Dental insurance covers 3 cleanings/yr?

Non-investing personal finance issues including insurance, credit, real estate, taxes, employment and legal issues such as trusts and wills
Post Reply
Topic Author
HEDGEFUNDIE
Posts: 3655
Joined: Sun Oct 22, 2017 2:06 pm

Dental insurance covers 3 cleanings/yr?

Post by HEDGEFUNDIE » Sat Nov 16, 2019 9:39 pm

In reviewing my options during Open Enrollment, I discovered that my dental insurance covers 3 cleanings per calendar year!

I had no idea this was a thing. Any idea how common this is?

User avatar
fortfun
Posts: 2457
Joined: Tue Apr 19, 2016 7:31 pm

Re: Dental insurance covers 3 cleanings/yr?

Post by fortfun » Sat Nov 16, 2019 9:44 pm

HEDGEFUNDIE wrote:
Sat Nov 16, 2019 9:39 pm
In reviewing my options during Open Enrollment, I discovered that my dental insurance covers 3 cleanings per calendar year!

I had no idea this was a thing. Any idea how common this is?
Mine has to be >6 months between cleaning.

tj
Posts: 2684
Joined: Thu Dec 24, 2009 12:10 am

Re: Dental insurance covers 3 cleanings/yr?

Post by tj » Sat Nov 16, 2019 9:51 pm

This is what Blue Cross Blue Shield federal plan covers. The others only cover 2.

HereToLearn
Posts: 558
Joined: Sat Mar 17, 2018 5:53 pm

Re: Dental insurance covers 3 cleanings/yr?

Post by HereToLearn » Sat Nov 16, 2019 9:56 pm

Not common. Every plan I have seen covered with some variation of two/year frequency limitation: every 180 days, every six months, twice per calendar year, etc. One Guardian plan offered a three week liberalization where they would still pay twice/year but claim would still be paid up to 21 days before the six month mark.

Periodontal scaling is often covered up to four times/year.

User avatar
GerryL
Posts: 2506
Joined: Fri Sep 20, 2013 11:40 pm

Re: Dental insurance covers 3 cleanings/yr?

Post by GerryL » Sat Nov 16, 2019 9:58 pm

When I was on employer insurance, they continued to cover 3 cleanings/year since I had a diagnosis of periodontal disease (ugh).

I am now on a pre-pay plan with my long-time dentist (who HATES dental insurance and will go into a 20-minue rant if you are not careful). I asked when I might go back to 2x a year and was told that once you are tagged with periodontal disease you can't go back. So, sort of like getting a tattoo.

tj
Posts: 2684
Joined: Thu Dec 24, 2009 12:10 am

Re: Dental insurance covers 3 cleanings/yr?

Post by tj » Sat Nov 16, 2019 11:15 pm

GerryL wrote:
Sat Nov 16, 2019 9:58 pm
When I was on employer insurance, they continued to cover 3 cleanings/year since I had a diagnosis of periodontal disease (ugh).

I am now on a pre-pay plan with my long-time dentist (who HATES dental insurance and will go into a 20-minue rant if you are not careful). I asked when I might go back to 2x a year and was told that once you are tagged with periodontal disease you can't go back. So, sort of like getting a tattoo.
When you find a new dentist. I've gone to new dentists and they not only don't think I need to come in that often, I can get the normal cleanings instead of periodontal maintenance.

anon_investor
Posts: 589
Joined: Mon Jun 03, 2019 1:43 pm

Re: Dental insurance covers 3 cleanings/yr?

Post by anon_investor » Sat Nov 16, 2019 11:17 pm

HEDGEFUNDIE wrote:
Sat Nov 16, 2019 9:39 pm
In reviewing my options during Open Enrollment, I discovered that my dental insurance covers 3 cleanings per calendar year!

I had no idea this was a thing. Any idea how common this is?
Extra money for your dentist! :moneybag :moneybag :moneybag

Topic Author
HEDGEFUNDIE
Posts: 3655
Joined: Sun Oct 22, 2017 2:06 pm

Re: Dental insurance covers 3 cleanings/yr?

Post by HEDGEFUNDIE » Sat Nov 16, 2019 11:38 pm

anon_investor wrote:
Sat Nov 16, 2019 11:17 pm
HEDGEFUNDIE wrote:
Sat Nov 16, 2019 9:39 pm
In reviewing my options during Open Enrollment, I discovered that my dental insurance covers 3 cleanings per calendar year!

