No-Wait Dental for the Demanding

[Northeast Agent]

I know a lot of your thoughts about dental (stuff $30 month in a shoebox and pay out of pocket), but I have a new client who is going to be a big p.i.t.a.

Lady is 62 and coming off COBRA. Stupidly helping her with an ACA plan (never again, I'm referring them to the Exchange) and dental/vision as well.

Very few plans offer no waiting periods for dental services like root canals, but a few do (Humana has one, UH One and also Ameritas). The issue is neither of her fancy Philly dentists seem to take dental insurance. One's website says:

Maximizing Your Dental Insurance Benefits

Our office always strives to maximize your dental insurance benefit. As a service to our patients, we routinely electronically process and submit dental insurance forms for our patients. Depending upon the dental insurance plan, a patient may receive reimbursement for dental procedures completed at our practice for a portion of the treatment fee, or none of the treatment fee. We are not participants in any insurance plan, and you will not find our names in a list of providers from your insurance company.

I assume a plan like Manhattan Life would work, as you can use any provider then be reimbursed but this lady started shrieking when I mentioned waiting periods. I met her through her FA, who mentioned she's "only" worth around $1M in assets. He usually only deals with high-worth clients ($10M+) and inherited her as a favor during a divorce settlement. So she's not broke, but a cheapskate.

 

[vic120]

I have in the past spent time with dental, trying to find a good plan, the best premium best bang for the buck, I ended up with a lot of service work and low commissions after dealing with a lot of objections and checking networks

Then I stopped selling dental all together until heard about Manhatten life, Its simple go to any dentist its very straight forward, I don't chase or fight with clients if you want this is it If not you can search out another plan This is what I say

Now its a fairly easy plan pays good commissions and I have had barely any service work

Yes for time to time I may not get a sale but its rare and even if it were not I still make more on this plan and save time not pushing or chasing after dental

I have the attitude of this is a great plan and most of my clients are happy but I don't care if you get it done and this has worked and if it didn't I would sell dental at all, I don't have the patience to spend too much time and energy with clients on dental

Although there will be waiting periods, I have not seen a no waiting period plan that makes sense, Usually there is little coverage at high cost

 

[LostDollar]

Caveat, not an agent.

(I say the following things, even though I have a different opinion about dental insurance than most of the agents who post regularly here.)

Is it necessary for you to assist this lady with dental/hearing coverage in order to maintain the relationship with the FA?

If not, I think it would be wise if you could make some excuse about not being involved in the dental insurance market and you are unable to help.

There is another regularly posting agent whose customer service experience with Manhattan is diametrically opposed to vic's. When I couple that with your initial post; in my opinion, if you get your fingerprints on this lady's dental plan in any way, shape or form, you are signing up for 20 years of customer service misery with "no" compensation.

 

[somarco]

DHMO and discount plans are the only ones I know of that do not have a waiting period. I believe Delta Dental modifies that stance with prior creditable coverage.

Regardless of which plan you recommend she probably won't like it and it will be up to you to fix it.

Most plans require you to use par providers if you want maximum benefit. And fewer than 20% of dentists will agree to discount their fees to accept network providers.

I have never SOLD a dental plan but have allowed a few to buy as long as they promise not to complain when they fall out of favor with the plan.

Your client probably will be a PITA but even more so if you suggest a dental plan. Just step away from the curb is my advice.

 

[LostDollar]

If you must pursue it, you might check with the dentist's office and see if they accept any dental discount cards.

When I was looking here a couple of years ago, I think UHC/Golden Rule had the shortest waiting periods of the plans I looked at, but even they had waiting periods on the highest level dental services like root canals. (I am sorry, there are 3 levels of services for dental coverage and I can't remember the technical insurance vocabulary for them off the top of my head. To some extent, UHC's waiting periods would reduce based on the amount of premium you were willing to pay.)

 

[Northeast Agent]

LostDollar said:

Is it necessary for you to assist this lady with dental/hearing coverage in order to maintain the relationship with the FA?

He didn't mention dental when we spoke. I met him once or twice at a local business association I belong to over a year ago then he called out of the blue in late summer. He belongs to a practice of about six FAs and said they have no one to help with their Medicare, either...

somarco said:

DHMO and discount plans are the only ones I know of that do not have a waiting period. I believe Delta Dental modifies that stance with prior creditable coverage.

I'm appointed to offer DPbrokers discount plans (haven't offered them, though) and will tell her to check with her dentist to see if they'll accept it if she doesn't want to wait.

 

[fed up]

PITA customers is one reason I gave up on prescription and dental plans. Every phone call was a fight and occupied valuable time arguing about a correct charge or discount. "Go to Walmart" and "I don't do dental plans" were a mantra. Too many dental plans are 1500 in premium for 1500 in coverage plus some discounts which are 100% OOP.

 

[goillini52]

Too many dental plans are 1500 in premium for 1500 in coverage.

Name one.

 

[somarco]

I'm appointed to offer DPbrokers discount plans (haven't offered them, though) and will tell her to check with her dentist to see if they'll accept it if she doesn't want to wait.

Beyond the network participation issue with discount plans, and that is a HUGE deterrent, there are other considerations.

I am appointed with DP Brokers as well and wish they would change their name, but that is not important now.

With an INSURED plan there is oversight. Claims for unneccessary work are denied. That leads to a different issue. Do you pay your dentist or try to stiff them for doing something that wasn't beneficial?

With insured plans some procedures require pre-authorization. Another truth serum for the dentist requiring justification or it's up to you if you want to pay cash.

With discount plans you also have no way of knowing if the dentist is making you have multilple appointments (which drive up your costs) when the work could have been done in one sitting.

You have no way of knowing if the dentist marks up their charges to discount them when you use the card.

And just like insured plans your client may have a reason to say "Is that all they pay?"

 

[fed up]

Name one.

Okay I was off a few bucks. Delta Dental is 756 for the year with a 1 time 100 deductible and 2000 limit on coverage. so you are paying year 1 856 in order to get back 2000. That should be enough for 1 crown. Maybe.