If FiRED, what do you use for dental insurance?

[FIREin2018]

I fired 2 years ago at age 47. (im single, no kids.)
I have Obamacare.
Dental insurance wasnt included in my plan last year.

this year, i opted for Dental insurance (Delta Dental $14/month) but i didnt understand it was just basic and nothing like what my employer offered.
it only covered cleaning and 50% of fillings. No root canals/crowns.

well, i went to my dentist and i need 3 crowns.
i knew i needed 1 and needed work on 2 other teeth but wasnt explained to me that those 2 teeth were also going to be crowns.

So what dental insurance do you have?
how much does it cost? Waiting period?
And how did you get it?

[Evgenia]

This is not helpful, I realize, but we've been FIRE for five years and haven't found any that is worth it. In some cases, we'd end up paying more in insurance than in a typical year of services. Note that we're just two adults with no kids, orthodontic expectations, etc.

We pay cash, but made sure to have an ACA insurance plan with an HSA, and we use the HSA funds for dental. We contribute the maximum to the HSA (not quite $7k/year) so, if you don't touch it for a year or two, it adds up enough to cover small surgeries, more expensive dental stuff, and all that.

[LifeHappens]

I've been self-employed for 10 years and have never purchased dental insurance. Buying it on the private market rarely makes financial sense. Like the previous poster suggested, funding an HSA and using those funds for dental is about the best you can do. In addition, some dentists will negotiate a bit for cash payments and some accept discount plans.

Sorry. Dental just sucks.

[Paul der Krake]

I bought the best PPO plan available and am writing it off from self-employment income, helping keep my AGI low.

I understand that this is basically protection money that I'm paying to a middle man with better pricing power. I hate everything about it, but it's what made the most sense.

[Linea_Norway]

There are plenty of people paying their dentist cash. Inhave never had a dentist insurance. Three crowns sounds like a lot, but that must be pretty unusual.

[Kris]

There are plenty of people paying their dentist cash. Inhave never had a dentist insurance. Three crowns sounds like a lot, but that must be pretty unusual.

Dental care in the US is extremely expensive, unfortunately. And dental insurance is pretty crap. There is a surprising amount of stuff they either won't cover or will only cover a ridiculously small amount.

Case in point: many years ago, I had to have an emergency root canal on a front tooth. The root canal itself was covered by my insurance at like 50%. The subsequent reconstruction and cap of the tooth? Nope. Because it was deemed "cosmetic."

[secondcor521]

I third the self-insure plus HSA.  I've self-insured dental since FIRE, and am starting my HSA next month.

[Frankies Girl]

I've never purchased dental insurance. I pay in full, get a great discount with them and last year they told me they offer a one time pay (like $130?) program that covers 2x cleanings and a 15% discount on anything else needed including crowns or implants - whatever.
They closed down completely for emergencies so I may be skipping the dentist all together this year, but had planned on do that deal when we went in.

Otherwise I just do my best to take REALLY good care of my teeth and gums. I wear a night guard to protect my teeth (I clench/grind otherwise), we use sonic toothbrushes, we don't eat super hard candy/foods, floss and brush every day.

The husband had to get a crown a few years ago and it was like $400? Husband said he was shocked at how much better our current dentist is than the one he used to go to (wanted $1,000 and this was like ten years ago!). So the other suggestion is to get a second opinion and maybe call around for pricing you don't have to stay with your current one, especially as it's odd they weren't really good at explaining what you needed done.

And also if it's REALLY extensive work needed, might look into dental schools? I know we get students asking for volunteers all the time on local social media for cleanings (they take much longer but are free or like $10) but they must have to train them on how to do crowns and such as well.

[Fishindude]

From what I've seen dental insurance does not work out mathematically in most cases.
We choose to go without and pay cash.