I had no idea this was a thing. Any idea how common this is?
Extra money for your dentist! :moneybag :moneybag :moneybag
Not my money.

Also I would imagine there is a correlation between more cleanings and fewer cavities / other dental issues.

anon_investor
Posts: 589
Joined: Mon Jun 03, 2019 1:43 pm

Re: Dental insurance covers 3 cleanings/yr?

Post by anon_investor » Sat Nov 16, 2019 11:41 pm

HEDGEFUNDIE wrote:
Sat Nov 16, 2019 11:38 pm
anon_investor wrote:
Sat Nov 16, 2019 11:17 pm
HEDGEFUNDIE wrote:
Sat Nov 16, 2019 9:39 pm
In reviewing my options during Open Enrollment, I discovered that my dental insurance covers 3 cleanings per calendar year!

I had no idea this was a thing. Any idea how common this is?
Extra money for your dentist! :moneybag :moneybag :moneybag
Not my money.

Also I would imagine there is a correlation between more cleanings and fewer cavities / other dental issues.
Good point, the insurance company may save money paying for the extra cleaning by reducing the number of other dental issues that will cost them more money.

Starfish
Posts: 1461
Joined: Wed Aug 15, 2018 6:33 pm

Re: Dental insurance covers 3 cleanings/yr?

Post by Starfish » Sun Nov 17, 2019 12:40 am

anon_investor wrote:
Sat Nov 16, 2019 11:17 pm
HEDGEFUNDIE wrote:
Sat Nov 16, 2019 9:39 pm
In reviewing my options during Open Enrollment, I discovered that my dental insurance covers 3 cleanings per calendar year!

I had no idea this was a thing. Any idea how common this is?
Extra money for your dentist! :moneybag :moneybag :moneybag

There is no money in cleanings.

blueman457
Posts: 456
Joined: Sun Jul 26, 2015 12:19 pm

Re: Dental insurance covers 3 cleanings/yr?

Post by blueman457 » Sun Nov 17, 2019 12:50 am

My insurance covers 4 cleanings a year by the hygienist, 2 examinations by the dentist.

First time I’ve had any dental insurance that covered 4 cleanings a year.

Blue man

SixAlpha
Posts: 112
Joined: Wed Mar 30, 2016 9:01 pm

Re: Dental insurance covers 3 cleanings/yr?

Post by SixAlpha » Sun Nov 17, 2019 9:13 am

tj wrote:
Sat Nov 16, 2019 11:15 pm
GerryL wrote:
Sat Nov 16, 2019 9:58 pm
When I was on employer insurance, they continued to cover 3 cleanings/year since I had a diagnosis of periodontal disease (ugh).

I am now on a pre-pay plan with my long-time dentist (who HATES dental insurance and will go into a 20-minue rant if you are not careful). I asked when I might go back to 2x a year and was told that once you are tagged with periodontal disease you can't go back. So, sort of like getting a tattoo.
When you find a new dentist. I've gone to new dentists and they not only don't think I need to come in that often, I can get the normal cleanings instead of periodontal maintenance.
This. I’ve been diagnosed with periodontal disease as well and my dentist is actively trying to get me back to 2x a year.

seawolf21
Posts: 307
Joined: Tue Aug 05, 2014 7:33 am

Re: Dental insurance covers 3 cleanings/yr?

Post by seawolf21 » Sun Nov 17, 2019 11:46 pm

Mine covers 3x annually as well

toofache32
Posts: 1868
Joined: Sun Mar 04, 2012 6:30 pm

Re: Dental insurance covers 3 cleanings/yr?

Post by toofache32 » Mon Nov 18, 2019 12:10 am

Starfish wrote:
Sun Nov 17, 2019 12:40 am
anon_investor wrote:
Sat Nov 16, 2019 11:17 pm
HEDGEFUNDIE wrote:
Sat Nov 16, 2019 9:39 pm
In reviewing my options during Open Enrollment, I discovered that my dental insurance covers 3 cleanings per calendar year!

I had no idea this was a thing. Any idea how common this is?
Extra money for your dentist! :moneybag :moneybag :moneybag

There is no money in cleanings.
Ditto this. Most of it goes to the hygienist, especially at insurance rates. The dentist will make more money by letting things go uncleaned and develop into larger cavities or perio pockets.

toofache32
Posts: 1868
Joined: Sun Mar 04, 2012 6:30 pm

Re: Dental insurance covers 3 cleanings/yr?

