Recommendations needed for dental insurance for someone with no dental plan

[worthit]

BHs:

A relative of mine doesn't have dental insurance but needs some work (cleaning, x-rays etc.). Are there self-insured insurance plans that forum members have experience with that they can recommend?

Thanks in advance.

[Jeepguy]

I visit the dentist of my choice and pay out of pocket. After trying various dental plans I found this to provide flexibility in where I visit and not more expensive when factoring in the insurance premiums I no longer pay.

[bob60014]

"Are there self-insured insurance plans that forum members have experience with that they can recommend?"

Well I'm self insured and pay out of pocket, so I recommend myself! Lol.

Dental plans are rarely cost effective.

[DesertGator]

All dental insurance sucks. 100% - no exceptions. Don't buy it.

[jebmke]

There are discount plans available; they are definitely NOT insurance. Some dentists accept them but some do not. Opinions vary on whether they are worth it.

Self-insurance is just another name for no insurance.

[keystone]

All dental insurance sucks. 100% - no exceptions. Don't buy it.

Yep, I don't think there's any great option out there. I was talking to a dentist friend of mine and he said dental insurance is like the opposite of health insurance. With health plans, you typically pay your deductible first then have potentially unlimited coverage. With dental plans, typically a nominal amount is covered up front and then everything else is out of pocket.

[KlangFool]

There are discount plans available; they are definitely NOT insurance. Some dentists accept them but some do not. Opinions vary on whether they are worth it.

Self-insurance is just another name for no insurance.

+1,000.

You get in-network discount price. It may or may not be worth it depending on the dental network it support at your location.

https://www.deltadental.com/us/en/prote ... -plan.html

KlangFool

[goblue100]

I visit the dentist of my choice and pay out of pocket. After trying various dental plans I found this to provide flexibility in where I visit and not more expensive when factoring in the insurance premiums I no longer pay.

This is what I do. I tried some insurance but once I figured out what it really covered which appeared not to be much I was just better off on my own. My dentist has a yearly plan for out of pocketers. It is slightly less than two out of pocket cleanings and x rays and I think he will give 10% off any work needed. I've done this the last two years.

All dental insurance sucks. 100% - no exceptions. Don't buy it.

I did not realize this was everyone else's experience as well. Makes me feel better I'm not missing something.

[260chrisb]

All dental insurance sucks. 100% - no exceptions. Don't buy it.

Sorry but this couldn't be farther from the truth IMO. There are many, many plans available. I can't speak to all of them but I've had very good results via work and on the exchange with Delta Dental plans. Dental costs are not unlike any and all other medical costs in that they are expensive and certainly being proactive and keeping your mouth healthy is step one. There are limitations to dental plans as there are with any health related insurance. For the cost of the premiums, benefits far and away exceed them just for routine cleanings and x-rays. They never cover everything unless you have some unique policy via a work plan but I'm pretty sure that doesn't exist. Keep your mouth healthy first, buy the best plan you can and utilize it to its fullest and then utilize your HSA for out of pocket balances.

[Kenkat]

All dental insurance sucks. 100% - no exceptions. Don't buy it.

They are great if your employer covers the premium. If you have to pay the premiums, it’s mostly just like pre-paying your own dental costs, so I agree it’s mostly not worth it.

My Cobra dental coverage just ended in January. The Cobra made sense for our situation as I had a dental implant finishing out and then my wife had a root canal and crown that happened as well during that period. My particular coverage had a feature where we had additional coverage over the $2000 per person yearly maximum, so everything got covered.


Now that Cobra has ended, we are just going to pay dental costs out of pocket.

[bradinsky]

Dental insurance has many benefits……..if you are the insurance company! Visit the dentist twice yearly for regular checkups & cleanings & pay out of pocket. Practice good dental hygiene & don’t waste your hard earned money on dental insurance.

[Carguy85]

All dental insurance sucks. 100% - no exceptions. Don't buy it.

This should be a sticky in the wiki if it’s not already!

[Tom_T]

All dental insurance sucks. 100% - no exceptions. Don't buy it.

Sorry but this couldn't be farther from the truth IMO. There are many, many plans available. I can't speak to all of them but I've had very good results via work and on the exchange with Delta Dental plans. Dental costs are not unlike any and all other medical costs in that they are expensive and certainly being proactive and keeping your mouth healthy is step one. There are limitations to dental plans as there are with any health related insurance. For the cost of the premiums, benefits far and away exceed them just for routine cleanings and x-rays. They never cover everything unless you have some unique policy via a work plan but I'm pretty sure that doesn't exist. Keep your mouth healthy first, buy the best plan you can and utilize it to its fullest and then utilize your HSA for out of pocket balances.

