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Why is dental insurance not on par with medical insurance?

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    Why is dental insurance not on par with medical insurance?

    Yes dental insurance is cheap at $25 a month but it only covers twice a year cleaning and once every 2 years x-rays. Want braces $5000, implants yikes $10,000. I rather pay higher premiums of let's say $100 a month for dental insurance and cover braces 80/20 like medical insurance or implants at 80/20. Why is dental insurance so cheap but covers so little compared to medical insurance? I say jack up the price of dental insurance and cover more services just like medical insurance. Any thoughts or opinions on the topic?

    #2
    1. You need better dental insurance. I pay about $16/mo. That covers 3 cleanings a year, annual x-rays, routine care like fillings and stuff, and discounted rates on a lot of other services. It's been a while so I don't remember the details but I think we got 20% off braces. So not 80/20 but it was still helpful. I'd much rather pay a low premium and not have coverage for a bunch of services that most of us will never need. My wife and I aren't getting braces or implants (hopefully) so why have insurance that covers those things.

    2. I think a lot of people will say you have this backwards. Medical insurance should be cheaper and cover less. This came up in a thread not long ago. My wife had a hysterectomy 15 years ago but we still have insurance that covers birth control and maternity care. Why? It would be nice to be able to opt out of that and pay a lower premium.

    I suspect that at some point in the past, the dental profession did a far better job negotiating their position than the medical profession did.
    Steve

    * Despite the high cost of living, it remains very popular.
    * Why should I pay for my daughter's education when she already knows everything?
    * There are no shortcuts to anywhere worth going.

    Comment


      #3
      We used to have great dental insurance, but it was heavily subsidized by DH’s employer. I can’t remember exactly how much it was-like $10 a pay period (not taxed). Last year, DH’s company was bought out. The new premium was $100/month and the coverage was terrible.
      So, I signed us up for dental insurance through my former employer. We pay slightly less than $100/month for better coverage than what we could get through DH’s employer. (At least we found a PPO that both our dentists accept). It’s our first year on this one, so I will have to see how it works out (in practice).

      Comment


        #4
        Originally posted by disneysteve View Post
        Medical insurance should be cheaper and cover less. This came up in a thread not long ago. My wife had a hysterectomy 15 years ago but we still have insurance that covers birth control and maternity care. Why? It would be nice to be able to opt out of that and pay a lower premium.
        The nature of insurance is that everyone kicks in to even it out so those who have larger bills can pay less (and can give obscene profits to insurance companies, but that's another issue). So if you let everyone pay less because they don't currently want coverage for certain things, the prices will have to go up for others who do have expensive medical issues. If the idea is that you should only pay premiums for the services you receive, then opt out of medical insurance and pay out of pocket for the services you do receive.

        As for dental, I think QMM has bad dental insurance. We pay way less and have far better coverage that it seems they have.

        Comment


          #5
          Originally posted by HundredK View Post

          The nature of insurance is that everyone kicks in to even it out so those who have larger bills can pay less (and can give obscene profits to insurance companies, but that's another issue). So if you let everyone pay less because they don't currently want coverage for certain things, the prices will have to go up for others who do have expensive medical issues. If the idea is that you should only pay premiums for the services you receive, then opt out of medical insurance and pay out of pocket for the services you do receive.

          As for dental, I think QMM has bad dental insurance. We pay way less and have far better coverage that it seems they have.
          Oh, I agree with you 100%. I don't support that opinion but I know that many people think that way. I was just trying to make that point. Insurance is shared risk.

          Dental insurance is different than medical insurance, though. The likelihood of one of us having some super expensive dental problem is very slim compared to the risk of an expensive medical problem. I'm fine having dental insurance just cover the routine stuff because the really costly dental things are pretty rare.
          Steve

          * Despite the high cost of living, it remains very popular.
          * Why should I pay for my daughter's education when she already knows everything?
          * There are no shortcuts to anywhere worth going.

          Comment


            #6
            My work offers 4 dental plans to choose from and I have Delta Dental PPO which is the best and most expensive plan at $30 a month. But dental plans nationwide are junk, mine's as well as yours. My teeth are good except for a root canal crowned gold molar which is absessed and sore and might need an implant so scheduled a May 4 appointment. Or the dentist might extract the tooth and build a bridge. Keep in mind Delta Dental does not cover either of these procedures and my out-of-pocket costs range from $3000 to $10,000. I have no problem paying and grateful to the Lord that I have the means but what good is dental insurance if my cost is $3000 to $10,000. Does your dental insurance cover it? I doubt it.

            Comment


              #7
              I think it's a trade off. Would you rather pay $1,200/year or more for many years on the off chance that you will someday incur a $5,000 bill or would you rather pay $300/year for many years and handle that $5,000 bill out of pocket? Your break even point there is only 5 or 6 years.

              Medical expenses, however, are an entirely different story. One fairly routine hospitalization can cost 6 figures. I'm much happier to insure against that than to insure against an expense of a few thousand dollars.

              I wonder if there are even dental plans out there that cover those sorts of things, and if so, how much do they cost.
              Steve

              * Despite the high cost of living, it remains very popular.
              * Why should I pay for my daughter's education when she already knows everything?
              * There are no shortcuts to anywhere worth going.

