Dental & Vision Insurance after 65 - best options?

Non-investing personal finance issues including insurance, credit, real estate, taxes, employment and legal issues such as trusts and wills
Topic Author
557880yvi
Posts: 194
Joined: Wed Mar 06, 2019 3:11 pm

Dental & Vision Insurance after 65 - best options?

Post by 557880yvi »

After spending far too much time looking at all the Dental & Vision plans offered in my state (MA) by the companies that offer Medicare Supplement plans (will be eligible in 2022), the benefits seem hardly worth the premiums. Dental plans are expensive and have very limited annual benefits. Vision plans are a bit more complicated to price out as they typically cover some or all of an eye exam but the remaining "benefits" are basically discounts on glasses/contacts - highly dependent on what, how often and how many you buy.

My recollection from reading many posts over the years here is that one is better off paying out-of-pocket and looking for discounts than paying for insurance - but want to be sure I have not missed something.

Are there better plans than what might be offered by the major insurers (i.e. UNH, BCBS, Humana, etc.) or is it most cost efficient to self-insure if one can afford to? Searches turn up a dizzying and confusing array of choices! Tried sources like Consumer Reports but nothing about insurance plans after 65. Although some Medicare Advantage Plans offer Dental and Vision, we are going with a traditional Medex Supplemental plan.

Appreciate any recommendations about options or sources to search. Thank you!
User avatar
David Jay
Posts: 11796
Joined: Mon Mar 30, 2015 5:54 am
Location: Michigan

Re: Dental & Vision Insurance after 65 - best options?

Post by David Jay »

557880yvi wrote: Thu Oct 07, 2021 2:56 pmMy recollection from reading many posts over the years here is that one is better off paying out-of-pocket and looking for discounts than paying for insurance - but want to be sure I have not missed something.
You are correct.

Insurance is for things where the cost of dealing with the problem would cause financial hardship. I have a paid-off home, but I carry home insurance because a loss of our house would cause financial hardship. In contrast, I do not buy extended warrantees on low cost appliances.
Prediction is very difficult, especially about the future - Niels Bohr | To get the "risk premium", you really do have to take the risk - nisiprius
123
Posts: 7850
Joined: Fri Oct 12, 2012 3:55 pm

Re: Dental & Vision Insurance after 65 - best options?

Post by 123 »

Based on our experience with assisting elderly relatives there are no really good options for vision and dental insurance.

The most reasonable option for vision care/glasses/contacts is a Costco membership. Standard eye exams are $75 - $100 at Costco in our area and glasses available are very reasonable in cost if you don't mind a limited selection. If someone wants the latest designer frames you would just need to pay the price elsewhere.

If you want Dental coverage the standard plans don't give you much beyond standard cleanings and exams. Their primary benefit is they do provide a "negotiated" price cap on various dental services if you find a participating dentist you're comfortable with. Some of those negotiated prices could be in favor of the dentist, that's a risk.
The closest helping hand is at the end of your own arm.
Topic Author
557880yvi
Posts: 194
Joined: Wed Mar 06, 2019 3:11 pm

Re: Dental & Vision Insurance after 65 - best options?

Post by 557880yvi »

123 wrote: Thu Oct 07, 2021 3:26 pm Based on our experience with assisting elderly relatives there are no really good options for vision and dental insurance.

The most reasonable option for vision care/glasses/contacts is a Costco membership. Standard eye exams are $75 - $100 at Costco in our area and glasses available are very reasonable in cost if you don't mind a limited selection. If someone wants the latest designer frames you would just need to pay the price elsewhere.

If you want Dental coverage the standard plans don't give you much beyond standard cleanings and exams. Their primary benefit is they do provide a "negotiated" price cap on various dental services if you find a participating dentist you're comfortable with. Some of those negotiated prices could be in favor of the dentist, that's a risk.
Wow, when Costco is a better choice than vision insurance from Blue Cross! Will have to check that out, never belonged to one of those clubs but it could now make sense. Thanks for the recommendation, we have one very close to here so that may work.
Topic Author
557880yvi
Posts: 194
Joined: Wed Mar 06, 2019 3:11 pm

Re: Dental & Vision Insurance after 65 - best options?

Post by 557880yvi »

David Jay wrote: Thu Oct 07, 2021 3:14 pm
557880yvi wrote: Thu Oct 07, 2021 2:56 pmMy recollection from reading many posts over the years here is that one is better off paying out-of-pocket and looking for discounts than paying for insurance - but want to be sure I have not missed something.
You are correct.

Insurance is for things where the cost of dealing with the problem would cause financial hardship. I have a paid-off home, but I carry home insurance because a loss of our house would cause financial hardship. In contrast, I do not buy extended warrantees on low cost appliances.
Have self-insured for many things over the years (and actually set up a separate investment account and "paid" premiums in lieu to it - has worked out very well). Looks like it may make sense to continue that and add dental & vision costs. Not sure we will see these coverages added to Medicare any time soon.
jebmke
Posts: 13673
Joined: Thu Apr 05, 2007 2:44 pm
Location: Delmarva Peninsula

Re: Dental & Vision Insurance after 65 - best options?

Post by jebmke »

I looked at this twice - once right before retiring and once after a few years. I could never make the numbers work. They typically have fairly low caps so your upside risk is still on you.

Some Medicare Advantage plans have good coverage for Dental and Vision but MA is not available in my area.
When you discover that you are riding a dead horse, the best strategy is to dismount.
BarbBrooklyn
Posts: 1069
Joined: Fri Aug 24, 2018 9:33 am
Location: NYC

Re: Dental & Vision Insurance after 65 - best options?

Post by BarbBrooklyn »

So, to clarify:

I realized a bunch of years ago that although I had "vision insurance" through my union, my MEDICAL insurance covered medical issues pertaining to my eyes.

Cataracts, dry eyes, a nevus on the back of my eye, corneal scratches, and retinal issues are all covered by my MEDICAL insurance.
Last edited by BarbBrooklyn on Thu Oct 07, 2021 7:53 pm, edited 1 time in total.
BarbBrooklyn | "The enemy of a good plan is the dream of a perfect plan."
User avatar
jeffyscott
Posts: 10003
Joined: Tue Feb 27, 2007 9:12 am
Location: Wisconsin

Re: Dental & Vision Insurance after 65 - best options?