Please define this. Did you have extra work done? How much did you save in exchange for the premiums?

[worthit]

Thank you, all. I never knew there were options for dental insurance beyond the traditional employer offered plans. This is valuable information. Appreciate the links and the responses.

[260chrisb]

All dental insurance sucks. 100% - no exceptions. Don't buy it.

Sorry but this couldn't be farther from the truth IMO. There are many, many plans available. I can't speak to all of them but I've had very good results via work and on the exchange with Delta Dental plans. Dental costs are not unlike any and all other medical costs in that they are expensive and certainly being proactive and keeping your mouth healthy is step one. There are limitations to dental plans as there are with any health related insurance. For the cost of the premiums, benefits far and away exceed them just for routine cleanings and x-rays. They never cover everything unless you have some unique policy via a work plan but I'm pretty sure that doesn't exist. Keep your mouth healthy first, buy the best plan you can and utilize it to its fullest and then utilize your HSA for out of pocket balances.

Please define this. Did you have extra work done? How much did you save in exchange for the premiums?

I'm yet to have extra work done but insurance is risk management. I don't know if I will. I hope not and likely won't although I've had my share of dental related issues in my life and thankfully always had good dental coverage via a work plan. I'm yet to have a car accident either but that doesn't mean I don't need insurance. I know it's not quite the same. So far this year with an initial exam, X-rays and a cleaning my insurance plan paid what would equal just short of 6 months worth of premiums and if I would have paid out of pocket I could have bought 9 months worth of insurance. I'm not saying these plans are all great but for me it seems the cost of risk management is worth the price of the premium. I'd have to review all the coverages included but just one event more than typical cleanings, exams and x-rays would warrant the policy based on whatever the amount covered would be.

[dbr]

A person's view of dental insurance may change as age advances. People are correct that dental insurance is basically just prepayment where insurance cost and treatment benefit tend to be about equal. However, translating the large net loss in carrying a policy for check up and cleaning to no benefit when needing crowns and other more expensive work is a mistake.

A factor that must be included is what are the allowed costs a dentist charges when he agrees to take you on a plan as opposed to not on a plan as opposed to granting a discount as opposed to negotiating a cost. The largest benefit may be a limit on costs as a result of simply participating in a plan.

But, yes, buying dental insurance for nothing but an annual check-up and cleaning does not pay.

[Morgan22]

You could try a discount plan. Ask if the dentist accepts any. If so which one. (Or ask if cash pay is provides a discount greater than a discount plan.)

Klang Fool linked the delta discount plan site in an earlier post.

You could also take a look at this for some different companies that offer discount plans.
https://www.newdentalchoice.com/
https://www.dentalplans.com/

[UpperNwGuy]

Are there self-insured insurance plans that forum members have experience with that they can recommend?

All those plans are pretty much the same. Just pick one. Delta Dental is the largest. Blue Dental is the one with the best integration into your regular health insurance, provided that it is Blue Cross Blue Shield. But the other plans are just as good.

[BradleyB]

Retired dentist here...

As an individual, dental "insurance" plans are next to impossible to get. Typically, you get a $1500 max benefit per year, but premiums cost you maybe half of that. If you have someone else (such an employer) then it is worth it.

Many plans are very restrictive as to where you can get your services. Many dentists to not participate in those plans because the reimbursement rates are so low. Like the AARP plans for example.

You will still have a copay of 20-50% for most procedures.

I know that many will sign up for plans thinking they get "free care," but it doesn't work that way. If you need extensive work, have a sit down with your dentist or their ins clerk and figure out what makes sense, for you.

[tj]

Retired dentist here...

As an individual, dental "insurance" plans are next to impossible to get. Typically, you get a $1500 max benefit per year, but premiums cost you maybe half of that. If you have someone else (such an employer) then it is worth it.

Many plans are very restrictive as to where you can get your services. Many dentists to not participate in those plans because the reimbursement rates are so low. Like the AARP plans for example.

You will still have a copay of 20-50% for most procedures.

I know that many will sign up for plans thinking they get "free care," but it doesn't work that way. If you need extensive work, have a sit down with your dentist or their ins clerk and figure out what makes sense, for you.

Typically, yes, individual dental insurance has extremely low annual max benefits, but there are options that have no such limitation, such as Physicians Mutual:

https://www.physiciansmutual.com/web/dental

There is out of network reimbursement so if you know that you need a lot of dental work, it could make sense even if you're dentist isn't in the network, but even better if you're dentist is in the network.

[BradleyB]

Yep.

I guess that there are 2 ways to go about this:

1-You really want to go to a specific dentist, so choose the ins plan that the office participates with.

