Dental Insurance

[OhMari]

`What is up with Dental Insurance.

We had decent coverage until we had to go on COBRA. I paid the extra $67 a month for Dental which is Delta Dental.

My daughter had a cleaning done and they took $50 off for the detuctible.

In April she had 2 cavities filled and they won't Pay for the anthesia and they only payed 50% of each cavity. How in the world are you suppose to get a cavity filled without being frozen. This is ridiculous. I noticed when my husband had a root canal they did not pay for the freezing either. This is absurb.

I also found out on my husband that they only pay 50% of a root canal and then only 50 % for the cap. When I called and asked the insurance company, she told me I should be grateful, cause some insurance companies pay only 30%.

I have to call again tomorrow and find out why they only pay 50% on cavities.

We know have different insurance as of May, I am going to have to go read the fine print to see what is covered under our new insurance. I know we have Ortho Insurance, but I read you have to be on the plan 9 months before they pay any benefits, my daughter is about half-way with her braces.

 

[disneydentist]

Deductible: fairly common.

50% for crowns: farily common.

50% for fillings and root canal: chintzy plan.


Charge for (local) anesthesia: time to find a new dentist. This is considered part of the service. The ADA even eliminated charge codes for local anesthesia several years ago.

Braces: good luck with switching plans midstream.

 

[buzzlady]

Most denetal insurance only pays $1,000 of the orthodontist.

 

[rascalmom]

In my experience of filing insurance for my husband's practice for years:

Dental Insurance is usually only worthwhile when part of a benefit
packaage you receive from your employer. If you have to pay for your own, any cost savings is very minimal, if existent at all. I've always thought the terminology used by the insurance companies is somewhat misleading - most insurance (homeowner's, medical, auto) stops the insured's loss. With "Dental Insurance" you have your usual deductible & contractual co-pay amounts, but also an annual limit to benefits which is very minimal. By the time you pay the premium, deductible, co-pays and "non-covered" services, most patients would be better off just setting aside some budgetary amount for dental care.

Correct on the "anesthesia" fee - this should be included in the fee for crowns & fillings, etc.

Stepping off soap box now - sorry!

 

[dennis99ss]

Be glad you have dental insurance

 

[gymnasticsmom68]

Charge for (local) anesthesia: time to find a new dentist. This is considered part of the service. The ADA even eliminated charge codes for local anesthesia several years ago.

I agree

 

[Mskanga]

Delta Dental is one of the worst insurances I have ever seen. I have it and it's the same thing, 100% coverage on x-rays and cleanings, but the rest of the services are at a discounted negotiated rate. This is an employer plan , not individual.
We go to THEIR dentist and they still don't pay what they should. I can understand for caps and all that stuff, but for fillings? Ridiculous.

 

[OhMari]

Charge for (local) anesthesia: time to find a new dentist. This is considered part of the service. The ADA even eliminated charge codes for local anesthesia several years ago.

I went back and looked and called my daughter's dentist and she said they gave her laughing gas. I told her I don't think my daughter needs laughing gas any more she is 14. They told me she was slightly nervous, who isn't when they go to the dentist. I found out the insurance company won't pay for laughing gas. With my husband though, he didn't have laughing gas and they didn't pay for his freezing on a root canal.

Braces: good luck with switching plans midstream.

My husband was unemployed for 10 months and now he is back to work and we have health insurance and dental. Everything changed over May 6. The new insurance probably won't cover the braces cause it is pre-exisiting.


We didn't have dental insurance for the first 15 years of our marriage. I did save 6 months, then we went to the dentist and paid at the time of services. If anyone had anything extra the dentist let me make payments.

 

[aprilgail2]

Originally posted by OhMari
`What is up with Dental Insurance.


I also found out on my husband that they only pay 50% of a root canal and then only 50 % for the cap. When I called and asked the insurance company, she told me I should be grateful, cause some insurance companies pay only 30%.

I

Wow, that is not good...I never pay a penny for dental, most everything is covered and what isn't the Dentist just eats.

 

[Feralpeg]

We are currently under Delta Dental with Cobra. I found the same thing when DD had a cleaning a two little fillings. As soon as I get moved, I'm switching to a better plan. We used to have Cigna. It paid very well.

 

[Az Pirates]

Originally posted by aprilgail2
Wow, that is not good...I never pay a penny for dental, most everything is covered and what isn't the Dentist just eats.

Sounds like you found a great dentist - I'd have you give me a referral, but Arizona to New York for dental work may be a tad much.

We used to have delta dental - just switched over and the new coverage is even worse!

 

[tiggersmom2]

Just a "For Your Information"

Just because the dentist "eats" the remaining balance on your account does not mean he is a great dentist. What this means is that he is contracted with a PPO plan to accept the fee that they will pay him along with your co-pay. Many beginning dentists do this because this is a good way to get alot of patients.


Many other dentists are not participants in the PPO plan - they still accept your insurance but the insurance usually pays them around 70-80% on preventative procedures and you are responsible for the remaining balance.