Post by jeffyscott »

Here's a another recent discussion of the same topic: https://bogleheads.org/forum/viewtopic.php?f=2&t=356660
557880yvi wrote: Thu Oct 07, 2021 2:56 pm My recollection from reading many posts over the years here is that one is better off paying out-of-pocket and looking for discounts than paying for insurance - but want to be sure I have not missed something.
Our minimalist dental insurance plan is really just a way of getting discounts, via effectively prepaying for two (discounted) preventive exams per year.

Not that it is going to pay a meaningful percentage of the total cost, but I have been surprised at the extra discounts and coverage that our cheap dental plan has provided this year, as my spouse goes through the steps for an implant. We only bought the plan because the $41 per month premium amounts to about a 25% discount over what we would pay in a normal year otherwise. Getting negotiated prices and a bit of coverage on some things beyond the semi-annual preventive exam/cleaning is a bonus.

On the consultation and extraction related to the future implant, they have saved us about $260 via discounts and coverage. She has yet to get the implant and crown, so there could be more. That's in addition to saving $627 on our first round of preventive exams with both of us having a second yet to go this year. The second round of exams will not have x-rays and so will be billed at $155 each, that will be anther $310 in savings. The total net saved for this 12 month period will be at least about $425.
The two greatest enemies of the equity fund investor are expenses and emotions. ― John C. Bogle
jebmke
Posts: 13673
Joined: Thu Apr 05, 2007 2:44 pm
Location: Delmarva Peninsula

Re: Dental & Vision Insurance after 65 - best options?

Post by jebmke »

BarbBrooklyn wrote: Thu Oct 07, 2021 4:21 pm So, to clarify:

I realized a bunch of years ago that althought I had "vision insurance" through my union, my MEDICAL insurance covered medical issues pertaining to my eyes.

Cataracts, dry eyes, a nevus on the back of my eye, corneal scratches, and retinal issues are all covered by my MEDICAL insurance.
True; although, when I had cataract surgery, there was an up charge for certain portions that I elected which were not covered by Medicare so it depends on what your insurance policy specifies. Same can be true for some dental procedures; medical insurance might cover some/part depending on the issue.
When you discover that you are riding a dead horse, the best strategy is to dismount.
User avatar
anon_investor
Posts: 8768
Joined: Mon Jun 03, 2019 1:43 pm

Re: Dental & Vision Insurance after 65 - best options?

Post by anon_investor »

557880yvi wrote: Thu Oct 07, 2021 3:38 pm
123 wrote: Thu Oct 07, 2021 3:26 pm Based on our experience with assisting elderly relatives there are no really good options for vision and dental insurance.

The most reasonable option for vision care/glasses/contacts is a Costco membership. Standard eye exams are $75 - $100 at Costco in our area and glasses available are very reasonable in cost if you don't mind a limited selection. If someone wants the latest designer frames you would just need to pay the price elsewhere.

If you want Dental coverage the standard plans don't give you much beyond standard cleanings and exams. Their primary benefit is they do provide a "negotiated" price cap on various dental services if you find a participating dentist you're comfortable with. Some of those negotiated prices could be in favor of the dentist, that's a risk.
Wow, when Costco is a better choice than vision insurance from Blue Cross! Will have to check that out, never belonged to one of those clubs but it could now make sense. Thanks for the recommendation, we have one very close to here so that may work.
Costco is very good for glasses/contactd, we used it for years before my current job which has heavily employer subsidized vision insurance.
BarbBrooklyn
Posts: 1069
Joined: Fri Aug 24, 2018 9:33 am
Location: NYC

Re: Dental & Vision Insurance after 65 - best options?

Post by BarbBrooklyn »

jebmke wrote: Thu Oct 07, 2021 4:30 pm
BarbBrooklyn wrote: Thu Oct 07, 2021 4:21 pm So, to clarify:

I realized a bunch of years ago that althought I had "vision insurance" through my union, my MEDICAL insurance covered medical issues pertaining to my eyes.

Cataracts, dry eyes, a nevus on the back of my eye, corneal scratches, and retinal issues are all covered by my MEDICAL insurance.
True; although, when I had cataract surgery, there was an up charge for certain portions that I elected which were not covered by Medicare so it depends on what your insurance policy specifies. Same can be true for some dental procedures; medical insurance might cover some/part depending on the issue.
Yes, true. But I realized that when a person in my office was delaying being seen when she saw "stars in my eyes" and needed to explain that wasn't vision care, it was medical care.
BarbBrooklyn | "The enemy of a good plan is the dream of a perfect plan."
michaelingp
Posts: 563
Joined: Tue Jan 17, 2017 8:46 pm

Re: Dental & Vision Insurance after 65 - best options?

Post by michaelingp »

I have dental insurance from GEHA through FEDVIP (I understand this is probably not available to the OP). By far the greatest benefit is the negotiated prices for procedures. I would say we get twice as much benefit from reduced prices than from actual cash payouts by the insurance company. Fortunately our long time dentist is "in-network" and it hasn't been hard to find in-network specialists (we live in a fairly large metropolitan area). I'm not saying that's a bad thing (getting discounts), it's just makes it really hard to evaluate whether the plan is worth it. I keep pretty good records, and including the discounts we come out ahead almost every year. If you just tallied the money the insurance company pays, most years would be less than our premiums (which is why they can stay in business). For example, we just got a bill from the dentist for $850. The insurance discounted this to $321 and paid $112 of that. So, we saved $529 from the discount, but only $112 from the insurance payment. Of course I have no idea how "real" that $850 charge is, but I assume that's what they'd ask us to pay if we didn't have insurance.

I don't see any need for vision insurance, in the sense of a plan you pay for and they pay for exams and glasses. In the Federal space, a lot of health insurance or dental plans come with a sort of free vision plan, but when you look into them, they are really just discount plans with one of the two huge eyeglass conglomerates, and you can probably get just as good prices from Costco (that's where we get our glasses). Note that some health insurance (like BCBS) pays for eye exams, just not for the refraction part.
User avatar
tcassette
Posts: 232
Joined: Wed Aug 12, 2015 12:20 pm
Location: Southeast Tennessee

Re: Dental & Vision Insurance after 65 - best options?

