, 2019, 06:03:12 AM »
The plus side of insurance, as the OP states, is for serious or catastrophic dental care. I'm glad I had the insurance when I needed to get periodontal surgery for recessed gums -- which is a common issue that happens with natural aging. I maxed out my insurance coverage for those procedures. Sure glad I had it.

Dr Kidstache

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Re: Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« Reply #30 on: January 13, 2019, 09:47:50 AM »
I'm a Dental Hygienist.  I would suggest checking with your dental office to see if they participate with any discount plans.  Our office participates with Delta Direct and Cigna Preferred.  The Delta plan is approximately $100/yr for your whole family.  You end up paying the office directly, but you get the Delta fee schedule contracted rates.  There are no maximums.  Delta pays nothing and there are no claims.  Hypothetically, if each crown is $1200, you'll end up paying $850ish.  The fees vary by region.  It would more than pay for itself in your case.  If you were a single person and got 2 cleanings a year and 1 set of bitewing X-rays, it would probably not be worth it.

Dental insurance is notoriously poor coverage relative to premiums. I use a dental savings plan (Aetna Vital Savings) like @DizzyDaisies recommends. I'm on Medicare - no dental coverage either. If your dentist doesn't participate in any of the savings plans and won't give you a cash discount, sounds like you have 2 options. 1) find a different dentist for the restorative work, 2) decide that your current dentist is worth ($6000 in restorative work - the cost difference of a different dentist) and pay up.

Rosy

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Re: Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« Reply #31 on: January 13, 2019, 11:42:17 AM »
I just thought I'd share my recent experience. I hadn't been to a dentist in almost 15 years so I went to a new one. I sat down with the cleaning person and she said I had very little plaque and made a comment on how well I must take care of my teeth.

What a joke. Cleanings, check ups, and x-rays are a scam.

Brush and floss regularly folks, the rest is just a money grab by dentists and insurance companies.

Not disagreeing with you - however - in my case, I had an immune disorder that caused severe tooth decay. Dentist and my mother of course:) always chided me on not taking care of my teeth.
Spent thousands to get it all fixed and "save" the remaining teeth.

Except - since nobody realized what was going on - I got to spend another $16K about 7 years later. Everything just keep decaying. I had constant nerve pain and infections and my teeth looked like I was a meth addict in the end.
I was lucky that my bone structure turned out to be good enough to have a couple of implants and I doubt anyone was ever so happy to have all their teeth pulled - a relief from pain and misery and constant dental visits.

I still wasn't diagnosed with the immune disorder until about 10 years later.

Just posting this in case it might help someone else - it's called Sjogren's and often portrayed as "just" having a dry mouth among other symptoms. Well, it isn't always so benign. This disease dries up your saliva and attack your glands. Google Sjogrens foundation - it is one of those awful diseases that mimics other diseases and is incredibly difficult to diagnose and the fun thing is that there is no cure.

Cranky

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Re: Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« Reply #32 on: January 13, 2019, 01:37:30 PM »
My dh brushed and flossed and didn't go to the dentist for about 10 years, and then he had such bad periodontal disease that he got liver abscesses and almost died, and then he had most of his teeth pulled. Getting his teeth cleaned twice of year would have been a real bargain.

v8rx7guy

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Re: Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« Reply #33 on: January 13, 2019, 02:24:58 PM »
Indeed it is a ripoff.  We did jump on the plan this year knowing that my wife was going to need her wisdom teeth pulled.  We also did a checkup early in the year and late in the year for everyone in the family.  We are off again for 2019.  I haven't done the math, but I think we got our money's worth last year.

ElleFiji

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Re: Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« Reply #34 on: January 13, 2019, 05:25:02 PM »
Yeah... it didn't make sense for me either. My health insurance has an optional add on for dental insurance. The health insurance includes emergency dental work. Neither health or dental covers work like braces or crowns and root canals and things like that. The dental insurance covers wellness checks and preventative care (it might cover fillings). But premiums worked out to an extra $500 with coverage being 70% to a maximum of $480 if I'm remembering correctly.

nereo

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Re: Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« Reply #35 on: January 14, 2019, 06:08:29 AM »
Our employer-sponsored dental plan has monthly premiums of $27/mo ($324) and covers one cleaning per year (which costs $115 at my dentist).  In-network services are either 80% off (simple proceedures) to 50% off (crowns, bridges, etc). The maximum annual payout is just $1,000.

