Dental Insurance

I am on Medicare and have a supplemental plan w/o dental coverage.

Other than through an Advantage plan, are there reasonable dental plans for medicare recipients?

There are a variety of real dental insurance plans in the $30-50/month range…as well as dental discount plans for much less.

How good your teeth are, and whether you are willing to change dentists will make a difference in what you may choose.

Medicare advantage plans can offer up to several thousand dollars of dental reimbursement, but then there are down sides to advantage plans as well.

Thank you for taking the time to respond

I am a dentist. All individual dental plans I have encountered are junk. Many use deceptive claims. For instance, they say, “Will pay 80% of fees for restorative procedures!” Then the mouse print says “80% of Medicaid fees,” which are ridiculous and no decent decent will work on you.

Administration of dental plans eats up 35% of premiums.

Especially avoid anything sold by Delta Dental.

People think they can pay X$ in premiums a year and get 2X$ or 3X$ worth of dental treatment. Business doesn’t work that way.

Patients naively believe dental plans can save them 50% and more. The truth is overhead in dental officers is 70% and more. Desperate dentists who sign up for these plans must resort to tricks like charging patients extra fees for things that are usually included with procedures, like outboard lab fees.

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I have a discount dental plan called Dental Source. It works well for me, and I am not sure if it uses a third party ins company. It is very reasonable, but only dentists in a certain midwest area uses it.
Tell me more about discount dental plans as an alternative to insurance.

Most are discount plans not true insurance, but then so are most medical plans now thanks to “co-insurance”. You used to co-pay up to your deductible and insurance would pay the rest for the year. Not anymore. Thanks Obama! :rofl:

Thanks everyone for taking the time to respond.

I don’t expect big issues so I am going to pay as I go. My dentist has a plan that I will investigate. I initially signed up but need to read the small print.

Again thank you all

The ads for these discount plans sound VERY attractive. “Save up to 50% on dental procedures!”

I assure you that no dentist could discount anywhere near this amount and stay solvent. The biggest discount you will ever manage is 20%. You might be able to get that yourself if you offer cash (hard cash, not plastic or checks) he can stick in his pocket.

Guys who play these discount plan games just charge patients for things ordinarily included in the procedure, in order to make up the lost revenue. Dentistry is not the high-profit profession layman thinks it is. Overhead is killing us, especially with supply and wage increases. I have been practicing 42 years and have never seen overhead go up as quickly as it has in the past two years.

Thanks for being candid Henrius. I came to that same conclusion some time ago, canceled my dental insurance and have come out ahead on cost. Dental insurance is crap.
If you need a lot of work that you really can’t afford check out the RV sites that talk about getting work done in Mexico. Many good experiences and some bad. Just like here.

Over the years, I have treated tons of patients that went to various countries for treatment. Most of them were very sorry. I can tell you many horror stories.

The best dentists in most countries are very good. But the spectrum of dentistry is much broader in third world countries (the ones with cheap prices.) In many countries, for example, unlicensed people often practice as dentists with forged documents, and the government does nothing to stop them. It is common for a dental assistant to try and pass herself off as a dentist after working for one for a short time.

I have actually treated patients in Colombia, Peru, and Lebanon. I have treated foreign nationals from all over the world. I have dentist friends in Germany, Ecuador, and Romania. I have attended conferences in many countries, so I am well versed in the standards of dentistry in different countries.

The AVERAGE care in Mexico is not all that good. I had a Mexican patient who returned recently with decent dental work. She knew who was good in her hometown. American dental tourists do not know. They go to clinics advertising on the internet or in magazines in airplanes. These are often not the best dentists.

Another problem in Latin America is dentists using metal alloys with no clue of what they are composed of. I met a Nicaraguan dentist who made his own crowns and had no idea what was in the metal he bought from some store in town. Dental laboratory work is not all that good in the third world. In India it is spectacularly bad.