[MissPeach]

A long time ago I used to manage the insurance plans for companies I worked for. For dental most only pay $1k-$2k in coverage max per year. So personally speaking, unless I have an employer covering a lot of the premium I have self insured here for years. Even paying cash out of pocket usually hasn't been too bad. Taking into account the premiums minus the $1-2K they'll chip in I usually come out ahead.

And if you do elect to get coverage to pay for these crowns, double check the coverage especially if you get a PPO. Most have waiting periods where you have to pay for coverage for 6-9 months before they'll cover anything major like that.

[Loren Ver]

We FIREd in 2019.  DH needs to have a dentist look at his teeth regularly and needs fillings regularly.  I have loads of fillings but take really good care of mine so need less work until these start to fail (they are all past their life expectancy but are hanging on).

We found that insurance was really not worth the cost so DH called the dentist that he liked and got the cash cost for work.  We now budget for it.  Once the pandemic is over I might start calling around to see if I find someone I like better than my old dentist I had to use through work.  Their non-insured costs seem high.

If I where you I would either call around for costs or check online for costs.  DH uses a walk in clinic type place (seems odd to me, but that is what is work had him using before) but they publish their costs online so you know what you are getting into head of time. 

[FIFoFum]

The Medicaid expansion health care (low income, free!) in my state has some options that include dental care. It includes cleanings, fillings, a lot of emergency care, xrays/check-ups, and some more involved work (crowns, root canals, bridges, etc.) with the potential for coverage/specialty referrals for more complicated dental problems. I don't know how common this is in different states or even on different plans/locations within my state.

The ACA plans do not cover any of this. You can buy the supplemental/generally-not-worth-it plans that everyone else has mentioned.

This is one reason that I deliberately tried to keep my MAGI at the Medicaid expansion level for a while & tried to get some dental care done while it wasn't going to cost me. Right now, I'm on an ACA plan again, because it can be hard to keep MAGI low enough while also realizing or earning taxable income on which to live.

[FIREin2018]

I've been self-employed for 10 years and have never purchased dental insurance. Buying it on the private market rarely makes financial sense. Like the previous poster suggested, funding an HSA and using those funds for dental is about the best you can do.

 In addition, some dentists will negotiate a bit for cash payments and some accept discount plans.

Sorry. Dental just sucks.

literal cash as in hundred dollar bills? or credit card as well?

[Frankies Girl]

I've been self-employed for 10 years and have never purchased dental insurance. Buying it on the private market rarely makes financial sense. Like the previous poster suggested, funding an HSA and using those funds for dental is about the best you can do.

 In addition, some dentists will negotiate a bit for cash payments and some accept discount plans.

Sorry. Dental just sucks.

literal cash as in hundred dollar bills? or credit card as well?

I know you weren't asking me but my dentist calls it "self pay" and give discounts solely based on you paying in full before walking out the door - credit cards are fine. (also cash/check/debit...) They consider the fee they pay for customers using CC is low considering the amount of paperwork/filing/hassle they'd be out going through insurance channels and they know it's paid right then so good for their monthly bottom line.

[slappy]

Like others have said, dental insurance is not usually a great deal and likely won't cover a huge portion of those crowns anyway. I do have dental insurance through work, but I am looking to switch dentists and this thread has reminded me that I should check on the self pay costs and then evaluate whether I want to re enroll in dental insurance during open enrollment. We do have three kids though, so that might sway it towards the insurance for us.

[Goldendog777]

I had MetLife with my previous employer.  When I was researching dental insurance right before I quit, I couldn’t find anything that didn’t require a 1 year or longer waiting period for fillings or crowns.  I ended up contacting MetLife directly and they had something called MetLife take-a-long dental.  No waiting periods because there wouldn’t be a gap in coverage.  It was $57 a month for my spouse and I.  They cover 80% of fillings, 50% of crowns and root canals and 2 free cleanings and 1 checkup a year.  Seems like either my husband or I end up with a crown or crown plus root canal so it’s worth it for us right now.   