              Comment


                #8
                I never thought of it that way, good point disneysteve. Yes, I would rather pay $5000 once every 5 or 6 years than $1200 a year for the same 5 or 6 years. I feel better a little better now.

                Comment


                  #9
                  Originally posted by QuarterMillionMan View Post
                  My work offers 4 dental plans to choose from and I have Delta Dental PPO which is the best and most expensive plan at $30 a month. But dental plans nationwide are junk, mine's as well as yours. My teeth are good except for a root canal crowned gold molar which is absessed and sore and might need an implant so scheduled a May 4 appointment. Or the dentist might extract the tooth and build a bridge. Keep in mind Delta Dental does not cover either of these procedures and my out-of-pocket costs range from $3000 to $10,000. I have no problem paying and grateful to the Lord that I have the means but what good is dental insurance if my cost is $3000 to $10,000. Does your dental insurance cover it? I doubt it.
                  I have Delta and they paid a lot of my last implant (I have three of them thanks to parents who never took me to the dentist ever). The first two there was no coverage, but it was added sometime in the last 5 years. If i recall correctly, there are certain parts of it they paid a percentage of and some things they wouldn't (I think they wouldn't pay at all for the scan to tell the dentist exactly how to place the post so that they don't hit nerves). My out of pocket for my last one was only maybe $3k total for everything from the extraction through every implant appointment. The prior two it was still newish tech and I paid much much more. We always joke at my cleanings that my mouth is my version of a fancy sports car. Our dental is through an employer though who has very very good coverage, so I don't know how that compares to the standard delta plan.

                  Comment


                    #10
                    I just looked it up -

                    After insurance, I paid:
                    $ 587.50 for the exam, tooth extraction and bone grafting.
                    $ 938.50 for the implant surgery
                    $ 1,013.00 for the crown
                    $ 400.00 for the CT scan (that's what tells the dentist where not to drill to avoid nerve problems)
                    $ 2,939.00 total out of pocket

                    Insurance paid:
                    $ 175.00 for the exam and xray
                    $ 287.00 for the extraction and bone grafting
                    $ 938.50 for the implant surgery
                    $ 707.50 for the crown
                    $ 854.00 for the abutment (i think that's a piece of the crown needed to attach it to the implant post, not sure)
                    $2,962.00 total paid by insurance

                    Cost of our dental insurance: $20 a month total for 2 people
                    Last edited by HundredK; 04-24-2021, 12:40 PM.

                    Comment


                      #11
                      Funny this subject just came up. We cancelled our dental insurance as of 3/31/21. Our dentist stopped taking insurance so we have to pay whatever the insurance company doesn't pay. Also, my husband had to have an implant of one of the lower front teeth and the insurance company didn't cover anything. I think probably because it is more for cosmetic than for chewing (not a molar) though if you don't have a tooth in that space, your whole bite is going to shift. So, it was $81 a month for two cleanings/exams per year each plus x-rays every so often plus a bit to cover if we had to have a filling or crown (all at the contracted rates - we have to pay the difference between what the dentist charges and what insurance pays). The insurance company says they cover 50% of a crown. Well, if your dentist doesn't take insurance, that 50% is 50% of maybe $700 (the contracted rate) and then you have to pay the additional $1350 or whatever it is. Just not worth it.

                      And, we'll get a 5% discount for credit card/cash.

                      Yes, we could change dentists but we have experienced two lousy dentists over the past 8 years or so and finally found someone we trust. And, we can walk to his office!

                      Comment


                        #12
                        Originally posted by HundredK View Post
                        I just looked it up -

                        After insurance, I paid:
                        $ 587.50 for the exam, tooth extraction and bone grafting.
                        $ 938.50 for the implant surgery
                        $ 1,013.00 for the crown
                        $ 400.00 for the CT scan (that's what tells the dentist where not to drill to avoid nerve problems)
                        $ 2,939.00 total out of pocket

                        Insurance paid:
                        $ 175.00 for the exam and xray
                        $ 287.00 for the extraction and bone grafting
                        $ 938.50 for the implant surgery
                        $ 707.50 for the crown
                        $ 854.00 for the abutment (i think that's a piece of the crown needed to attach it to the implant post, not sure)
                        $2,962.00 total paid by insurance

                        Cost of our dental insurance: $20 a month total for 2 people
                        Thanks for posting this HundredK, good to know. My dentist had to refer me to a specialist and could only provide me with a quote range which I posted above. Your prices are exact prices for services rendered. And looks like Delta Dental paid 50% which is great.

                        Comment


                          #13
                          My uncle was a dentist (retired now) and from birth until about 30 years old he always fixed my teeth religiously so I was fortunate to have good dental services. The gold crown molar that is going bad is from about 1989.

                          Comment


                            #14
                            Exact coverages for my Delta Dental plan. Click image for larger version

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                              #15
                              Originally posted by QuarterMillionMan View Post
                              might need an implant so scheduled a May 4 appointment. Or the dentist might extract the tooth and build a bridge. Keep in mind Delta Dental does not cover either of these procedures
                              I'm confused. That's not what the chart says.
                              Steve

                              * Despite the high cost of living, it remains very popular.
                              * Why should I pay for my daughter's education when she already knows everything?
                              * There are no shortcuts to anywhere worth going.

                              Comment

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