Post by tcassette »

We have a good UHC Medicare Advantage plan partially subsidized by a previous employer. It includes a yearly eye exam, but no other vision or dental coverage. I have concluded that dental plans are way too expensive if you have maintained good dental health.
michaelingp
Posts: 563
Joined: Tue Jan 17, 2017 8:46 pm

Re: Dental & Vision Insurance after 65 - best options?

Post by michaelingp »

BarbBrooklyn wrote: Thu Oct 07, 2021 4:51 pm Yes, true. But I realized that when a person in my office was delaying being seen when she saw "stars in my eyes" and needed to explain that wasn't vision care, it was medical care.
I was seeing stars once many years ago when I did certain movements. I called my eye doctor, just asked for an exam. They said the next appointment was 3 weeks away. I said, "Would it make a difference if I said I was seeing stars?" They said, "Sir, can you get here in 15 minutes?" True story.
BarbBrooklyn
Posts: 1069
Joined: Fri Aug 24, 2018 9:33 am
Location: NYC

Re: Dental & Vision Insurance after 65 - best options?

Post by BarbBrooklyn »

michaelingp wrote: Thu Oct 07, 2021 6:31 pm
BarbBrooklyn wrote: Thu Oct 07, 2021 4:51 pm Yes, true. But I realized that when a person in my office was delaying being seen when she saw "stars in my eyes" and needed to explain that wasn't vision care, it was medical care.
I was seeing stars once many years ago when I did certain movements. I called my eye doctor, just asked for an exam. They said the next appointment was 3 weeks away. I said, "Would it make a difference if I said I was seeing stars?" They said, "Sir, can you get here in 15 minutes?" True story.
The same was true of my colleague. She called HER eye doc and was given an appt three weeks hence.

I called the opthamology office down the block and said "stars in her eyes" and the receptionist said "please have someone walk her very slowly up the block".
BarbBrooklyn | "The enemy of a good plan is the dream of a perfect plan."
toofache32
Posts: 2319
Joined: Sun Mar 04, 2012 6:30 pm

Re: Dental & Vision Insurance after 65 - best options?

Post by toofache32 »

michaelingp wrote: Thu Oct 07, 2021 6:31 pm
BarbBrooklyn wrote: Thu Oct 07, 2021 4:51 pm Yes, true. But I realized that when a person in my office was delaying being seen when she saw "stars in my eyes" and needed to explain that wasn't vision care, it was medical care.
I was seeing stars once many years ago when I did certain movements. I called my eye doctor, just asked for an exam. They said the next appointment was 3 weeks away. I said, "Would it make a difference if I said I was seeing stars?" They said, "Sir, can you get here in 15 minutes?" True story.
I'm not sure why the astonishment here. Most doctors offices keep a few spots open for emergencies. An exam does not qualify as an emergency. Certain vision changes do. True story.
PowderDay9
Posts: 527
Joined: Fri Oct 12, 2018 12:29 pm

Re: Dental & Vision Insurance after 65 - best options?

Post by PowderDay9 »

The value of a dental plan is that they have contracted rates with participating providers that are typically 20-50% lower than the charges you would normally pay. Over 65 year olds are by far the highest utilizers of dental services.

I'd recommend a dental discount plan if they are available in your area. If not, then consider buying a low cost standalone dental plan.

Many seniors get dental coverage on their Medicare Advantage plans. MA plans have been increasing in popularity and the percentage of plans that offer comprehensive dental have substantially increased in the last 5 years.
User avatar
arcticpineapplecorp.
Posts: 8723
Joined: Tue Mar 06, 2012 9:22 pm

Re: Dental & Vision Insurance after 65 - best options?

Post by arcticpineapplecorp. »

just found out there's dental for VA (Veterans Administration) members. Don't know if you are but thought i'd mention it. didn't know about this until recently.
It's hard to accept the truth when the lies were exactly what you wanted to hear. Investing is simple, but not easy. Buy, hold & rebalance low cost index funds & manage taxable events. Asking Portfolio Questions | Wiki
toofache32
Posts: 2319
Joined: Sun Mar 04, 2012 6:30 pm

Re: Dental & Vision Insurance after 65 - best options?

Post by toofache32 »

arcticpineapplecorp. wrote: Thu Oct 07, 2021 9:11 pm just found out there's dental for VA (Veterans Administration) members. Don't know if you are but thought i'd mention it. didn't know about this until recently.
As someone who used to work in a VA dental clinic, benefits are only available for those designated as 100% service connection.
toofache32
Posts: 2319
Joined: Sun Mar 04, 2012 6:30 pm

Re: Dental & Vision Insurance after 65 - best options?

Post by toofache32 »

PowderDay9 wrote: Thu Oct 07, 2021 9:10 pm The value of a dental plan is that they have contracted rates with participating providers that are typically 20-50% lower than the charges you would normally pay. Over 65 year olds are by far the highest utilizers of dental services.
But this is only for the (on average) $1200 of dental benefits per year.
User avatar
jeffyscott
Posts: 10003
Joined: Tue Feb 27, 2007 9:12 am
Location: Wisconsin

Re: Dental & Vision Insurance after 65 - best options?

Post by jeffyscott »

toofache32 wrote: Thu Oct 07, 2021 9:30 pm
PowderDay9 wrote: Thu Oct 07, 2021 9:10 pm The value of a dental plan is that they have contracted rates with participating providers that are typically 20-50% lower than the charges you would normally pay. Over 65 year olds are by far the highest utilizers of dental services.
But this is only for the (on average) $1200 of dental benefits per year.
No, that would be a limit on what the plan will pay in benefits. The discount applies to any (in-network) services, it's not limited by the maximum benefits that are payable.

For example, on a recent claim of ours, the amount billed was $319, the amount allowed was $232, the insurance paid $128.50 and we paid $103.50. Only the $128.50 actually paid by the insurance counts toward the $1000 per person limit of our policy, the $87 discount does not.
The two greatest enemies of the equity fund investor are expenses and emotions. ― John C. Bogle
toofache32
Posts: 2319
Joined: Sun Mar 04, 2012 6:30 pm

Re: Dental & Vision Insurance after 65 - best options?