[facepalm]

Where I am at that $14 a month for two cleanings and half of fillings would be a great deal. I pay my dentist $120 a year just to have a third cleaning done that Delta won't cover.

For big expenses, I just pay cash. I had a molar go bad on me ten years ago and had to pay to have it cut out and a post (implant) put in, plus a new crown. came to about $8000. While I hated the expense, it was fun walking in and writing a check for six grand (didn't have a rebate card at the time). Thankfully, the cost of implants has dropped quite a bit since then.

[Samuel]

In non-Covid times there's also the medical tourism route for bigger ticket dental work. There are really good clinics in Mexico, Costa Rica, etc, that specialize in fixing American's teeth for significantly less than US prices.

[Cali4en]

I've had a Cigna DPPO Advantage plan for six years since FIRE'ing and it's about as good as dental insurance gets on the private market here, which admittedly isn't that great.

It's one of the few that has a fairly wide acceptance umbrella and offers decent benefits.  Major benefits have a waiting period, as I've found with all dental plans, but the routine stuff (cleanings, xrays, preventative) kicks in on day one.  Terms are on the nicer side of typical - $1,500 annual limit, $50 deductible (none for routine), routine stuff is free, minor stuff covered at 80%, major stuff covered at 50%.  My monthly premium is $34, which works out annually to about $50 less than the cash discount cost my dentist charges for a full year of routine maintenance services.

If you view it as pre-paying for routine stuff, then the actual insurance component costs less than $5 a month.  The major value though is that I've never found a dentist who will offer cash pricing comparable to the discounts negotiated by the insurance company.  So any significant use of services makes it a financial win.

One nice thing is that Cigna hasn't increased my premium at all over the last six years.

[Trifle]

One and a half years into FIRE here, and so far we are self-paying for dental work.  Most expensive thing so far has been braces for the 15 year old.  (Insurance would not have covered anyway).  Knock on wood, no other problems so far.  Just routine visits and cleanings.  But if problems crop up, that's what the HSA is for. 

[FIREin2018]

The Medicaid expansion health care (low income, free!) in my state has some options that include dental care. It includes cleanings, fillings, a lot of emergency care, xrays/check-ups, and some more involved work (crowns, root canals, bridges, etc.) with the potential for coverage/specialty referrals for more complicated dental problems. I don't know how common this is in different states or even on different plans/locations within my state.

The ACA plans do not cover any of this. You can buy the supplemental/generally-not-worth-it plans that everyone else has mentioned.

This is one reason that I deliberately tried to keep my MAGI at the Medicaid expansion level for a while & tried to get some dental care done while it wasn't going to cost me. Right now, I'm on an ACA plan again, because it can be hard to keep MAGI low enough while also realizing or earning taxable income on which to live.

my state also expanded Medicaid but i chose Obamacare because i was planning on doing some Roth conversions.
but if i dont do the conversion, my income will be like $9k this year.

Is it possible to switch from Obamacare to Medicaid in the middle of the year?

[Linea_Norway]

There are plenty of people paying their dentist cash. Inhave never had a dentist insurance. Three crowns sounds like a lot, but that must be pretty unusual.

Dental care in the US is extremely expensive, unfortunately. And dental insurance is pretty crap. There is a surprising amount of stuff they either won't cover or will only cover a ridiculously small amount.

Case in point: many years ago, I had to have an emergency root canal on a front tooth. The root canal itself was covered by my insurance at like 50%. The subsequent reconstruction and cap of the tooth? Nope. Because it was deemed "cosmetic."

I live in one of the most expensive countries in the world and dental treatment is also very expensive here. And in addition we pay 25% vat, on detal and everything else.

I have noticed that a private dentist with small clinic (just one dentist, no assistants) was a lot cheaper than big clinics. But unfortunately, as soon as the single dentist has a good customer base, they get bought up by the big clinic.

[jim555]

You can drop into Medicaid mid year, just re-estimate your income. 

