Dental Coverage Feedback

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helloeveryone
Posts: 124
Joined: Sun Sep 04, 2016 5:16 pm

Dental Coverage Feedback

Post by helloeveryone » Thu Sep 13, 2018 10:00 pm

I was hoping to get feedback from the group on my dental benefits decision this year (should I have selected the other plan) and also see what you recommend for future dental coverage.

My work dental coverage options for subscriber and family is Delta Dental ($84.83/month) vs. Dental Plus ($176.24/month). (there is an HMO option for $26.40/month which I have never considered but maybe should if all we tend to get is cleanings & annual X-rays)

The coverage differences are as follows:

Delta Dental vs. Dental Plus
Deductible - $25 vs. plan pays deductible
Max annual benefit - $1250 vs. $3000
Orthodontics lifetime benefit $1250 vs. $3000
Diagnostic & Preventative 100% vs. 100%
Basic services - 80% vs. 100%
Endodontics - 80% vs. 100%
Periodontics - 80% vs. 100%
Oral Surgery 80% vs. 100%
Major services - 50% vs. 80%
Orthodontics benefits 50% vs. 80%

We knew in early summer one child would need braces. So we scheduled the braces appt for after 9.1.2018 knowing we could fund our flex and also switch plans because the orthodontics benefits were better.

Turns out the braces cost $2000. So I opted for the Dental Plus coverage this year after always choosing Delta Dental prior to that. The coverage is $91.41/month more (annually - $1096.92 more)

Since the plan covers 80% we paid $400 with flex. (minus $24 for cash/debit 6% discount)
Had I chosen the Delta Dental - I would have been responsible for $1000 (minus $56 cash discount)


Looking back - maybe I should have chosen the cheaper plan? Since the math shows I paid $1096.92 more in coverage to save $600.

The rest of our dental care just consists of cleaning twice a year for a family of four.

The braces are the first stage. As all the adult teeth come in the nine year old will need stage 2.

But who knows when that will be so it wouldn't really impact this year.


I realize the more expensive plan covers 100% vs. 80% of a lot of things and 80% vs. 50% of the rest but for the last 10+ years we have always just had cleanings which are covered at 100% by both plans. Also the more expensive plan covers max benefits of $3000 vs. $1250.

Any thoughts on the above scenario based on your experiences with dental needs/braces etc...?

Thank you


helloeveryone
Posts: 124
Joined: Sun Sep 04, 2016 5:16 pm

Re: Dental Coverage Feedback

Post by helloeveryone » Thu Sep 13, 2018 11:46 pm

I started reading it and thought this was a prank post then got the dental insurance part. I also found other posts. It really seems like I should save $3k per year, pay out of pocket for everything. Leftover $ builds up year over year until we need dental care beyond prevention at which point we should have enough $ to deal with it.

I never looked into the dental plans that much but as many others have posted it truly is a prepayment plan.

toofache32
Posts: 1331
Joined: Sun Mar 04, 2012 6:30 pm

Re: Dental Coverage Feedback

Post by toofache32 » Fri Sep 14, 2018 7:41 am

That link is a great explanation of dental "insurance" which is not really insurance. The only time I've seen dental "insurance" be a good deal is when someone else (employer) is paying for it.
And the first line is so true. New patients often like to say they haven't been to the dentist in a long time because they didn't have dental insurance. :oops: It's an interesting mentality. I wonder how they eat without grocery insurance.

ScubaHogg
Posts: 38
Joined: Sun Nov 06, 2011 3:02 pm

Re: Dental Coverage Feedback

Post by ScubaHogg » Fri Sep 14, 2018 9:49 am

Am I reading this correctly? With Delta Dental you pay $1013.16/y ($84.83x12) to maybe not have to pay $1250 (max annual benefit)? That...doesn't seem like a good deal.

The Dental Plus ($2114 to maybe save $3000) doesn't seem much better.

I'm assuming I'm reading this wrong, in which case, please ignore my questions. 8-)

SimonJester
Posts: 1631
Joined: Tue Aug 16, 2011 12:39 pm

Re: Dental Coverage Feedback

Post by SimonJester » Fri Sep 14, 2018 10:57 am

ScubaHogg wrote:
Fri Sep 14, 2018 9:49 am
Am I reading this correctly? With Delta Dental you pay $1013.16/y ($84.83x12) to maybe not have to pay $1250 (max annual benefit)? That...doesn't seem like a good deal.

The Dental Plus ($2114 to maybe save $3000) doesn't seem much better.

I'm assuming I'm reading this wrong, in which case, please ignore my questions. 8-)
Its close to that analogy however one thing to point out, your insurance also is giving you a discounted rate vs cash pay.

Example my DDS will bill $800 for a procedure, this is also the cash price. The insurance then discounts this procedure to $400, and pays %50, leaving me paying $200. So essentially I "saved" $600 with my insurance / gift card.

The higher end dental insurance is worth it if you have a lot of dental expenses and hit that yearly maximum.
"They who can give up essential liberty to obtain a little temporary safety, deserve neither liberty nor safety." - Benjamin Franklin

mptfan
Posts: 4675
Joined: Mon Mar 05, 2007 9:58 am

Re: Dental Coverage Feedback

Post by mptfan » Fri Sep 14, 2018 11:24 am

toofache32 wrote:
Fri Sep 14, 2018 7:41 am
New patients often like to say they haven't been to the dentist in a long time because they didn't have dental insurance. :oops: It's an interesting mentality. I wonder how they eat without grocery insurance.
LMAO

Iridium
Posts: 270
Joined: Thu May 19, 2016 10:49 am

Re: Dental Coverage Feedback

Post by Iridium » Fri Sep 14, 2018 11:47 am

ScubaHogg wrote:
Fri Sep 14, 2018 9:49 am
Am I reading this correctly? With Delta Dental you pay $1013.16/y ($84.83x12) to maybe not have to pay $1250 (max annual benefit)? That...doesn't seem like a good deal.