Post by toofache32 »

jeffyscott wrote: Thu Oct 07, 2021 9:48 pm
toofache32 wrote: Thu Oct 07, 2021 9:30 pm
PowderDay9 wrote: Thu Oct 07, 2021 9:10 pm The value of a dental plan is that they have contracted rates with participating providers that are typically 20-50% lower than the charges you would normally pay. Over 65 year olds are by far the highest utilizers of dental services.
But this is only for the (on average) $1200 of dental benefits per year.
No, that would be a limit on what the plan will pay in benefits. The discount applies to any (in-network) services, it's not limited by the maximum benefits that are payable.
Google "non-covered services dental". All but 11 states have laws prohibiting dental insurance plans from restricting fees that the insurance is not even paying. You might be in one of the 11 states right now, but these are disappearing. If the insurance is not covering these benefits, then the finances are between the dentist and patient and the insurance has nothing to do with it.
Topic Author
557880yvi
Posts: 194
Joined: Wed Mar 06, 2019 3:11 pm

Re: Dental & Vision Insurance after 65 - best options?

Post by 557880yvi »

[/quote]

Google "non-covered services dental". All but 11 states have laws prohibiting dental insurance plans from restricting fees that the insurance is not even paying. You might be in one of the 11 states right now, but these are disappearing. If the insurance is not covering these benefits, then the finances are between the dentist and patient and the insurance has nothing to do with it.
[/quote]

Not sure I understand what you mean "restricting fees"?


All of the information provided in these posts has been invaluable! A challenge faced in the area where I live is that most of the dentists that are considered good dentists are not in-network with just about any plan. Although they will bill your insurance they hold the patient responsible for any balance difference. It is very frustrating and expensive. We briefly tried a dentist who was in-network with our previous workplace dental insurance and it worse than going to a car dealership. From the minute we first made an appointment, all it was was hard-sell from every person in the practice (hygienist, dentist, receptionist) for services not needed or wanted or that were completely unnecessary ($1,500 deep gum cleaning, $3,500 snoring appliance, replace all fillings, crown healthy teeth to improve smile). Of course, the insurance didn't cover any of this!

Greatly appreciate all the insight and information. Am going to call current dentist's office this morning and ask how they would bill certain procedures if we don't have insurance. If I can get a response from them, will share what they say. Thank you
HomeStretch
Posts: 6988
Joined: Thu Dec 27, 2018 3:06 pm

Re: Dental & Vision Insurance after 65 - best options?

Post by HomeStretch »

toofache32 wrote: Thu Oct 07, 2021 11:43 pm Google "non-covered services dental". All but 11 states have laws prohibiting dental insurance plans from restricting fees that the insurance is not even paying. You might be in one of the 11 states right now, but these are disappearing. If the insurance is not covering these benefits, then the finances are between the dentist and patient and the insurance has nothing to do with it.
^^^ True in my state due to a law change 5 years ago.

OP, in my case this meant that when my dental plan did not cover a service (such as orthodontia/retainer in my case), I did not receive the dental insurance plan’s contract rate for the non-covered service. I paid my dentist the full non-discounted charge for the non-covered service.
User avatar
jeffyscott
Posts: 10003
Joined: Tue Feb 27, 2007 9:12 am
Location: Wisconsin

Re: Dental & Vision Insurance after 65 - best options?

Post by jeffyscott »

toofache32 wrote: Thu Oct 07, 2021 11:43 pm
jeffyscott wrote: Thu Oct 07, 2021 9:48 pm
toofache32 wrote: Thu Oct 07, 2021 9:30 pm
PowderDay9 wrote: Thu Oct 07, 2021 9:10 pm The value of a dental plan is that they have contracted rates with participating providers that are typically 20-50% lower than the charges you would normally pay. Over 65 year olds are by far the highest utilizers of dental services.
But this is only for the (on average) $1200 of dental benefits per year.
No, that would be a limit on what the plan will pay in benefits. The discount applies to any (in-network) services, it's not limited by the maximum benefits that are payable.
Google "non-covered services dental". All but 11 states have laws prohibiting dental insurance plans from restricting fees that the insurance is not even paying. You might be in one of the 11 states right now, but these are disappearing. If the insurance is not covering these benefits, then the finances are between the dentist and patient and the insurance has nothing to do with it.
Thanks, I was not aware of that. We're not in one of those 11 states, the extra discounts have been on things where there was some coverage ("problem focused consultation" and extraction). I guess we'll be paying full freight on the next steps in my wife's implant adventure :( .

The discounted rate can still apply, even when coverage is exhausted, depending on the state. For example, if the insurance has already paid out $1200 and you have another service that would otherwise be covered they may have to give you the discount. So the total effective benefit of the policy can be a bit more than the limit, due to things like that. Also the "$1200 in benefits" is actually a bit more, because of the discount. For example, if the average discount is 25% then the $1200 would represent $1600 in benefits.

With the limits on what can be discounted, it makes it even more the case that it only makes sense to buy the insurance when the cost of the premiums is less than the cost of the things that it will definitely pay for would be at an acceptable dentist (typically that's two exams/cleanings per year, one set of regular x-rays per year, and panoramic x-ray every 3-5 years). For us, paying that on our own would come to a bit over $400 per year per person, or about $34 per month per person.
The two greatest enemies of the equity fund investor are expenses and emotions. ― John C. Bogle
toofache32
Posts: 2319
Joined: Sun Mar 04, 2012 6:30 pm

Re: Dental & Vision Insurance after 65 - best options?

Post by toofache32 »

557880yvi wrote: Fri Oct 08, 2021 6:31 am
Google "non-covered services dental". All but 11 states have laws prohibiting dental insurance plans from restricting fees that the insurance is not even paying. You might be in one of the 11 states right now, but these are disappearing. If the insurance is not covering these benefits, then the finances are between the dentist and patient and the insurance has nothing to do with it.
[/quote]

Not sure I understand what you mean "restricting fees"?


[/quote]

An insurance company should not be able to tell your dentist what their fees should be when the insurance company is not even a party to the transaction. But in 11 states still, the dentist is still supposed to charge only the discounted insurance rates if the dentist is in-network but there are no remaining benefits.
EverHopeful
Posts: 56
Joined: Wed Nov 30, 2016 8:27 pm
Location: Illinois

Re: Dental & Vision Insurance after 65 - best options?