In NY the Medicaid Managed Care plans cover BASIC dental, but no root canals.  Usually a very limited network of dentists.

Lots of plans use Dentaquest.
https://www.dentaquest.com/state-plans/regions/newyork/

[K_in_the_kitchen]

I'm still covered because DH is going to OMY until he doesn't want to be there anymore.

Our old dentist (10-20 years ago) referred out everything to specialists.  Eventually we got a new dentist, and it's so different.  I needed an emergency root canal a few years ago, my first in a long time, and my dentist did it himself.  He told me he trained to do them so he could save his patients money.  He also fights with the insurance company for his patients.  When I was a new patient I cracked a molar and needed a crown.  My dentist doesn't like to do an automatic root canal, which many do for the cracked molar because the insurance company always pays for the crown if you have a root canal.  The insurance company refused to pay for my crown because they said they couldn't see the crack in the photos he submitted with the claim.  I saw what was happening because of the EOB statements I would receive.  In the end, the insurance wouldn't pay their portion, but my dentist never charged me more than my portion.  He took the loss rather than passing it to me, and said it was because he truly believed the crown was necessary.

I don't think I ever knew before this how much a private dental practice is a business, and how the dentist can make choices.  If I ever change dentists, I will be sure to find one who will negotiate prices if paying cash, and who has learned to do some procedures rather than automatically sending patients to the endodontist and oral surgeon.  I have to pay the price for what isn't my fault -- my teeth were badly affected by childhood poverty and malnutrition + a lack of care in the early years (I had dental care 3X between the ages of 0 - 18).  I suppose I don't have bad teeth, but I acquired fillings galore at ages 14 and 18, and over the years they've leaked and I've needed root canals and crowns.  I don't tend toward gum disease, and I take good care of my teeth, so for many years it's just been dealing with molars chock full of fillings.

[SunnyDays]

I had a great plan while working and didn't use much of it because I just didn't need it.  Mostly for cleanings and the odd small re-fill.  Once I retired, I found that insurance didn't pay, and of course now that I don't have it, I'm starting to need more work done.  But I plan to just keep paying out of pocket anyway - I can afford it.

[BTDretire]

I'm 65 and never had Dental Insurance. Dental costs are not likely to bankrupt you.
Car accident, healthcare and house loss/liability can, that's where you buy insurance.
 I guess if you know that you will have big dental issues and will win the gamble of paying the premiums,
 go ahead. Doesn't feel right to me though.

[norajean]

Self insure and shop around. There are many horribly over priced dentists (driving white Mercedes).  Go to a dirt poor part of town, sit in a filthy waiting room and you can get very affordable dentistry. Same goes for veterinarian.

[iris lily]

I’ve never had dental insurance. My employer never provided it for free, anything I could buy just seems silly as not worth it.  So my  insurance is: I self insure. Same for eyeglasses, and honestly, DH’s eyeglasses were for many years more expensive than any dental bills we had.

Then he had cataract surgery which also fixed his  nearsightedness and now he wears no glasses. That’s like a damn miracle, I can’t believe it!  His eyeglasses were $1000 and I’m not talking about fashion frames because he’s a nerdy old guy and does not need fashion frames.

[JoJo]

I self insure and visit a dentist when I visit my parents, as their dentist is way cheaper than any in my city, I think around $110 for cleaning + dentist check up.  I was hoping to get down to So. Cal this year and go to one of the recommended dentists in Los Algodones that cost around $30.  But to note, I haven't had any major dental problems since I had my wisdom teeth out over 25 years ago. 

[bmjohnson35]

No dental insurance now Fired in 2020.  Our dentist agreed to charge previously insured rates for corrective work.  Pay out of pocket.  Our insurance never really paid that much anyway. Use Obamacare for health insurance.