The Dental Plus ($2114 to maybe save $3000) doesn't seem much better.

I'm assuming I'm reading this wrong, in which case, please ignore my questions. 8-)
Remember that this is coverage for the whole family.

Each family member per year:

2 x Cleanings @ $125
1 x X-Rays @ $50

So, the preventive care costs about $300 in preventive care. OP has 4 members of the family, so annual preventive care cost of $1200 / year. Plus, if someone needs something major, then Delta will kick in up to an additional $950, and you get the contracted rate vs the cash rate. So, until OP's kids go off to college, it probably roughly works out.

dowse
Posts: 346
Joined: Tue Sep 10, 2013 3:10 pm

Re: Dental Coverage Feedback

Post by dowse » Fri Sep 14, 2018 11:58 am

Look into the Cigna Dental Savings Plan - not insurance, but you pay an annual fee of about $200 for discounted dental services at participating dentists. In most cases, you are better off with this plan as compared with paying premiums for insurance and being subject to caps.

https://www.cignadentalplans.com/?affid ... OkQAvD_BwE

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Artful Dodger
Posts: 442
Joined: Thu Oct 20, 2016 12:56 pm

Re: Dental Coverage Feedback

Post by Artful Dodger » Fri Sep 14, 2018 12:44 pm

It could very well be a wash. One thing to keep in mind is the tax status of the premiums. Most plans use a section 125 flex arrangement to reduce your wages by the amount of premium. This is similar to the flexible spending account you mentioned. As you state, there is a $1097 difference between the Delta plan and the Dental Plus plan. For most people, they will save the 7.65% FICA + fed tax + state tax. You would have to know your marginal tax rate, but this could easily be 25-35%, reducing the extra cost to between $713 and $822. Since you are already up by $600, a few extra services paid at the richer scale should bring total paid benefits to equal or exceed your additional premium.

helloeveryone
Posts: 124
Joined: Sun Sep 04, 2016 5:16 pm

Re: Dental Coverage Feedback

Post by helloeveryone » Fri Sep 14, 2018 1:54 pm

ScubaHogg wrote:
Fri Sep 14, 2018 9:49 am
Am I reading this correctly? With Delta Dental you pay $1013.16/y ($84.83x12) to maybe not have to pay $1250 (max annual benefit)? That...doesn't seem like a good deal.

The Dental Plus ($2114 to maybe save $3000) doesn't seem much better.

I'm assuming I'm reading this wrong, in which case, please ignore my questions. 8-)
you are reading it correctly. I transcribed the numbers from our options.

helloeveryone
Posts: 124
Joined: Sun Sep 04, 2016 5:16 pm

Re: Dental Coverage Feedback

Post by helloeveryone » Fri Sep 14, 2018 1:56 pm

SimonJester wrote:
Fri Sep 14, 2018 10:57 am
ScubaHogg wrote:
Fri Sep 14, 2018 9:49 am
Am I reading this correctly? With Delta Dental you pay $1013.16/y ($84.83x12) to maybe not have to pay $1250 (max annual benefit)? That...doesn't seem like a good deal.

The Dental Plus ($2114 to maybe save $3000) doesn't seem much better.

I'm assuming I'm reading this wrong, in which case, please ignore my questions. 8-)
Its close to that analogy however one thing to point out, your insurance also is giving you a discounted rate vs cash pay.

Example my DDS will bill $800 for a procedure, this is also the cash price. The insurance then discounts this procedure to $400, and pays %50, leaving me paying $200. So essentially I "saved" $600 with my insurance / gift card.

The higher end dental insurance is worth it if you have a lot of dental expenses and hit that yearly maximum.
very true. for example if phase two were to be thid plan year it works out great. I think phase two of braces is several years later though.

helloeveryone
Posts: 124
Joined: Sun Sep 04, 2016 5:16 pm

Re: Dental Coverage Feedback

Post by helloeveryone » Fri Sep 14, 2018 1:57 pm

Artful Dodger wrote:
Fri Sep 14, 2018 12:44 pm
It could very well be a wash. One thing to keep in mind is the tax status of the premiums. Most plans use a section 125 flex arrangement to reduce your wages by the amount of premium. This is similar to the flexible spending account you mentioned. As you state, there is a $1097 difference between the Delta plan and the Dental Plus plan. For most people, they will save the 7.65% FICA + fed tax + state tax. You would have to know your marginal tax rate, but this could easily be 25-35%, reducing the extra cost to between $713 and $822. Since you are already up by $600, a few extra services paid at the richer scale should bring total paid benefits to equal or exceed your additional premium.
I didnt consider the taxes. You are absolutely right the premiums are taken pretax so we do save money on that. If we exceeded our flex $ for the year and subsequent out of pocket costs won’t have the pretax savings.

helloeveryone
Posts: 124
Joined: Sun Sep 04, 2016 5:16 pm

Re: Dental Coverage Feedback

Post by helloeveryone » Fri Sep 14, 2018 1:58 pm

dowse wrote:
Fri Sep 14, 2018 11:58 am
Look into the Cigna Dental Savings Plan - not insurance, but you pay an annual fee of about $200 for discounted dental services at participating dentists. In most cases, you are better off with this plan as compared with paying premiums for insurance and being subject to caps.

https://www.cignadentalplans.com/?affid ... OkQAvD_BwE
thks for the tip

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