Highest Dental Plan Payout - Even With Long Wait

[Zoaty]

Hello Fellow Reps,

Does anyone know which Dental Plan has the highest percent payout for services such as cavities and other mid or high level services?

Even if it takes a year before graduating to the highest level of benefits, and even if it's not the cheapest plan I'm curious what's out there.

Any thoughts would be great!

Thanks in advance!

 

[goillini52]

Hello Fellow Reps,

Does anyone know which Dental Plan has the highest percent payout for services such as cavities and other mid or high level services?

Even if it takes a year before graduating to the highest level of benefits, and even if it's not the cheapest plan I'm curious what's out there.

Any thoughts would be great!

Thanks in advance!

Which do you want, % or annual maximum?

 

[Chazm]

Manhattan pays 80% but only up to 1.5k. Bright (something) pays up to $5k.

 

[goillini52]

Manhattan pays 80% but only up to 1.5k. Bright (something) pays up to $5k.

UCT gets up to 90% and goes up to $2,500 a year. Nationwide is 100/80/50% from year 1 up to $5,000 a year on a PPO and it covers implants 50%.

https://files.constantcontact.com/41811bda401/73d18e8a-8747-445a-ac88-3fb0a84202fc.pdf

 

[somarco]

Hello Fellow Reps,

Does anyone know which Dental Plan has the highest percent payout for services such as cavities and other mid or high level services?

Even if it takes a year before graduating to the highest level of benefits, and even if it's not the cheapest plan I'm curious what's out there.

Any thoughts would be great!

Thanks in advance!

Highest percentage means nothing.

If a plan says it pays 90% for fillings then how much does it pay in dollars? You have no idea and neither does your client.

The REAL question should be 90% of WHAT amount?

Actual billed charge by the dentist? Or 90% of what the carrier feels is a "reasonable" amount for the service?

Dentist bills $200 for a "routine" filling.

Does the plan pay 90% of $200 = $180?

Or does the carrier feel a reasonable fee would be $100 and pays 90% of $100 = $90.

If the dental plan involves a network and the dentist does not participate they can balance bill for the difference. Many times the dentist will bill the patient $200 (payable at time of service), file the claim for you and allow the carrier to reimburse you direct.

Almost all dentists will file a claim for you, but a small percentage of dentists will participate in networks and accept the repriced amount as paid in full.

 

[LostDollar]

Caveat, Not an agent

When I was looking for Dental Insurance, I looked for some lists like this:

http://www.texashealthoptions.com/cp2/dentalcompanies.html

Checked each one out to see if they had a product in my state,

And then did some company benefit and premium comparisions between the ones with products in my state. (I also considered ones on the MarketPlace and 2 or 3 I had read about here.)

You are likely going to have to do your own research on the companies and their products, relating that information to the combination of your market (zip code) and your own specific "ideal dental insurance parameters" to determine what is "out there" for whatever specific special need you are considering at this time.

You are also going to need to consider things like

HMO vs PPO
How restrictive (limited provider participation) is the network in your market
Group or Non-group
Under 65 or 65 and older
Do I want a plan that combines Dental, Hearing and Vision
Do I want Insurance or a Discount Card