Do not underestimate the need for post-op care. Suppose you have a root canal in Costa Rica and you have post-op problems? No one here will treat your post-op problems for free. Most will be disgusted and tell you to go back to Costa Rica to have them attend it.

If you get an implant in another country that is not FDA approved, good luck having anything done to it here. I won’t touch an implant surgically placed in another country, and a lot of dentists are like me.

I could give patients the names of a good dentist in El Salvador or Romania, but patients are know-it-alls and think they can “research” it out on the internet. Good luck with that. Did you know that employees and owners of many of these foreign clinics post fake online rave reviews to reel in suck patients flush with US dollars?

Ok Doc you got me.

You know good Dentists in Mexico, how about letting us know? Preferably right along our Border.

Can’t tell you the joy I felt paying $6500 in the US for ONE implant. I’ve got a used car in my mouth. Mexico Dentist advertised $2500. Can you really blame economically challenged people for trying find a better deal out of country.

Help us out with some recommendations.

I don’t know any dentists in Mexico. I have one good friend in El Salvador and another in Romania, and an orthodontist friend in Cuenca Ecuador.

No dentist in the USA charges $6500 for one implant. They may charge $6500 for a pre-planning CAT scan surgical guide, graft if necessary, implant, abutment, and implant crown.

I tell you again the LAST procedure I would have done on foreign soil is surgical implant placement. You never know if the implants are FDA approved in the US. If not, you cannot get parts for them in the US. Things can go wrong with implants. Screws loosen. Bone is lost. There can be infections around them. Will you be going to to to a foreign destination if any of this happens? We American dentists don’t want to mess with foreign-placed implants. Patients are helpless in foreign courts so they try to blame us if we touch them.

If you MUST experiment with foreign dental care the best bet is dentures. The worst that can happen is you waste your money on something you cannot wear.

The clinics on the border are the last place I would go. Larger cities with universities are more likely to have the really good dentists. But who is decent and who is a schmuck?

As I tour Mexican dental offices, the thing that amazes me most is the lack of care in sterilization of instruments compared to here. It is rare that they have more than two or three handpieces, so they cannot sterilize them.

Better to go an American dental school and have students and residents work on you. You will trade extra time for monetary savings. It is easier to travel to a dental school than south of the border.

thanks for everyone’s insights

So how does one acquire a dental insurance plan akin to health insurance where you pay up front to a limit, then insurance covers the remaining…? Or you pay up front to a limit, then insurance begins to co-pay until another threshold is reached, then insurance will cover the remaining. Surely there is something available that’s not just based on this inverted insurance model — e.g., $2G’s up front coverage, …then you pay 100% thereafter w/o limit…(?)

That’s not Insurance. Insurance is meant to protect the individual from the other side, where costs accumulate beyond the individual’s ability to pay. And considering the costs associated with Dental Care up front, $2G’s is nothing. I recall 2 crowns w/o dental insurance ca 2006 costing me just over $4,000.

Now with Obamacare in place & ~16 yrs of inflation (especially inflation over the last year), even with $2G’s to throw at the bill with inverted insurance, how is dental beyond cleaning even accessible to the average American…?

These people that have several dental implants, say 8 upper & 8 lower, that pay well in excess of $100K, that makes sense to me because they are actors/actresses that sign $multi-million contracts. But an individual that has to pay ~$7,000+ per implant, what does $2,000 of inverted insurance even matter?

If an individual were to ask for 2 Dental implants, even with inverted insurance, the pre-payment of the procedure would require an amount of cash that isn’t even legal to carry on one’s person without supporting documentation. Given current banking laws in the US today, the Dentist would seem obliged to request that documentation to submit to the Internal Revenue Service.

If inverted insurance is all that is available for Americans, than the oral health of ~60%+ of America is severely compromised. The incentive to seek out dental care abroad becomes substantially more cost effective, particularly to Mexico where health care is successfully privatized, unlike the privatization in the United States that is a massive failure. And this would seem not to be a major problem just for Americans in need of dental care — what of American Dentists when Americans forego seeking dental care or do seek dental care abroad instead? I would imagine this is a serious existential crisis for American Dentistry.

