Actual dental question

[iceman]

what ended up happening with the original deal in the first post?

[4matic]

You are a month late but I have had dental work planned to straddle two calendar years to avoid going over the coverage limit.

My fancy SF dentist likes Delta.

[Rideski]

On the mid tier plan there are no maximums, and no waiting period hopefully. Although that’s what I’m worrried about. Which is why I haven’t asked them directly but maybe I should. The base plan doesn’t include crowns.
Actually pondering ways I could collaborate with a pseudo employer to get on a group plan.

[fatnslow]

what ended up happening with the original deal in the first post?

Two visits, the week after that I saw his wife had a brand new car. I guess I made the first payment on it.

[Danno]

I have Delta, large group plan, they're not great but not terrible. Pretty common insurance carrier in Colorado.

[old goat]

Yeah that’s exactly what I’m worried about, would be self paid at a mid tier plan to the tune of $500 a year or so. I need two crowns and if they actually pay the claim I’d come out a bit ahead. Not so much if I didn’t need the crowns.

I'm looking at a crown right now. Tooth is obviously broken but dentist is taking xray as proof for Delta. The dentist should know what documentation delta needs to accept the claim. OTOH if you already have an issue with two teeth I would assume Delta would not cover that issue--the preexisting condition thing, but I don't know, just assuming. Wouldn't make sense for them to cover, otherwise people would just wait until they need something expensive, take out insurance, cancel after the work was done.

[4matic]

Dental insurance doesn't have pre-existing condition. They just don't pay that much annually and they don't pay for work already started. For example, you can't get a crown prepped on one claim and then claim the completed crown on another.

[Rideski]

Good to know thanks. It’s a year contract minimum, so buying that @$500 and then getting claim denied would be worst case scenario. Dentist is top notch and will do everything by the book.

[VTeton]

Delta and blue cross are the only good insurances for dentists to take and only certain versions of them. If your dentist is in network with every insurance, he she has to be crazy efficient running a ton of chairs at once to make a buck. May be working 3-4 chairs while also seeing hygiene. Easy to burn out fast and many good dentists dont want that life.

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[old goat]

Dental insurance doesn't have pre-existing condition. They just don't pay that much annually and they don't pay for work already started. For example, you can't get a crown prepped on one claim and then claim the completed crown on another.

thanks. Yeah dental insurance is kind of the opposite of actual insurance. Pays for routine care and maybe one procedure, at least the plan I'm on.

[Name Redacted]

If your dentist is in network with every insurance, he she has to be crazy efficient running a ton of chairs at once to make a buck. May be working 3-4 chairs while also seeing hygiene. Easy to burn out fast and many good dentists dont want that life.

^^^this

Yep, you will get the best work done at fee-for-service dentists. They do exist. They accept little to no insurance, and are the best because of it.

[m2711c]

I still think it’s really weird that “dental work“ is not considered healthcare to be covered under regular healthcare insurance. Those dentist must have one hell of a fucking lobby. It just does not make any sense to me. I mean, you can die from not taking care of your teeth. And you would think dying would be covered under health care. But what the fuck do I know, I ain’t no fucking dentist.

[Name Redacted]

I still think it’s really weird that “dental work“ is not considered healthcare to be covered under regular healthcare insurance. Those dentist must have one hell of a fucking lobby. It just does not make any sense to me. I mean, you can die from not taking care of your teeth. And you would think dying would be covered under health care. But what the fuck do I know, I ain’t no fucking dentist.

It is pretty amazing how many health problems can be avoided by simply taking care of your teeth and gums. However, western medicine would rather ignore that fact and keep feeding you pills.

[Danno]

I still think it’s really weird that “dental work“ is not considered healthcare to be covered under regular healthcare insurance. Those dentist must have one hell of a fucking lobby. It just does not make any sense to me. I mean, you can die from not taking care of your teeth. And you would think dying would be covered under health care. But what the fuck do I know, I ain’t no fucking dentist.

Agreed. Also really weird that vision is separate from normal health insurance. How the fuck is a wheelchair medical equipment but glasses aren't?

[Rideski]

All the yes. Then toss in being self employed. Almost enough to convince me to go back corporate. Wait. is it snowing? K I’ll get back to you on that.