So if you just go for the annual cleaning you will lose money.  If you have a cleaning and a filling or two you might break even.  If you have more complex work done you'll recoup a little, but it's limited by the $1,000 maximum (and you've paid $324 in premiums).

tl;dr - the maximum one could save is $624 under my plan, with extensive dental work in one calendar year.  Most years you will lose either $324 (if you don't go tot he dentist) or $209 (if you just have your cleaning).


radram

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Re: Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« Reply #36 on: January 14, 2019, 06:30:16 AM »
I have been quoted $100-$150 per month to cover 3 of us with $1500 of coverage. I passed. This year while signing up for ACA, I selected that I wanted to add dental coverage for a fee. I went with delta dental. $1,000 of coverage, preventative is covered, $270 annual deductible, 6 month waiting period for most treatments and a discount on treatments. Monthly premium is $50.50 for 3 of us. It may be that they gave me a discount for the first year to get me as a client.

6 month waiting period? How the fuck am I supposed to know when I can go 6 months without a treatment? They can just jack the price next year and my 6 month clock resets after I switch providers.

I agree my mouth not being my health is insane. Same with my eyes. and my hearing. What the fuck. I am looking forward to pricing knee insurance in the future.


PoutineLover

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Re: Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« Reply #37 on: January 14, 2019, 07:39:29 AM »
I think it really depends on the plan. My premiums are 330 per year for single coverage, and I get two cleanings per year. They each cost 190 and I'm reimbursed 180 so I save 30 bucks in a normal year. If I didn't have the plan I'd probably only go once a year. But I've also needed gum grafts at 500 each, reimbursed 80 percent, and now I need a crown for 1340, of which 865 will be reimbursed. The plan also covers xrays every two years. So the plan is fine in regular years, and it really helps in years where I need more work done. There's a max of 2000 per year, but so far I've never hit it. I think regular dental visits are important, and definitely would never stop going just to save money. For those who can't afford dental care or insurance, I highly recommend university dental clinics.

trollwithamustache

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Re: Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« Reply #38 on: January 14, 2019, 07:45:26 AM »
FWIW, we've had good luck talking to a couple dentists about cash prices. Some Dentists are interested in not dealing with Insurance, some are happy to keep doing what they are doing.  The guys who want cash work are priced cheaper than getting insurance.

catccc

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Re: Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« Reply #39 on: January 14, 2019, 10:41:47 AM »
I get a lot of value out of my dental insurance; it usually is if you need any work and you stay in network.  Otherwise, the benefit caps and balance billing will hurt.  Negotiated rates make a big difference for me.

I like my dentist who is out of network with my workplace sponsored plan.  I actually figured out that it was worth paying a separate individual insurance premium to an insurance provider for which they are in network for pre-negotiated rates.  Make sure you fully understand the plan before you write it off.

TexasRunner

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Re: Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« Reply #40 on: January 14, 2019, 11:01:06 AM »
Look for new dentists that are advertising heavily in your area.   Then negotiate the best rates.  Read a few things on negotiating.   You should be able to save at least 50%.   Bring cash up front.

THIS.  Call around and state that you will be paying in cash or cashiers check up front.  Ask for the best rate they can give and let them know you'll be calling around.  Very unlikely they wont go down to insurance agreement levels.


We do the same with healthcare.  My employer's plan is $10,380 in premiums with a $5,000 deductible, then you pay 30%.  In other words, for a $25,000 car wreck, we would pay $10,380 + $5,000 + $6,000 copay... or $21,380.00 of a $25,000.00 event that is statistically unlikely and may not even be on our dime (like a car wreck where other insured party is at fault).  There comes a certain point where it just doesn't make sense mathematically to have insurance.




Edit to add:  Before anyone says anything about preventative care and prescriptions, We are charged $30 copay for each doctors visit...  If I pay cash then its $45 TOTAL up front.  Prescriptions are a little worse but our family is young and in good health.  Generic drugs do just fine for the small stuff.
« Last Edit: January 14, 2019, 11:07:25 AM by TexasRunner »

Cranky

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Re: Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« Reply #41 on: January 14, 2019, 11:10:31 AM »
Good luck getting out of the hospital for $25k, though.

frugaliknowit

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Re: Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« Reply #42 on: January 14, 2019, 12:14:40 PM »
Dental Insurance:  Just smoke and mirrors, fagetaboudit!


Shop each procedure around...create competition.

TexasRunner

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Re: Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« Reply #43 on: January 14, 2019, 12:38:28 PM »
Good luck getting out of the hospital for $25k, though.

How much do you think cash payment would be for a 2-night stay with 3 X-rays and 1 MRI?  Back when we were on even better insurance, I paid $7,250 for that event in addition to the $8,400 paid in premiums throughout the year (that was early in the year, we cancelled insurance after that).  That was the only major medical event that year.  I had a long-time friend who worked in that hospital's billing department run through the numbers if we had agreed to pay in cash over 12 months.  Had there been no insurance in the equation, she would have been able to do 12 payments of $1629.00 without even getting supervisor's approval, lower with permission.  Considering that (and basically all other hospital stays for young people) is a statistical outlier, and we paid for 5 years of insurance with no major incidents other than that one, we come out WAY behind by having insurance.