2-Pick a plan, they find a dentist on the list.

It might matter what type of tx you anticipate needing. Routine preventive care and simple fillings or something quite complicated.

[tj]

Yep.

I guess that there are 2 ways to go about this:

1-You really want to go to a specific dentist, so choose the ins plan that the office participates with.

2-Pick a plan, they find a dentist on the list.

It might matter what type of tx you anticipate needing. Routine preventive care and simple fillings or something quite complicated.

I wouldn't even know where to begin to look for an "excellent" dentist for major work - I know some people just go out of the country to get that stuff done!

I've liked some of the dentist that I have had, but it's been nothing more than a filling (other than when I had wisdom teeth removed and braces, but my parents chose those people)

[dowse]

When I retired, I compared costs for various scenarios ranging from just cleanings to multiple crowns or bridges in a calendar year. In all cases, I was better off using a discount plan the my dentist accepted, first Cigna, now replaced with Dental Choice. This is due both to high premiums plus annual caps. The discount plans have no caps and cost about $100-200 per year for participation. I also used Carington temporarily for an oral surgeon.

[CaptainT]

My and many dentist have a customer care plN where you pay something like 300 for 1 cleanings , x rays, and 25% off everything else for a year. (My dentist calls this the Smiles Plan)

Ask your dentist if they do this this may be a better deal.

[Hebell]

At my husband's retirement, we looked around at dental insurance, and decided against it because of its lack of value. But we did find a dentist that has a senior plan for those over 60, that includes cleanings and diagnostics at a bundled price with discounts on any further work.

[WhyNotUs]

While many of criticisms of individual dental plans are correct, another concern is that "self-insuring" can create an incentive for one not to have regular cleanings. We are learning more about the benefits and importance of dental health. Regular cleanings are a good investment in health.

I have had good dental coverage, a prepaid plan with a franchise dental outfit (Comfort Dental), and no coverage. If you can get it through work, that is usually the best option. If you do not have coverage, discipline yourself to get the cleanings.

[illumination]

I'm not sure if I have ever had dental insurance, and it's just never been a problem. Get a good electric toothbrush, floss and self insure.

I guess if I had ongoing issues, I would reconsider, but I'm usually not a fan of insuring for events that can't "break" me financially. One month of my health insurance premium is about what I have spent for the last several years of out of pocket, dental expenses for myself.

Many dental practices have their own sort of "subscription plans", I had ones for my kids. Truthfully, I figured out I was better out of pocket.
The most expensive dental procedure have been cosmetic, things like braces for my children, etc. And getting that kind of coverage is not the usual, off the shelf dental plan.

[dbr]

People should take into account the fact that the dentist may have agreed to a fee schedule set by your plan that is less than an uninsured patient would be charged. In that case eschewing insurance could be costly. This is a separate limit on your costs aside from coverage and reimbursement. Whether or not you can negotiate or buy an even lower cost without the insurance would be an issue to investigate with the particular dentist.

[calwatch]

The other issue would be emergency dental care, same as emergency health care. My dental plan at work may only have a $1750 annual payout limit but they have a wide network of dentists in the "premier" network which agreed to take specified charges. While not all Delta dentists participate in the PPO, almost all dentists are in the premier network.

[zlandar]

The employer-offered ones can make sense. The premiums can be subsidized/paid by the employer and whatever premium you have to pay is pre-tax. I calculated the cost of paying out-of-pocket vs signing up for the employer plan for routine cleaning/xrays. Insurance was the winner. Dental insurance has very low caps and I don't expect it to cover the cost of major dental work.

The ones you have to sign up on your own... nope.

[tj]

The other issue would be emergency dental care, same as emergency health care. My dental plan at work may only have a $1750 annual payout limit but they have a wide network of dentists in the "premier" network which agreed to take specified charges. While not all Delta dentists participate in the PPO, almost all dentists are in the premier network.

As a federal employee, I have access to GEBA which has a Delta Dental of PA plan that i can keep even after I resign from the federal government, at any age.

To me, it seems like a no brainer to ride this one out for the rest of my life unless I get some other job with a super cheap plan (but I'd probably just keep both).

The Standard plan basically breaks even on preventative and has a decently large annual benefit max, and the Enhanced annual benefit max is so large that it might as well be unlimited.

https://www.geba.com/dental-insurance-0 ... -services/

[BradleyB]

I wouldn't even know where to begin to look for an "excellent" dentist for major work - I know some people just go out of the country to get that stuff done!