Post by toofache32 » Mon Nov 18, 2019 12:11 am

Please note that "2 cleanings a year" means you need 180 days between cleaning. If you schedule after 178 days, it will not be covered.

tj
Posts: 2684
Joined: Thu Dec 24, 2009 12:10 am

Re: Dental insurance covers 3 cleanings/yr?

Post by tj » Mon Nov 18, 2019 12:24 am

toofache32 wrote:
Mon Nov 18, 2019 12:11 am
Please note that "2 cleanings a year" means you need 180 days between cleaning. If you schedule after 178 days, it will not be covered.
Depends on the plan.

User avatar
BogleFanGal
Posts: 391
Joined: Mon Mar 20, 2017 6:59 pm

Re: Dental insurance covers 3 cleanings/yr?

Post by BogleFanGal » Mon Nov 18, 2019 12:18 pm

lucky you - this is my pet peeve. I need 3 cleanings - despite diligent daily hygiene that goes way beyond what most people do, I have bad genes when it comes to teeth/gums and build up plaque easily. I have 2 diff plans - HDHP plus dental plan and every year, I must pay for the 3rd cleaning out of pocket. It's ridiculous, as my dental plan never kicks in a cent for their promised preventive care because they claim I've used my benefit through my HDHP health insurance. I've had diff dental plans and they all say the same thing.
"Life would be infinitely happier if we could only be born at the age of eighty and gradually approach eighteen." Mark Twain

InvestorThom
Posts: 70
Joined: Sun May 07, 2017 12:10 pm

Re: Dental insurance covers 3 cleanings/yr?

Post by InvestorThom » Mon Nov 18, 2019 12:37 pm

Are non-employer based dental plans, e.g., those purchased through ACA exchanges, even worth it?

I live in a HCOL area. The plans I looked at didn’t even cover half the cost of cleaning/exam. My dentist was out of network and I’m not interested in going to a teeth cleaning factory dentist. People mention “prepay”. The ones I looked at were more like paying for 40% off coupons. Overall they didn’t seem worth it in the long run.

Regardless of two cleanings/year or three, how does the math work for others?

User avatar
willthrill81
Posts: 13952
Joined: Thu Jan 26, 2017 3:17 pm
Location: USA

Re: Dental insurance covers 3 cleanings/yr?

Post by willthrill81 » Mon Nov 18, 2019 12:52 pm

Our employer-provided dental insurance covers two cleanings a year per insured household member.
“It's a dangerous business, Frodo, going out your door. You step onto the road, and if you don't keep your feet, there's no knowing where you might be swept off to.” J.R.R. Tolkien,The Lord of the Rings

Barsoom
Posts: 210
Joined: Thu Dec 06, 2018 9:40 am

Re: Dental insurance covers 3 cleanings/yr?

Post by Barsoom » Mon Nov 18, 2019 1:09 pm

I think mine covers up to a certain dollar amount. I do 3 cleanings per year, and end up having to make a partial payment on the third cleaning.

-B

Camp Shore
Posts: 6
Joined: Sun May 21, 2017 11:43 am
Location: Central Florida

Re: Dental insurance covers 3 cleanings/yr?

Post by Camp Shore » Mon Nov 18, 2019 6:36 pm

My husband sold his dental practice this year...I worked with the billing and insurance for years. So here's (some of) what I know...

Dental insurance plans vary a lot in the number of cleanings, the services covered, yearly maximum payment, how much patient is responsible for, how much a contracted dentist may charge for a given service, and so on. Companies that offer dental insurance may offer any number of plans. We can't just tell you what to expect from "Delta", "MetLife", or most others. It depends on the specific plan, not just the company that offers or administers the plan.

The typical cleaning and exam (ADA codes D1110, D0120) will usually be covered twice a year; some plans do cover more. Many plans will cover the standard cleaning and also a periodontal cleaning. ( We saw many patients who alternated between offices, 2 hygiene visits per year with the general dentist and 2 at the periodontist's office.) Some plans require a minimum number of days between cleanings, and some only limit the number of cleanings per calendar year.

Most of what you or insurance pays for a cleaning and exam goes to the hygienist's salary and to operating expenses. That visit is not a money maker for the dentist. On the other hand, the exam may find issues that will produce some income. Regular exams should help catch smaller, less expensive problems.

Post Reply