People get sticker shock when they see a 84k bill for a hospital stay, but its artificially inflated pricing to get the numbers high enough to still turn a profit after the insurance companies pay out 1/3rd of that.  People can (and regularly do) get pricing at the same levels as the insurance companies, especially if you call ahead for agreed amount and pay in cash. 



FWI- I have done the math on his before.  Until the medical market and insurance markets get fixed, my family won't be doing insurance at all.


Insurance Breakdown

2013 - $1768 Principle (YAY!) - $950 Deductible Per Person - $3500 Deductible Total - 25% copays beyond
2014 - $2178 Principle (Eh...) - $1100 Deductible Per Person - $4500 Deductible Total - 30% copays beyond
2015 - $3248 Principle (Boo.) - $1100 Deductible Per Person - $4500 Deductible Total - 30% copays beyond
2016 - $4504 Principle (Yuck) - $2500 Deductible Per Person - $4500 Deductible Total (May have been 5k here, but unsure so I'm going with the lower number). - 30% copays beyond
2017 - $8376 Principle (Ugh.) - $5000 Deductible Per Person - $5000 Deductible Total (NOTE:  We didn't pay this.  This is the year we said FU to the medical insurance industry) - 30% copays beyond
2018 - $10380 Principle (....) - $5000 Deductible Per Person - $5000 Deductible Total then copay.  (Note:  Again, we aren't paying.) - 33% copays beyond

Medical Spending had it been cash totals:
2013 - 1 ER visit - 4 doctors visits - 0 Hosp stays - Cash cost would have been about $420 to $720.
2014 - 1 ER visit - 5 doctors visits - 0 Hosp stays - Cash cost would have been about $665 to $965.  ER was X-rays for broken collarbone.  Total cost without insurance would have been $380 as it was quick and there was no cast.  "Sticker price" was around $1200 but could have been drastically reduced per friend.
2015 - 0 ER visits - 5 doctors visits - 1 Hosp stays - Cash cost would have been about $225.  PLUS OBGYN and birth costs would have been $9500 pre-agreed (we considered it).
2016 - 0 ER visits - 6 doctors visits - 0 Hosp stays - Cash cost would have been $270.
2017 - 1 ER visit but rolled into a hospital stay - 8 doctors visits - 1 Hosp stay -  Cash cost would have been $19,550 for the hospital, MRIs and CAT scan.  Doctors visits were higher due to specialty.  $225 plus $495.  $20270 cash cost for the whole year.
2018 - 0 ER visits - 4 doctors visits - 0 Hosp stays - Cash costs (have) been $180.

Medical spending WITH insurance...
2013 - $1768 + 4x$30 (Dr Copay) = $1888.00
2014 - $2178 + $75(EM Copay) + 5x$30 (Dr Copay) + $450 x 25% procedural copay (ER XRay Copay) = $2515.50
2015 - $3248 + 5x$30 (Dr Copay) + 14x$45 (OBGYN Copay with ins) + 4500 x 30% (Birth procedural copay) = $5378.00
2016 - $4504 + 6x$30 (Dr Copay) = $4684.00
2017 - $8376 + 5x$30 (Dr Copay) + 3x$45 (Specialist Copay) + $5000 max deductible + $7500 x 30% copay beyond deductible = $15911.00
2018 - $10380 + 4x$30 (Dr Copay) = $10500.00


So a true comparison of all costs in on an insurance plans vs cash pay comes out as follows:

2013 - $1888.00 on insurance vs $720.00 (worst case)
2014 - $2515.50 on insurance vs $965.00 (worst case)
2015 - $5378.00 on insurance vs $9725.00 (includes birth costs in both)
2016 - $4684.00 on insurance vs $270.00
2017 - $15911.00 on insurance vs $20270.00 (worst case)
2018 - $10500.00 on insurance vs $180.00

2013 - Cash wins by $1168.00 (though, if anything had happened, 2013 insurance was MUCH better than now). (This includes an ER visit)
2014 - Cash wins by $1150.00 (This includes a broken collarbone ER visit...)
2015 - Insurance wins by $4347.00 (Due to childbirth being expensive... lol)
2016 - Cash wins by $4414.00
2017 - Insurance wins by 4359.00 (NOTE:  This includes an extremely expensive 2 night, CAT scan and MRIs hospital stay.  A "worst of the worst" by medical cost standards aside from something like cancer, and insurance still only wins out by 5k or so.  That should be VERY telling to people.  After this fiasco I started running the numbers and we killed off the insurance bill.  We paid a fee for it but it still came out ahead.)
2018 - Cash wins by $10320.00  (Note:  nothing happened to make insurance worth it.  Some people might claim that if we had insurance in 2018 that we might have made different choices but we really wouldn't.  We used regular kiddo's doctor when they got sick.  We wouldn't have gone to the ER either way, because thats expensive and wasteful.  Overall, I'm VERY glad we turned off the insurance leech...)