The above post is pure baloney. American dental care is as much private as it is in Mexico. The Mexican government does not add so many mandates and regulations as exist here in the US to make care more expensive- including the 2.3% Obamacare tax on dental equipment and supplies, mandatory OSHA, HIPPA and narcotic annual courses that are totally stupid and a waste of time.

The main reason dental care is cheaper in 3rd world countries is much cheaper labor, offices spaces can be smaller due to no ADA act, and rents and utilities are cheaper. 3rd world dental labs NEVER use expensive metals like gold or platinum or palladium. Few dentists I have met in Mexico sterilize their handpieces (drills.) It degrades them, and they can’t afford to buy more than one or two.

No dental plan like you describe exists in the world for good reason. You can’t insure for things you know you need. Dental implants didn’t even exist 25 years ago and are a luxury. Not having them does not “severely compromise” Americans’ health. Missing teeth can be replaced more economically with fixed bridges or removable partials. Even with lower fees in Mexico, even fewer Mexicans have dental implants.

If teeth are lost unexpectedly in an auto accident, they will be paid for by that policy.

No colleagues I know charge $100K for implant supported bridges. The biggest fees I hear are $60,000 if a lot of grafting is necessary. Average case prices for both arches run less than $50K.

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One of the unrecognized benefits of dental insurance is that it removes the blank check that dentists have to raise their rates. It is true that the insurance covers only a percentage of what you are charged, and there are often hefty deductibles and copays. However, we’ve found that our true savings are the 25% or so write downs that our dentist takes because his rack rate is much higher than the negotiated insurance rate. His uninsured patients are paying this much higher rate, not realizing that by getting insurance they would be entitled to the much lower rates. It is like the exorbitant medical bills that are knocked down by Medicare/other insurers. This alone makes the insurance financially worth considering once you find a dentist that you like.

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If you are right, it means your dentist’s cash patients are getting royally screwed to subsidize your discount treatment. Are you OK with that?

The main reason I don’t sign up for these crummy dental plans is I think it is immoral to charge different groups of patients different fees for exactly the same service. This is what our corrupt medical system does.

I will tell you a secret. Prostituting Providers who sign insurance contracts have to make up the difference in some way. Here are the ways they do it.

1, “Upcode” procedures so they net the same. Example a simple extraction becomes a surgical extraction. No one will know.

  1. Charge patients on the crummy plans for things that are ordinarily no charge. Some tack on a lab fee for crowns, others charge a fee for the temporary, others charge for a buildup even if none is done.

  2. Perform unecessary treatment. If the insurance fee is too low to make a profit on one filling, treatment plan three posterior fillings in a row that he can do with the same nerve block.

Crummy insurance plans encourage dentists to do this. Crummy insurance plans are one of the two reasons that professional ethics have declined so much.

What if the dentist you like does not sign up for your schmuck plan? Most good dentists don’t. I haven’t met one honest and competent dentist ever that signed up for Cigna DMO.

The two best ways of finding a terrible dentist are:

  1. Going to one advertising on TV.
  2. Selecting one from an insurance list.

Is it possible that there are many dentists who are not as dishonest as you suggest in padding their bills, who take insurance subscribers to supplement a steady flow of business?

It’s also possible that some dentists are more efficient, and still can make a nice profit off the negotiated insurance rates rates because they keep their overhead lower than yours.

And yes, I’m fine with cash patients sometimes paying more than I do. They are not paying premiums and risking that the overall cost is higher during those years when less care is needed.

I chose my dentist not from insurance networks but from the recommendations of friends who are intelligent consumers, and who are happy after years of service. The fact that he is willing to work with insurance is a bonus.

As long as I get good service, I’d rather pay an insurance company to negotiate rates on my behalf, rather than to be left to do my own investigation of whether my dentist is charging exorbitant rates - like what happens to cash paying hospital patients.