Dental Insurance?

Discussion in 'Community Discussion' started by puma1552, Nov 20, 2013.

  1. puma1552 macrumors 601

    Joined:
    Nov 20, 2008
    #1
    So, my company pays the premiums for our health and dental insurance so the employees pay nothing out of pocket, which sounds great at first.

    Until you need to actually use it. Then you realize that not to look a gift horse in the mouth, but the insurance is probably the cheapest/lowest coverage you can get.

    Case in point, my wife is in the 3 step process of getting an implant/crown (extraction, implant, crown). According to insurance, they pay 50% of major restorative services such as this, which sounds alright.

    Until you realize that your cap for the entire year is a lousy $1000 per person. And yes, cleanings come out of that. So a couple hundred bucks per cleaning and you are left with a whopping $600 for the year, everything else is out of pocket. Also, there is no rollover year to year. Use it or lose it. Also, between my wife and I, we get $2000. Of course, we can't pool this $2000 and share it. So even though I haven't hit my cap, we still need to pay everything out of pocket on hers when I have money that won't get used. Perhaps being able to pool the money wouldn't be fair to single people, who will only get $1000, but I'd like to think of the ability to pool the money as a perk of being married, but such perk doesn't exist I guess.

    So in the end, my wife's implant will cost $7,000. Spread out across two insurance years, it will be $5k out of pocket, plus we already had to pay for her second cleaning this year since we hit this cap. Additionally, we will have to pay for both of her cleanings next year out of pocket as well. And on top of all this, it turns out one of her permanent retainers is busted (no idea how that happened) so we will have to pay out of pocket to have that fixed as well.

    So all in all, the dental insurance is basically worthless for anything beyond a couple cleanings and maybe a filling. A big scam more or less, even for my company since the company indeed does pay a premium to them but they certainly don't get much back; I don't know what my company pays in premiums but if the maximum return is $1000 per person, I would sure hope the premium is next to zero.

    My health insurance is free too, but with a $5000 deductible before the insurance starts paying 80/20. Preventive care is at least covered 100% though. But that's another can of worms.

    So, I was wondering, right now my wife declines insurance at her job since she's on my policy, but I was thinking is it possible to have/use two different types of insurance? Could we sign up for insurance through her job also and use both when we go to the dentist?

    On the same vein - don't get it political - I was thinking as an alternate to that maybe we could get in on Obamacare for supplemental insurance in addition to mine if we find something good there?

    So does anyone use two kinds of insurance and how does that work when it comes time for the insurance companies to divvy up and pay out? Or do they just point the finger at the other one to max out before they will step up and make it a big cluster that isn't worth the hassle and would leave me holding the bag?
     
  2. mobilehaathi macrumors G3

    mobilehaathi

    Joined:
    Aug 19, 2008
    Location:
    The Anthropocene
    #2
    I believe the answer is yes, but you'd have to fill out some extra paperwork at the beginning. Then the two companies negotiate with each other on how to coordinate coverage of your benefits.
     
  3. senseless macrumors 68000

    senseless

    Joined:
    Apr 23, 2008
    Location:
    Pennsylvania, USA
    #3
    Dental care is very expensive and people tend to use it a lot. So, if the insurance was more comprehensive, the premiums would be just as expensive.

    As far as pooling the benefit, I'm guessing the insurance premium for couples is not twice as much as for a single person.

    I don't do the insurance for the reason you cited, plus the limited selection of doctors.
     
  4. malman89 macrumors 68000

    Joined:
    May 29, 2011
    Location:
    Michigan
    #4
    Sounds like a rough situation, but with middling coverage and incredibly expensive procedures, then that's what happens.

    I am fairly happy with my current insurance through my employer. It's ~$17/pay period (semi-monthly). All preventative/diagnostics are 100% covered, while major and minor restorative procedures are 75% - including composite resin fillings, not the "we'll cover 75% of a mercury filling cost and you pay the difference," so I'm pretty pleased.

    I had to get an onlay a year out of college and that was a few hundred bucks. Wasn't too pleased with paying that, but oh well. I shudder at what my parents paid for braces and getting my 4 wisdom teeth removed.
     
  5. mscriv macrumors 601

    mscriv

    Joined:
    Aug 14, 2008
    Location:
    Dallas, Texas
    #5
    I don't have multiple insurance policies, but from what I understand when you do have more than one policy then you have to designate a primary and a secondary. The primary pays first depending on the coverage provided and the secondary comes in after that to cover when their policy will alow. So, in your case, if your wife obtained a policy through her employer then she would likely have to designate that as the primary and your family coverage of her would be secondary. She should be able to ask her HR rep for a contact number and call the insurance provider to get these questions answered. Likewise you could contact your employers insurance provider and ask them how they handle multiple policies as well.
     

Share This Page