Post by EverHopeful »

We are grateful to live near a Dental & Optometry School where insurance is not required. I have found the care done by students ready to be solo practitioners within a year to be exceptional and incredible value. They are supervised and even before a cleaning or any work is done a Dentist/Optometrist Professor reviews and approves. To give an example, I had a dental exam, extensive xrays, a cleaning and 4 old fillings replaced over the course of 4 visits and the total was $447; our old dentist charged our insurance $230 just for a cleaning. I have friends who have had wisdom tooth surgery, teeth pulled and dentures made at the University and while you need patience because of time it takes and all the supervision, the care and outcome has been tremendous. The University near me also has an Optometry school so our comprehensive eye exams (including dilation and glaucoma tests) are only $55, it's $65 if you want contact lenses. Just a PSA to explore a local University for Dental & Vision care. The one we use is Midwestern University which is in Arizona and Illinois https://www.midwestern.edu/ and I have friends who have used University of Illinois for Dental. What I appreciate is they create a treatment plan and review the costs BEFORE they commence the work, brilliant! :happy
Topic Author
557880yvi
Posts: 194
Joined: Wed Mar 06, 2019 3:11 pm

Re: Dental & Vision Insurance after 65 - best options?

Post by 557880yvi »

EverHopeful wrote: Fri Oct 08, 2021 9:49 am We are grateful to live near a Dental & Optometry School where insurance is not required. I have found the care done by students ready to be solo practitioners within a year to be exceptional and incredible value. They are supervised and even before a cleaning or any work is done a Dentist/Optometrist Professor reviews and approves. To give an example, I had a dental exam, extensive xrays, a cleaning and 4 old fillings replaced over the course of 4 visits and the total was $447; our old dentist charged our insurance $230 just for a cleaning. I have friends who have had wisdom tooth surgery, teeth pulled and dentures made at the University and while you need patience because of time it takes and all the supervision, the care and outcome has been tremendous. The University near me also has an Optometry school so our comprehensive eye exams (including dilation and glaucoma tests) are only $55, it's $65 if you want contact lenses. Just a PSA to explore a local University for Dental & Vision care. The one we use is Midwestern University which is in Arizona and Illinois https://www.midwestern.edu/ and I have friends who have used University of Illinois for Dental. What I appreciate is they create a treatment plan and review the costs BEFORE they commence the work, brilliant! :happy
This is a great idea - Tufts Dental School in Boston is certainly an option for folks who live in eastern MA.

As an update, I did contact our dentist's office today. They are only in-network with BCBS and Delta dental plans - so initially thought great! But upon further questioning, the only accept 1 plan in each, neither of which are the plans offered to seniors and of course, happen to be the most expensive plans they sell. May need to look for a different dental practice too. But the advice about the discounts insurance provides makes a very compelling case for getting insurance! Many thanks for the wonderful comments.
tj
Posts: 5269
Joined: Thu Dec 24, 2009 12:10 am

Re: Dental & Vision Insurance after 65 - best options?

Post by tj »

EverHopeful wrote: Fri Oct 08, 2021 9:49 am We are grateful to live near a Dental & Optometry School where insurance is not required. I have found the care done by students ready to be solo practitioners within a year to be exceptional and incredible value. They are supervised and even before a cleaning or any work is done a Dentist/Optometrist Professor reviews and approves. To give an example, I had a dental exam, extensive xrays, a cleaning and 4 old fillings replaced over the course of 4 visits and the total was $447; our old dentist charged our insurance $230 just for a cleaning. I have friends who have had wisdom tooth surgery, teeth pulled and dentures made at the University and while you need patience because of time it takes and all the supervision, the care and outcome has been tremendous. The University near me also has an Optometry school so our comprehensive eye exams (including dilation and glaucoma tests) are only $55, it's $65 if you want contact lenses. Just a PSA to explore a local University for Dental & Vision care. The one we use is Midwestern University which is in Arizona and Illinois https://www.midwestern.edu/ and I have friends who have used University of Illinois for Dental. What I appreciate is they create a treatment plan and review the costs BEFORE they commence the work, brilliant! :happy

$230 for cleaning sounds pretty ridiculous, I can't believe your insurance had paid that much.
chw
Posts: 1129
Joined: Thu May 24, 2012 4:22 pm

Re: Dental & Vision Insurance after 65 - best options?

Post by chw »

Regarding dental insurance, we are buying a plan thru the state (MA) health connector network. The plan gives us coverage at network rates (much lower than out of network), and reasonable coverage for non routine dental work also at network rates. I figure the premiums ($55/ mo, pp) are more or less a wash, and end up being ahead if we have any sort of work done during the year.
michaelingp
Posts: 563
Joined: Tue Jan 17, 2017 8:46 pm

Re: Dental & Vision Insurance after 65 - best options?

Post by michaelingp »

tj wrote: Fri Oct 08, 2021 6:13 pm $230 for cleaning sounds pretty ridiculous, I can't believe your insurance had paid that much.
For just the cleaning, yes, but most dentists add an "exam" (a few minutes of looking in your mouth), plus if you got a routine x-ray that could easily push you to $230.
Topic Author
557880yvi
Posts: 194
Joined: Wed Mar 06, 2019 3:11 pm

Re: Dental & Vision Insurance after 65 - best options?

Post by 557880yvi »

chw wrote: Fri Oct 08, 2021 6:47 pm Regarding dental insurance, we are buying a plan thru the state (MA) health connector network. The plan gives us coverage at network rates (much lower than out of network), and reasonable coverage for non routine dental work also at network rates. I figure the premiums ($55/ mo, pp) are more or less a wash, and end up being ahead if we have any sort of work done during the year.
I thought that once you turned 65 and/or were eligible for Medicare that you could not use the MA Health Connector to purchase any form of health insurance?
Topic Author
557880yvi
Posts: 194
Joined: Wed Mar 06, 2019 3:11 pm

Re: Dental & Vision Insurance after 65 - best options?