TexasRunner

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Re: Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« Reply #44 on: January 14, 2019, 12:56:19 PM »
Overall, Cash would have won out by $8,746.00 but once you account for (just a few years) worth of compounding, you would have ended up with $9,734.50 more.  As such, we have been taking the exact same payment we would have made towards insurance and have been putting into investment accounts (IRAs and 401k mixed).  If anything happens, we will negotiate out with the hospital to make 12 (or however many) payments to pay off the bill.  As such, we could cash-roll the payments instead of paying insurance.  The only way we lose out is if we have multiple statistically rare events in the same year. 

Math doesn't work out in favor of that happening either...  If something has a 1:40,000 chance of happening.  The likelihood of that happening more than once is astronomically small (IE [1/40000]^2 or 1/1.6bil.  It may be more likely for one 'major event' to lead to extremely high costs (like early onset cancer, heart attack in your 20s, etc), but that is the whole point of insurance...  Insure against "reasonable" but unlikely events.  As is, reasonable events would cost almost the same paying cash as paying insurance while still being extremely unlikely.  So it doesn't make sense to buy insurance...

Note:  2018 isn't an outlier.  Considering that is the "new price to play the game", had the premiums been similar for 2016 and 2014, you would have seen numbers that were just as drastic.  That would be 30k in savings instead of just 8k...


It is the same as if I were to buy homeowners insurance to cover 165k house plus 45k of valuables.  BUT if there were a fire, I would have to pay 50k in deductibles and copays and the premium is 35k a year...  NO ONE WOULD PAY THAT.  Why on earth do we pay it (and allow the merry-go-round to keep spinning) when it comes to healthcare...?

/off-soapbox.
« Last Edit: January 14, 2019, 01:10:57 PM by TexasRunner »

SnackDog

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Re: Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« Reply #45 on: January 16, 2019, 04:52:39 AM »
Broken wrists, ER visits and x-rays are well and good, but insurance is for major costs.  Six weeks in the hospital after a major accident. Intensive care.  Multiple surgeries.  A disease.  Cancer.

Raiser your deductible if you can afford the higher co-pays, etc to enjoy the lower premium.

TexasRunner

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Re: Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« Reply #46 on: January 16, 2019, 08:04:29 AM »
Raiser your deductible if you can afford the higher co-pays, etc to enjoy the lower premium.

Thanks to ACA, thats the highest deductible I can have.  In 2010 and 2011 I had (real) catastrophic insurance with a $10,000 deductible, a 3mil cap, and paid 240$ A YEAR in premiums.  No Dr visits or other preventative care included.  That was awesome.  Now those plans are illegal so.....

ReadySetMillionaire

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Re: Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« Reply #47 on: January 16, 2019, 08:16:08 AM »
Keep in mind another benefit of dental insurance - they negotiate rates with dentists.  My dentist has a fee schedule for various plans.  For my insurance, once I hit the cap ($1050 but a $50 deductible), then I'd have to pay their full rate.  However, I have secondary dental through my husband and that plan has negotiated that I pay the negotiated rate even once their cap is reached (again $1050 but a $50 deductible).

This myth is right up there with the "you should spend two months of your salary on your engagement ring."  It's just taken as true and nobody seems to even question it.

I have never in my life had an experience where a procedure was more expensive in cash than it would be going through insurance.  Dentists, dermatologists, surgeons, gastroenterologist, etc. Every single thing I've ever negotiated in cash is far less expensive than if it goes through insurance, and quite frankly, it's never been close.

In my experience, healthcare providers are ecstatic when they don't have to go through insurance.  It cuts out a huge middle man and they get paid faster.

Mgmny

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Re: Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« Reply #48 on: January 16, 2019, 11:59:19 AM »
For major reconstructive surgery, dental tourism is a great idea. Go to mexico for a few days, get the work done for pennies on the dollar, come home.


GettingClose

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Re: Wow - Dental Insurance is a HUGE racket and a ripoff!!!
« Reply #49 on: January 16, 2019, 12:09:02 PM »
Quote
Go to mexico for a few days, get the work done for pennies on the dollar, come home.

I have a close family member who is a dentist, and ends out having to take care of bad outcomes from this approach.  Apparently there are very good dentists in Mexico, and very bad ones, but the regulatory system is much worse than the US.  So the work of the good ones is just as good as anything here, and 1/4 (or less) of the price.  But the work of the bad ones is far, far worse, and expensive to clean up back in the US.