[Obstruction]

We have dental ins. available through my wife’s employer and we opted out after a few years ago. What with co-pays, deductibles and the portion of the premium she had to pay we rarely came close to breaking even on it. Will admit that it was marginally beneficial when our two kids were younger and we had 4 people covered.

[billyk]

Good to know thanks. It’s a year contract minimum, so buying that @$500 and then getting claim denied would be worst case scenario. Dentist is top notch and will do everything by the book.

Figure out exactly what the policy will cover in advance. Many times they only cover a portion of the cost, like 50% for crowns, and there is a deductible and yearly cap.

[old goat]

^^^this

Yep, you will get the best work done at fee-for-service dentists. They do exist. They accept little to no insurance, and are the best because of it.

Do you have any evidence for that? My dentist works 830-430 4 days per week, always has time to fit me in for my monthly dental emergency, takes Delta, and seems to do good work as far as I can tell. She cut back on the frequency of cleanings my previous dentist had me on, so doesn't seem to be hurting for money.

Figure out exactly what the policy will cover in advance. Many times they only cover a portion of the cost, like 50% for crowns, and there is a deductible and yearly cap.

My policy through work covers 100% of the Delta contracted fee (which is less than the billed fee), no deductible or copay, up to $2000/yr per person. I pay everything over that. Like I said, it's a group policy, maybe unusually generous? And like I said, not really insurance--an insurance policy would pay everything over $2000, not everything under.

[Danno]

do we have any actual dentists here? Like honest to god dentists? Because I have a dental question, getting differing info from my dentist and my periodontist, and would like to talk to someone in the business but not in the business of taking my money.

[RootSkier]

^^^this

Yep, you will get the best work done at fee-for-service dentists. They do exist. They accept little to no insurance, and are the best because of it.

My dentist does not accept insurance and 100% of your fees are due at the time of service. They will, however, submit your already-paid bill to your insurer for you. So the process is to pay with a tax-free HSA debit card and then get a check in the mail for "reimbursement" from your insurer 10 days later. It works great and I see no problems whatsoever.

[XXX-er]

I used to mail bills to sunlife and they send the check, I suppose at some point they realized they were wasting a lot of time checking stuff that was correct 99% of the time so they put it on-line

fill out an online form & submit, the $$$ is direct deposited to my bank account in < 24 hrs

[VTeton]

Do you have any evidence for that? My dentist works 830-430 4 days per week, always has time to fit me in for my monthly dental emergency, takes Delta, and seems to do good work as far as I can tell. She cut back on the frequency of cleanings my previous dentist had me on, so doesn't seem to be hurting for money.


My policy through work covers 100% of the Delta contracted fee (which is less than the billed fee), no deductible or copay, up to $2000/yr per person. I pay everything over that. Like I said, it's a group policy, maybe unusually generous? And like I said, not really insurance--an insurance policy would pay everything over $2000, not everything under.

Almost every office will take delta. Very few offices will be in network with 20 other insurance plans or the state option.

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[Name Redacted]

My dentist does not accept insurance and 100% of your fees are due at the time of service. They will, however, submit your already-paid bill to your insurer for you. So the process is to pay with a tax-free HSA debit card and then get a check in the mail for "reimbursement" from your insurer 10 days later. It works great and I see no problems whatsoever.

Yep, the office can still submit it to your insurance.

I guess I shouldn't say those dentists are better though, there are a lot of good dentists in the world and many take insurance. I just feel like those are generally the better offices. Whatever you do, avoid corporate dental offices like Comfort Dental.

[CovertM]

Whole lotta anecdotal talk and pontificating on the dental profession going on here. I thought we were all in the business??

[4matic]

I started with a strip mall dentist yesterday at the Bright Now chain. I really like this dentist and staff. Read the Yelp reviews and took a chance. I’d been going to expensive dentist that I really liked but couldn’t afford without insurance. $475 for X-rays? I bought the Bright Now insurance and a cleaning is only $66 so I can go quarterly. Crown price is $999. I asked about other insurance plans and basically they said prices are rigged by the insurance companies so it will be about the same no matter what. A few hundred either way.