Post by 557880yvi »

tj wrote: Fri Oct 08, 2021 6:13 pm
EverHopeful wrote: Fri Oct 08, 2021 9:49 am We are grateful to live near a Dental & Optometry School where insurance is not required. I have found the care done by students ready to be solo practitioners within a year to be exceptional and incredible value. They are supervised and even before a cleaning or any work is done a Dentist/Optometrist Professor reviews and approves. To give an example, I had a dental exam, extensive xrays, a cleaning and 4 old fillings replaced over the course of 4 visits and the total was $447; our old dentist charged our insurance $230 just for a cleaning. I have friends who have had wisdom tooth surgery, teeth pulled and dentures made at the University and while you need patience because of time it takes and all the supervision, the care and outcome has been tremendous. The University near me also has an Optometry school so our comprehensive eye exams (including dilation and glaucoma tests) are only $55, it's $65 if you want contact lenses. Just a PSA to explore a local University for Dental & Vision care. The one we use is Midwestern University which is in Arizona and Illinois https://www.midwestern.edu/ and I have friends who have used University of Illinois for Dental. What I appreciate is they create a treatment plan and review the costs BEFORE they commence the work, brilliant! :happy

$230 for cleaning sounds pretty ridiculous, I can't believe your insurance had paid that much.
My dentist out her in the suburbs/boondocks charges $350 for a cleaning - no xrays and it's extra if they come in for 2 minutes to do an "exam". This is the going rate around here. As a CPA I can understand why with staff, benefits, rent (although he owns the building) and all the costs to run a business - direct costs and overhead, that $700/hour revenue generated from one treatment room is reasonable to cover costs and provide some profit.
chw
Posts: 1129
Joined: Thu May 24, 2012 4:22 pm

Re: Dental & Vision Insurance after 65 - best options?

Post by chw »

557880yvi wrote: Fri Oct 08, 2021 7:41 pm
chw wrote: Fri Oct 08, 2021 6:47 pm Regarding dental insurance, we are buying a plan thru the state (MA) health connector network. The plan gives us coverage at network rates (much lower than out of network), and reasonable coverage for non routine dental work also at network rates. I figure the premiums ($55/ mo, pp) are more or less a wash, and end up being ahead if we have any sort of work done during the year.
I thought that once you turned 65 and/or were eligible for Medicare that you could not use the MA Health Connector to purchase any form of health insurance?
You are allowed to purchase dental insurance. There are no tax credits/subsidies involved which is why I believe they allow it. We just went through the sign up process earlier this year.
egrets
Posts: 661
Joined: Sun Jul 05, 2020 2:56 pm

Re: Dental & Vision Insurance after 65 - best options?

Post by egrets »

BarbBrooklyn wrote: Thu Oct 07, 2021 4:21 pm So, to clarify:

I realized a bunch of years ago that although I had "vision insurance" through my union, my MEDICAL insurance covered medical issues pertaining to my eyes.

Cataracts, dry eyes, a nevus on the back of my eye, corneal scratches, and retinal issues are all covered by my MEDICAL insurance.
I have an ophthalmologist exam once a year and Medicare/Medigap pays for everything except doing the glasses prescription. I am guessing it's a rare older person who doesn't have an eye thing that qualifies them for this.
Lazareth
Posts: 294
Joined: Tue Nov 01, 2016 9:21 am
Location: New England

Re: Dental & Vision Insurance after 65 - best options?

Post by Lazareth »

557880yvi wrote: Thu Oct 07, 2021 2:56 pm After spending far too much time looking at all the Dental & Vision plans offered in my state (MA) by the companies that offer Medicare Supplement plans (will be eligible in 2022), the benefits seem hardly worth the premiums. Dental plans are expensive and have very limited annual benefits."
I came to the same conclusion. I am in MA with Medicare (age 67) and excellent BCBS MEDEX supplement. I decided to self-insure vision and dental and use good-value providers. My vision situation is a bit complex and yet I have had excellent results from Walmart Vision for optometrist and optician services. Using my Walmart prescription I recently went online to zenni.com and bought gradual-bi-focal high-index prescription sunglasses for under $100. I love them. For dental I go to a nearby public health clinic's dental department and I pay out-of-pocket. The level of expertise and professionalism has been excellent. A recent post and crown cost me about half of what I paid to the "family dentist" for a similar procedure ten years ago.
a/67, retired, married, enjoy p/t employment.
Topic Author
557880yvi
Posts: 194
Joined: Wed Mar 06, 2019 3:11 pm

Re: Dental & Vision Insurance after 65 - best options?

Post by 557880yvi »

Lazareth wrote: Sun Oct 10, 2021 6:38 pm
557880yvi wrote: Thu Oct 07, 2021 2:56 pm After spending far too much time looking at all the Dental & Vision plans offered in my state (MA) by the companies that offer Medicare Supplement plans (will be eligible in 2022), the benefits seem hardly worth the premiums. Dental plans are expensive and have very limited annual benefits."
I came to the same conclusion. I am in MA with Medicare (age 67) and excellent BCBS MEDEX supplement. I decided to self-insure vision and dental and use good-value providers. My vision situation is a bit complex and yet I have had excellent results from Walmart Vision for optometrist and optician services. Using my Walmart prescription I recently went online to zenni.com and bought gradual-bi-focal high-index prescription sunglasses for under $100. I love them. For dental I go to a nearby public health clinic's dental department and I pay out-of-pocket. The level of expertise and professionalism has been excellent. A recent post and crown cost me about half of what I paid to the "family dentist" for a similar procedure ten years ago.
Would you mind sharing which BCBS MEDEX supplement (unless it is the Supplement that is no longer available after 2019 - your age may have put your right on the change!) Thank you
Lazareth
Posts: 294
Joined: Tue Nov 01, 2016 9:21 am
Location: New England

Re: Dental & Vision Insurance after 65 - best options?

Post by Lazareth »

557880yvi wrote: Tue Oct 12, 2021 8:35 am
Lazareth wrote: Sun Oct 10, 2021 6:38 pm
557880yvi wrote: Thu Oct 07, 2021 2:56 pm After spending far too much time looking at all the Dental & Vision plans offered in my state (MA) by the companies that offer Medicare Supplement plans (will be eligible in 2022), the benefits seem hardly worth the premiums. Dental plans are expensive and have very limited annual benefits."
I came to the same conclusion. I am in MA with Medicare (age 67) and excellent BCBS MEDEX supplement. I decided to self-insure vision and dental and use good-value providers. My vision situation is a bit complex and yet I have had excellent results from Walmart Vision for optometrist and optician services. Using my Walmart prescription I recently went online to zenni.com and bought gradual-bi-focal high-index prescription sunglasses for under $100. I love them. For dental I go to a nearby public health clinic's dental department and I pay out-of-pocket. The level of expertise and professionalism has been excellent. A recent post and crown cost me about half of what I paid to the "family dentist" for a similar procedure ten years ago.
Would you mind sharing which BCBS MEDEX supplement (unless it is the Supplement that is no longer available after 2019 - your age may have put your right on the change!) Thank you
It is called MEDEX 3 and it is an employer-paid Medicare plan through Blue Cross Blue Shield for Medicare recipients who already have (pay for) Medicare A & B. I believe it covers Medicare Part A and B deductibles and co-insurances, prescription drugs, and OBRA benefit: https://tinyurl.com/yh576ck6
a/67, retired, married, enjoy p/t employment.
Sage16
Posts: 176
Joined: Sun Mar 27, 2016 11:06 pm

Re: Dental & Vision Insurance after 65 - best options?