I've liked some of the dentist that I have had, but it's been nothing more than a filling (other than when I had wisdom teeth removed and braces, but my parents chose those people)

It sound like you had minimal/routine treatment at your previous dentist and felt comfortable there. Assuming you still live nearby, I would go there. If you need a lot of work, ask if you can phase it over time.

By "major work," that would mean multiple missing teeth, advanced gum disease, cosmetic restorative, implants...that sort of thing. And a really, really big issue with this sort of thing is follow up, maintenance and revision. That is where going out of the country gets you in trouble. I had a few patients ask me for help, but the fix was as much as if they had it done locally in the first place. No thanks.

[EricGold]

This is a bit of an old thread, but here is my evaluation of the Delta 'Turquoise' plan in New Mexico for myself and my wife. It costs $900 a year.

Maximum benefit is $1,500 per person per year. This is distinct from maximum savings, which includes the discount off the list price in addition to the amount that Delta pays.

In the first year, Delta pays 30% of the bill, 40% in the second year of insurance, and 50% in the 3rd year of insurance
The Delta Premier schedule is about 75% of the Dentist list price. Savings are higher with the Delta PPO plan if your dentist participates.
The OOP is about 50% of the dentist list price for the Delta Premier up to $10k of list charges per plan member.

All together,
The break-even is $1,800 combined of list price treatment. $540 of maximum benefit will have been spent
In the $1,800 - $10,000 marginal list cost bucket, 50% off
Past $10,000 of list price treatment, a 25% discount off the list price of each marginal dollar is saved

One interesting detail: The 'turquoise plan' does not require a minimum time before the benefit is allowed for any treatment.

---
My dentist currently offers me a 15% senior+ cash discount off list price. My oral surgeon offers no discount
Here https://docs.google.com/spreadsheets/d/ ... sp=sharing
is a spreadsheet I concocted. It is not perfect, but I think it gives a good idea of whether to buy this plan and its overall cost/savings for different dental care scenarios.

[adamthesmythe]

All dental insurance sucks. 100% - no exceptions. Don't buy it.

Disagree. I have had a Delta dental plan through an employer, which paid a useful portion of the cost of crowns etc.

But if OP is looking for a stand-alone plan that will pay a substantial part of implants- no, not gonna happen. And for routine care- probably self-pay is fine.

[RudyS]

My and many dentist have a customer care plN where you pay something like 300 for 1 cleanings , x rays, and 25% off everything else for a year. (My dentist calls this the Smiles Plan)

Ask your dentist if they do this this may be a better deal.

My dentist has a similar plan. Good option.

[Copernicus]

My and many dentist have a customer care plN where you pay something like 300 for 1 cleanings , x rays, and 25% off everything else for a year. (My dentist calls this the Smiles Plan)

Ask your dentist if they do this this may be a better deal.

Is this the Smiles plan you have through your dentist?:
https://smilesdental.com/membership-program-plan/

Thanks.

[chw]

Depending on your state, you may be able to buy a reasonable plan through your state’s health insurance exchange. Our state does not require an ACA health insurance plan to purchase a plan- I currently have Delta Dental while enrolled in Medicare. The cost is reasonable, and our dental practice is in network. I disagree with others that insurance is not needed. If an unexpected procedure is needed, out of network(or lack of insurance) costs can rack up quickly.

[Parkinglotracer]

There is a dental school near us that offers 45 dollar cleaning and X-rays with students and instructors. We pay cash for the rest. Our dentist gives a little discount for paying cash .

[tj]

There is a dental school near us that offers 45 dollar cleaning and X-rays with students and instructors. We pay cash for the rest. Our dentist gives a little discount for paying cash .

Your dentist doesn't care that you go to a dental school for cleanings?

[Youndo]

Depending on your state, you may be able to buy a reasonable plan through your state’s health insurance exchange. Our state does not require an ACA health insurance plan to purchase a plan- I currently have Delta Dental while enrolled in Medicare. The cost is reasonable, and our dental practice is in network. I disagree with others that insurance is not needed. If an unexpected procedure is needed, out of network(or lack of insurance) costs can rack up quickly.

Similar experiences with Delta and unexpected costs. Last year, I needed an extraction and an implant. Delta’s share of the cost equaled roughly 8 times of my annual premium. In uneventful years of cleanings/xrays, the benefits are about 120% of the premium.
I get Delta through my ex-employer’s retiree benefits and am happy with it.

[GeMoney]

I have an individual basic PPO plan from Delta. The premiums have been steady over the past 5 years and based upon my calculations the premiums are essentially the same cost as me paying for the preventive services (cleaning, x-rays, checkup) at full price. The savings kicks in when I need additional work where minor things like tooth extractions and fillings are at 50% off or at a minimum the contract rate which is approx 40% less than the standard billing rate.

