Dental Insurance

[Yagents]

Re: Dental Insurance!

One word.......Mexico. Dentists of Los Algodones Mexico - Yuma, AZ

That's what some do in AZ that have that have big dental work.

 

[The HIC Group]

Re: Dental Insurance!

Last week I had a client call me wondering why her teenage child that needs 14 teeth implants are not covered by her health insurance.

This is not a cosmetic or due to injury. She mentioned it was due to her adult teeth that is simply not there. I'd like to point her in the right direction so here is what I am asking. Can anyone help this family? She is in FL and will need 14 implants.

1. Will she be covered even if it is a pre-x?

2. Premiums for a family of 4 (mom dad and 2 teenage girls)?

3. What would be the COST???? She was told by her dentist that it would run around $3k per tooth. That is $42k!!!!! From my limited experience in dental, major stuff will only cover around 40% on average? Is that correct? However, on a $42k dental bill, if the client payed cash, I am sure the Dentist would reduce it 40%, hence no need for insurance?

Am I missing anything? If anyone out there thinks they can help, let me know and I will get you in contact with this client.

Hello,

That is very unfortunate. You must find a strong dental insurance network plan that will offer strong discounted network rates.

Feel free to send me a note if you would like to discuss various plans in FL. ssok @ thehicgroup.com

 

[WCMason]

I'm looking for another dental option. Do you offer contracts for this Ameritas plan? I love the "no waiting" period provision.

I checked them out today. No waiting period appears to be for those who can prove creditable coverage in past 30 days. Good feature for most T65.

 

[pcbinsurance]

Re: Dental Insurance!

I know people who go to Cancun for their dental work. Nice to parlay a vacation with some dental work.

 

[deadhead]

Re: Dental Insurance!

When I went to Ameritas' website it showed a 1500 cap with a 6 month wait

 

[SamIam]

Re: Dental Insurance!

People are going there with all the problems at the border & hearing about them killing Americans.

 

[Yagents]

Re: Dental Insurance!

They actually have charter buses that take people down there. I guess when you have tooth pain, and not enough money, a little violence doesn't stop you. That mexican city is actually populated by mostly dentists, and it's kept pretty safe. When you have big work that needs to be done, saving $10,000 is worth the risk.

 

[The HIC Group]

Re: Dental Insurance!

They actually have charter buses that take people down there. I guess when you have tooth pain, and not enough money, a little violence doesn't stop you. That mexican city is actually populated by mostly dentists, and it's kept pretty safe. When you have big work that needs to be done, saving $10,000 is worth the risk.

I'm curious, How much of a savings would you receive by going to a Mexican dentist?

 

[Yagents]

Re: Dental Insurance!

It's about 50-75% off
Prices and Services | Algodones Dentists

 

[The HIC Group]

In the 31 years I've been in this industry, marketers have come up with new ideas for individual/family dental, but when the dust settles, nothing has changed. Here's the history on individual/family dental:

INDEMNITY OR PPO - They are more expensive, have low annual benefit maximums ($1000 to $1500 usually), and have long waiting periods for major services (and sometimes even for basic services). Of course, this is necessary to avoid adverse selection, early utilization followed by early termination. The problems are that the member could fund their own dental care with the amount of premiums + deductible & co-insurance. Another problem is that the insurance company tends to spike the premium rate (or cancel the entire program) after the waiting periods are over. The only time this really can mathematically benefit the client is when the client has a large number of children, and they all get their preventive work for free, plus some basic & major services.

PREPAID DENTAL, DENTAL HMO, DENTAL DISCOUNT PLAN - very inexpensive premium (usually paid annually at about $100 for a single or $200 for a family). No waiting periods. Unlimited benefits. You pay specific copays for each listed service. When you calculate it out, it comes out to practically 100% for Preventive, 80% for Basic and 50% for Major - very similar to the co-insurance structure of an indemnity plan. Sometimes certain specialists in an area get together and refuse to sign up on these lists (like Endodontists who do root canals for instance), so that can cause a problem. There are a bzillion of these plans. I hate these plans. I get too many complaints. But if a client insists on it, I just give them my broker link at dentalplans.com. I tell them to ask their dentist which plan he works with, and then just sign up for that plan. Problems with these plans are --- It's an HMO style restricted network. The Dentists tend to come and go, because they use these discount plans to build a practice, then they drop the plans. Established dentists usually don't sign up on the network, and actually hate these plans. Dentists get paid very little from the premium (actually, it's a fee not a premium because this isn't actually insurance). The portion of the "fee" that they get is so low that they must gather it for several months before they can justify seeing the member for their initial exam, xrays, cleanings (which is usually free to the member). For that reason, many times the member calls for an appointment and is told the next available appointment is 9 months away. Sometimes the member gets dinged for quite a number of services for additional copays. Sometimes the member gets a little less quality materials in their mouth. I'm not saying all Dentists do this, but some do. You can't blame the dentist for this - the discount plan is quite a deep discount.

GROUP INSURANCE - this is true insurance. The other ones listed above really aren't - they are just another way to budget for costs. Some small businesses try to avoid the individual/family dental problems by buying it as a business group. However, most dental insurers won't insure very small businesses or family controlled businesses. In other cases, group dental insurance can be a very fine product to offer.

DELTA DENTAL - here in AZ, if you call a dentist and ask which plan they take, the first answer you get is Delta Dental!!! Just recently Delta Dental of AZ came out with their own individual dental plan. It's not bad. It has all the issues I mentioned in the first paragraph above about indemnity/ppo plans. But in this case, they are probably a stayer. Delta very rarely enters a market unless they know they can succeed, and the chances that they will discontinue the program after the waiting period is over is slight. (BTW, Delta waives the waiting period for current Delta members who don't have a lapse in coverage when they transition from group to individual). I'm not promoting Delta, btw (I have no stake in it), just saying they might be a stayer when other indemnity/ppo insurers tend to withdraw from the market or spike renewal premiums after waiting periods are over.

good info. thank you
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I am going to contract with BCBS and have been looking at the dental plans. What attracts me to them is the fact that there is no underwriting and the apps are very simple ie.- plan A B or C very cut and dried. Of course the comissions are like picking cotton, the more you pick, the more you make. In your opinion, what is the very best company for dental plans ?

Most indemnity plans like Assurant and Medico pay the most commissions first year and then barely nothing the second year. These indemnity plans have the worst retention.

The network plans like Golden Rule, Humana, Aetna, Delta, etc. are the better plans for your clients but pay 5-10% level commissions. Network plans have the best retention.

The best network plan I've come across is with Ameritas.
- Ameritas is the 2nd largest Dental Network behind Delta Dental
- Can use any provider.
- 2,500 max limit
- no waiting periods for preventative, basic or major services
- vision insurance included w/ no waiting period
- up to 28% level commissions (new/renewal)
- 12 month advance
- paid weekly
- easy online enrollment


hope this helps.