Post by Sage16 »

When I went on Medicare I lost my retiree dental coverage. I asked my dentist for his recommendation on dental insurance and he told me it was a waste of money. In my case he felt I may be good for the next 10 years with just twice a year cleanings. My recent cleaning cost $185 including x-rays. I paid with my HSA debit card with never taxed dollars.
Bogle on investing: Diversify, focus on low costs, invest for the long term. Don't speculate and don't be distracted by volatility.
MikeG62
Posts: 3819
Joined: Tue Nov 15, 2016 3:20 pm
Location: New Jersey

Re: Dental & Vision Insurance after 65 - best options?

Post by MikeG62 »

557880yvi wrote: Thu Oct 07, 2021 2:56 pm After spending far too much time looking at all the Dental & Vision plans offered in my state (MA) by the companies that offer Medicare Supplement plans (will be eligible in 2022), the benefits seem hardly worth the premiums. Dental plans are expensive and have very limited annual benefits. Vision plans are a bit more complicated to price out as they typically cover some or all of an eye exam but the remaining "benefits" are basically discounts on glasses/contacts - highly dependent on what, how often and how many you buy.

My recollection from reading many posts over the years here is that one is better off paying out-of-pocket and looking for discounts than paying for insurance - but want to be sure I have not missed something.

Are there better plans than what might be offered by the major insurers (i.e. UNH, BCBS, Humana, etc.) or is it most cost efficient to self-insure if one can afford to? Searches turn up a dizzying and confusing array of choices! Tried sources like Consumer Reports but nothing about insurance plans after 65. Although some Medicare Advantage Plans offer Dental and Vision, we are going with a traditional Medex Supplemental plan.

Appreciate any recommendations about options or sources to search. Thank you!
We self insure for Dental because the economics of purchasing that insurance just don't make sense to me. We do buy vision through VSP because that one seems economically worthwhile.
Real Knowledge Comes Only From Experience
toofache32
Posts: 2319
Joined: Sun Mar 04, 2012 6:30 pm

Re: Dental & Vision Insurance after 65 - best options?

Post by toofache32 »

Dental "insurance" is not really insurance. It's actually the opposite of insurance. It would be like if your auto insurance paid for your oil change but not a major collision. This is the best explanation I have come across: https://meadfamilydental.com/2011/12/li ... rol-freak/
User avatar
jeffyscott
Posts: 10003
Joined: Tue Feb 27, 2007 9:12 am
Location: Wisconsin

Re: Dental & Vision Insurance after 65 - best options?

Post by jeffyscott »

toofache32 wrote: Wed Oct 13, 2021 8:02 am Dental "insurance" is not really insurance. It's actually the opposite of insurance. It would be like if your auto insurance paid for your oil change but not a major collision. This is the best explanation I have come across: https://meadfamilydental.com/2011/12/li ... rol-freak/
Yep, and if an insurance company were to sell me a package that would cover two oil changes per year for $45 at the dealer that we go to (which would cost ~$60, otherwise), plus $50 off if I happen to need a brake job and $10 off if I need an air filter, that would be worth buying (this is equivalent to about where our dental is).

OTOH, if it were $100, then I'd likely pass on it, unless I knew that I was going to need the brake job.
The two greatest enemies of the equity fund investor are expenses and emotions. ― John C. Bogle
ceejay185
Posts: 11
Joined: Thu Feb 18, 2010 4:58 pm

Walmart Dental

Post by ceejay185 »

Just curious if anyone has had any experience with Walmart Dental Services? Their operations are currently limited to Arkansas, Georgia, and Illinois. But $30 for teeth cleaning sounds like an incredible deal! https://www.walmarthealth.com/schedule/ ... 2&nbr=4108
Big Dog
Posts: 2838
Joined: Mon Sep 07, 2015 4:12 pm

Re: Dental & Vision Insurance after 65 - best options?

Post by Big Dog »

MikeG62 wrote: Wed Oct 13, 2021 7:39 am
557880yvi wrote: Thu Oct 07, 2021 2:56 pm After spending far too much time looking at all the Dental & Vision plans offered in my state (MA) by the companies that offer Medicare Supplement plans (will be eligible in 2022), the benefits seem hardly worth the premiums. Dental plans are expensive and have very limited annual benefits. Vision plans are a bit more complicated to price out as they typically cover some or all of an eye exam but the remaining "benefits" are basically discounts on glasses/contacts - highly dependent on what, how often and how many you buy.

My recollection from reading many posts over the years here is that one is better off paying out-of-pocket and looking for discounts than paying for insurance - but want to be sure I have not missed something.

Are there better plans than what might be offered by the major insurers (i.e. UNH, BCBS, Humana, etc.) or is it most cost efficient to self-insure if one can afford to? Searches turn up a dizzying and confusing array of choices! Tried sources like Consumer Reports but nothing about insurance plans after 65. Although some Medicare Advantage Plans offer Dental and Vision, we are going with a traditional Medex Supplemental plan.

Appreciate any recommendations about options or sources to search. Thank you!
We self insure for Dental because the economics of purchasing that insurance just don't make sense to me. We do buy vision through VSP because that one seems economically worthwhile.
Protip from my glasses guy: his senior patients enroll in VSP every other year as vision generally doesn't decline that rapidly and most folks don't need new lenses every year.
User avatar
willthrill81
Posts: 26167
Joined: Thu Jan 26, 2017 3:17 pm
Location: USA

Re: Dental & Vision Insurance after 65 - best options?