[IowaFarmBoy]

Before I retired, my employer offered a dental plan through Cigna that basically prepaid for cleanings and checkups and provided limited coverage for work beyond that. The cost was probably not far off of what they would have cost out of pocket but the big advantage was that I could pay for them with pre-tax dollars.

Now, my dentist offers a similar plan that may be saves me $50-100 year if I prepay. But not pre-tax.

[funyun]

Totally agree with others who say to not purchase it. I'd work directly with the dentist and see what they can do in terms of discounts for immediate cash payment. We have it only because the employer provides it for free, but honestly, it covers very little when all is said and done. It's too bad dental insurance isn't integrated with medical insurance. Seems so silly to have it be separate.

[Parkinglotracer]

There is a dental school near us that offers 45 dollar cleaning and X-rays with students and instructors. We pay cash for the rest. Our dentist gives a little discount for paying cash .

Your dentist doesn't care that you go to a dental school for cleanings?

I didn’t ask him but he seems ok with it. We spend 1/2 year down south and I get one cleaning there and x rays and get the other with my normal hygienist / dentist last each year. At the school the student cleans my teeth and looks at X-rays. The instructor hygienist then critiques and pokes here and there. Then the instructor dentist comes in and does all the above with a few pokes. He gives me a note to take back to my regular dentist. Overall they a lot 4 hours to a student cleaning but it doesn’t usually take that long. I asked for second year student so the cleaning and work is a bit quicker.

[AllMostThere]

Seems that the overwhelming majority of people suggest self-insuring for dental. Curious if this methodology still applies for a Family of 4? DW will be retiring end of this year, and her employer retirement insurance does not include dental. If we desire dental insurance, we will need to pay the full Cobra rates of $1700 / year. I seem to be stuck in analysis paralysis as this just seems to be pre-paying for the 2X cleanings + exam for four people. At least one of us needs additional work every year (fillings, root canal, etc.).

[motorcyclesarecool]

I use a limited expense FSA to pay for our dental expenses for our family of 4. And earn credit card cash back as I do it. We’ve also timed out our cleanings such that one of them falls during my employer’s open season. That way if any of us needs extra work we get 50/50 odds that I can calibrate the FSA amount for the following year and get it done then. I did a gold crown that way a few years ago.

[JayB]

Our local dentist offers his own plan for about $365 annually that covers cleanings and exams twice a year and gives a discount on x-rays and other things. We have turned it down. So far at least, spouse and I have been going for one cleaning and exam a year, with the dentist saying after each visit that this frequency is entirely adequate for us. The cost is about $180 per person. We also refuse routine x-rays for reasons I don't want to detail here. There is nothing absolutely magic about having to go to a dentist for cleanings twice a year; that seems to be a rarely-challenged business-building rule of thumb which is overkill for some people who take excellent care of their teeth and get good checkups.

[DarkHelmetII]

All dental insurance sucks. 100% - no exceptions. Don't buy it.

Don't know about the "open market" but across numerous employers my annual dental premiums have added up to roughly what was covered for two routine / cleaning visits per year. So worst case for me (financially) has been break even but if I were to have required something else the insurance would have helped. But regardless when were talking about plans with limits in the thousands of dollars the overall financial impact just isn't very large one way or another, especially when compared to major medical.

[tj]

Seems that the overwhelming majority of people suggest self-insuring for dental. Curious if this methodology still applies for a Family of 4? DW will be retiring end of this year, and her employer retirement insurance does not include dental. If we desire dental insurance, we will need to pay the full Cobra rates of $1700 / year. I seem to be stuck in analysis paralysis as this just seems to be pre-paying for the 2X cleanings + exam for four people. At least one of us needs additional work every year (fillings, root canal, etc.).

Cobra might be the best option you have, but after it runs out, consider this one if your dentist is in network:

https://www.physiciansmutual.com/web/dental

Also consider:

https://www.ncd.com/dental-metlife-benefits/

[criticalmass]

Nearly every week I receive mail from another local dentist offering an exam, cleaning, x rays, etc for new patients at a special price $79-89.

If I didn’t have insurance, I would pick one and then ask if they would honor in network rates for future visits. Most dentists will offer a similar discount for cash customers if they are in network for major plans.

When I had expensive specialist/periodontist work done, I found a highly respected provider in network for my insurance, and split the work across two plan years as it was over the $3k max for any year. (part 1: late December, part 2: a few weeks later). Unfortunately, that provider went out of network after December 31 of year 1. Fortunately, they agreed to honor the same rate for part 2 when we discussed this before all work began.

Takeaway; When not using insurance, ask nicely for network pricing. Competition for new patients is high in many areas.