BJ

[FIREin2018]

yes. Income reduction is a qualifying event so you can change to Medicaid at anytime but you have to prove your income is reduced and I believe it is done on a month to month basis and not annual.

so i should have gone on Medicaid 1st at the beginning of the year then switch to Obamacare when my income exceeded Medicaid's threshold?

[Paul der Krake]

You really want to avoid switching to/from Medicaid mid-year if you can. It makes ACA credits much, much more complicated to forecast, apply for, and reconcile accurately.

[jim555]

yes. Income reduction is a qualifying event so you can change to Medicaid at anytime but you have to prove your income is reduced and I believe it is done on a month to month basis and not annual.

so i should have gone on Medicaid 1st at the beginning of the year then switch to Obamacare when my income exceeded Medicaid's threshold?

It isn't a problem to drop into Medicaid, just re-estimate and it will drop you in.  Remember it is monthly, while ACA is yearly.

[jim555]

You really want to avoid switching to/from Medicaid mid-year if you can. It makes ACA credits much, much more complicated to forecast, apply for, and reconcile accurately.

I actually did a mid-year drop in.  The reconcile was no problem, those Medicaid months have no subsidy to reconcile.  It wasn't any more complex than a normal year.

[I'm a red panda]

My employer based insurance has a $1,500 limit on services. It costs me only a few dollars a pay period; but if I was retired, I'd have no problem just going without. 

[SimpleCycle]

When I didn't have dental insurance, I had a dental discount plan.  I worked with my dentist to purchase one accepted at her office.  You pay a small annual amount (around $160) and then get a "negotiated rate" on all procedures.  Definitely ask your dentists office if there are any they accept.

[jim555]

I believe you have 60 days of increased income (higher then Medicaid monthly allowable) to go off Medicaid and onto an ACA plan. Having too high an income for Medicaid in any 60 day period is a qualifying event which means you can then apply for an ACA plan at anytime of the year and not just during open enrollment. You can check your states website and it should list the requirements. Just remember that an ACA policy is based on annual MAGI income and Medicaid is based on monthly.

In NY they let you keep it until the annual re-certification date, even if income has gone up.  Since we are in a declared COVID emergency no one will lose Medicaid while the emergency exists.  I was supposed to lose it and they won't let me out.

[Much Fishing to Do]

I don't think there are many dental plans left that are literally worth anything under any situation (so many have maximum caps that are below or barely above the premium).  The only way I can see ever having coverage is if I FIRE soon enough to have some of my kids covered under CHIP (which is amazing coverage, my sister had it for her kids when her husband was in school and got everything done she could for them during that time)

[Catbert]

Many years ago I had dental insurance for a year or two.  It didn't pencil out for me then (or now) so I dropped it.  Paying for two cleanings a year is about the same cost as dental insurance.  I *think* insurance co makes money charging dentists to be "in-network" or working it so that your co-pay is pretty much all the dentist gets.  Anyway it always seemed like a racket to me.

Why are you suddenly needing so much work?  Haven't been to dentist for years?  Ignored previous recommendations?  Accident?  Or switched dentists bc of insurance and suddenly need a lot of work?   Especially if the latter get a second opinion!

[Blue Skies]

We have employer sponsored dental insurance.  Our cost is approximately the same as what we would pay for two cleanings per year out of pocket.  It covers 50% of crowns, but they calculate the 50% based on a fictitious average cost for a crown.  Which means that even though I called around to various dentists and the best price I could get was $1000, the insurance only paid $200 because according to them the average cost for a crown is $400...
So, yeah, dental insurance doesn't do a whole lot of good.  Just budget for it and plan to pay for tooth maintenance.

[Roots&Wings]

I was told I'd need 2 costly crowns earlier this year (teeth really hurt, hairline cracks) then pandemic hit and everything went on hold. Using a nightguard for clenching/grinding plus remineralizing toothpaste and mouthwash has worked out for me, pain is gone (took about a month) and the crowns have been averted for near term.

If you can shop around and try something in the short term to reduce pain, that could be another option.