Post by willthrill81 »

While I'm strongly in the 'self-insure all that you can' camp, I have been told that the negotiated pay rates for dental work on dental insurance plans can result in lower total cost vs. paying out of pocket yourself. However, I'm not sure how accurate that is. I do know that when I review the explanation of benefits for our dental plan (job benefit for me), there is often a substantial difference between the 'charged' rate and the 'allowed' rate. But what I don't know is which of those rates a cash customer would actually pay.
“Good and ill have not changed since yesteryear; nor are they one thing among Elves and Dwarves and another among Men.” J.R.R. Tolkien, The Lord of the Rings
bberris
Posts: 1788
Joined: Sun Feb 20, 2011 9:44 am

Re: Dental & Vision Insurance after 65 - best options?

Post by bberris »

willthrill81 wrote: Sat Oct 16, 2021 6:34 pm While I'm strongly in the 'self-insure all that you can' camp, I have been told that the negotiated pay rates for dental work on dental insurance plans can result in lower total cost vs. paying out of pocket yourself. However, I'm not sure how accurate that is. I do know that when I review the explanation of benefits for our dental plan (job benefit for me), there is often a substantial difference between the 'charged' rate and the 'allowed' rate. But what I don't know is which of those rates a cash customer would actually pay.
This is true, but you don't need insurance to get the preferred rate. You can join what amounts to a savings club such as Preferred Network Access from Cigna to get the reduced rates. There are many others, and they all have a network of dentists that agree to the allowed charges for each procedure. Some dental practices have their own club. I like it better than insurance because it's cheaper, there are no claims, and no rejections.

I would only buy dental insurance if it was employer subsidized. Even then, the claims were a tremendous hassle. When my former employer switched providers, my claim was rejected for continuing care because the condition was "pre-" existing. Pre- to what I don't know.
toofache32
Posts: 2319
Joined: Sun Mar 04, 2012 6:30 pm

Re: Walmart Dental

Post by toofache32 »

ceejay185 wrote: Sat Oct 16, 2021 6:04 pm Just curious if anyone has had any experience with Walmart Dental Services? Their operations are currently limited to Arkansas, Georgia, and Illinois. But $30 for teeth cleaning sounds like an incredible deal! https://www.walmarthealth.com/schedule/ ... 2&nbr=4108
I'll do it for $17.
Amazing how everyone talks about price but never quality.
User avatar
willthrill81
Posts: 26167
Joined: Thu Jan 26, 2017 3:17 pm
Location: USA

Re: Dental & Vision Insurance after 65 - best options?

Post by willthrill81 »

bberris wrote: Sat Oct 16, 2021 7:26 pm
willthrill81 wrote: Sat Oct 16, 2021 6:34 pm While I'm strongly in the 'self-insure all that you can' camp, I have been told that the negotiated pay rates for dental work on dental insurance plans can result in lower total cost vs. paying out of pocket yourself. However, I'm not sure how accurate that is. I do know that when I review the explanation of benefits for our dental plan (job benefit for me), there is often a substantial difference between the 'charged' rate and the 'allowed' rate. But what I don't know is which of those rates a cash customer would actually pay.
This is true, but you don't need insurance to get the preferred rate. You can join what amounts to a savings club such as Preferred Network Access from Cigna to get the reduced rates. There are many others, and they all have a network of dentists that agree to the allowed charges for each procedure. Some dental practices have their own club. I like it better than insurance because it's cheaper, there are no claims, and no rejections.

I would only buy dental insurance if it was employer subsidized. Even then, the claims were a tremendous hassle. When my former employer switched providers, my claim was rejected for continuing care because the condition was "pre-" existing. Pre- to what I don't know.
Interesting. Thanks for the info. That's definitely something we'll look into once I retire and lose our current dental policy.
“Good and ill have not changed since yesteryear; nor are they one thing among Elves and Dwarves and another among Men.” J.R.R. Tolkien, The Lord of the Rings
doobiedoo
Posts: 47
Joined: Fri Jul 23, 2021 1:10 pm

Re: Dental & Vision Insurance after 65 - best options?

Post by doobiedoo »

557880yvi wrote: Thu Oct 07, 2021 2:56 pm After spending far too much time looking at all the Dental & Vision plans offered in my state (MA) by the companies that offer Medicare Supplement plans (will be eligible in 2022), the benefits seem hardly worth the premiums. Dental plans are expensive and have very limited annual benefits. Vision plans are a bit more complicated to price out as they typically cover some or all of an eye exam but the remaining "benefits" are basically discounts on glasses/contacts - highly dependent on what, how often and how many you buy.
...
Are there better plans than what might be offered by the major insurers (i.e. UNH, BCBS, Humana, etc.) or is it most cost efficient to self-insure if one can afford to? Searches turn up a dizzying and confusing array of choices! Tried sources like Consumer Reports but nothing about insurance plans after 65. Although some Medicare Advantage Plans offer Dental and Vision, we are going with a traditional Medex Supplemental plan.
I use Kaiser Medicare Advantage Plus which costs $16/month [in southern CA]. I found a good dentist on the eligibility list in my area, He is way cheaper than my previous dentist and maybe even does better work.

I still use my old optometrist [~$200 per year for exam], but I may switch to Kaiser's optometry services at some point.
I have found the $350 allocation for hearing aids to be useful too.

Unfortunately for the OP, I don't think Kaiser is available in MA.
User avatar
TexasPE
Posts: 493
Joined: Sat Feb 17, 2018 8:41 pm
Location: Southeast Texas

Re: Dental & Vision Insurance after 65 - best options?

Post by TexasPE »

557880yvi wrote: Fri Oct 08, 2021 7:45 pm [
My dentist out her in the suburbs/boondocks charges $350 for a cleaning - no xrays and it's extra if they come in for 2 minutes to do an "exam". This is the going rate around here.
Shop around - I live in a MCOL area and cleaning (no insurance) is $74, cleaning with full set of Xrays is $124. My dentist is in his late 50s, owns his office building, and works 4 days a week. He isn't trying to pay down a six-figure student loan and doesn't push cosmetic procedures.
At 20: I cared what everyone thought about me | At 40: I didn't give a damn what anyone thought of me | Now that I'm 60: I realize that no one was really thinking about me at all | Winston Churchill (?)
Post Reply