Health insurance problem

I plan on retiring at 62. I need health insurance, including eye and dental until I reach Medicare. When wife retires she will have her single plan paid for, but no dental or eye.

I have looked on the market place, and that is probably the way I will go. Some plans have dental, but I cannot add wife. Suggestions?

@Henrius You have any opinions on dental options?

Not Henrius, but after looking into dental insurance after losing ours, I concluded that it was not worth the money. May pay for cleanings and annual xrays, but one needs to look at what your dentist charges vs, premiums. I found it, at best, breakeven. Payments for more involved work usually take 2-3 years before insurance will pay.

I think vision coverage is about the same benefit, not much.

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I was afraid of that. Wife inherited her bad teeth. She does everything right, but I can see issues down the road. Thanks for the input.

Yes it’s frustrating that dental insurance is not insurance but a payment plan instead.

It’s not like you pay the first couple thousand out of pocket and then are covered by insurance. It unfortunately covers what you can easily cover yourself but not cover what insurance is supposed to cover

All individual policies are junk. Insurance companies have to have their cut for overhead and profit. Dentists who sign up for these risky-dink plans play games with upcoding procedures and charging for things usually free. Two articles on the subject:

You have found out what most people find out. Think a “free” government dental addition to Medicare will be worth a hoot? Then I have got a bridge to sell you.

Please thank the government for increasing the cost of dental care via the 2.3% Obamacare tax on our equipment and supplies. Of course, economic illiterates like KCFlyer and Comrade Friday say increasing our costs don’t affect the prices of our services.

Also, thank the EPA for the new up-front and yearly costs imposed on dentists for a non-existent threat to wastewater.

But you don’t understand. It is impossible to insure for something you know you need on a recurring basis. It would be like insurance for replacing worn out tires on your car. Just how would that work? Better to save the money each month so you will have it to pay for the new tires when the time comes.

You insure for unexpected, catastrophic costs.

I had a bridge removed and am getting a couple of implants.

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That is the best pun on this forum to date.


Exactly that’s why it’s frustrating that dental insurance covers cleanings, X-rays, etc instead of covering crowns, root canals, bridges, and implants if necessary. The latter especially if a sinus lift is necessary can be quite expensive

Dental insurance should really only kick in if you have an expense over a certain amount, aka $2,000, $5,000, $10,000 and should only cover something unexpected not that you bought the insurance because you knew you needed dental work done

My wife has a dental plan that covers $2k per person but my dental plan covers up to $30k and is in network with her dentist. The kids have Medicaid but we don’t go to a dentist that accepts it

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The problem, like medical insurance, is purchasing only when there is a need. If dental insurance covered expensive things like implants and sinus lift grafts, people would only buy it when they knew they needed such expensive services.

Needing root canals is more likely unexpected. It can come out of the blue on a tooth that was crowned or filled a long time ago, for instance.

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Is there any dental insurance with a damn?

I’ll admit I spent most my career contract. So I don’t know shit about insurance. I was paid either per diem or per case. I was never a partner. So I never saw the bottom line.

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Individual dental policies were never worth buying. Group employment policies are sometimes worth it if the employer is subsidizing the premiums. However, more and more group policies are junk as well. Delta and Southwest Airlines have switched to Delta Dental. Due to low reimbursements, I am limiting procedures on existing airline patients and not accepting any new patients from those companies. I advise employees to skip the Delta Dental and just fund their Flex Benefit plans.

The bottom line is claims administration eats up a large amount of the premium dollar. The dream of every patient is to pay $20 a month premium and get $2000 a year of dental care. How would that business model work anyway?

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Are Dentists part of the Problem? Had a Dentist for about 25 years.
Had Metropolitan Insurance. When I saw how little they paid, I asked if I dropped the Insurance… would I pay more.

He said yes I would pay much more than insurance paid.
Consider he would have less paperwork, payment at time of service. No Billing No Waiting!.
This was not an HMO or Capitation policy.

He is now retired as am I. I am on Cigna and what I pay for a crown… (I have several) is very good.

I’ll be interested to see Henrius’ response, but from what I can observe…

The phenomenon you are referencing is industry-wide. Therefore it is not especially efficient to blame virtually all of the individual dentists collectively, as they are simply responding to incentives.

More likely the effect is due to shitty legislation/regulation cooked up by the revolving door of trade groups/lobbyists (both dentists and insurers) and government officials/aides.

The Democrats are correct. We definitely need a “Great Reset.” But it involves nuking the hundreds of thousands of tumorous tendrils of crappy government policy that are cumulatively diminishing competition/transparency and providing guaranteed income for a limited number of well connected players.

That is kind of the problem. In the ideal sense, if you have insurance and need dental work, you would be covered for catastrophic expenses. If you found out that you needed dental work and then tried to get insurance, you would not be covered.

It makes zero sense to cover small expenses just because people are unable to budget because of the cost of claims administration.

It would make a lot more sense to only cover dental care in excess of $5,000.

Is Government a part of the problem? Today I spent half of Saturday in my office working with a technician to install an expensive EPA required filter on my suction. Total cost was $1180 and recurring yearly fees of about $700 plus postage if I replace the filter cartridges myself. All for a device that does nothing of value except make regulators feel good.

I guarantee no dentist on a Cigna plan will do a partial gold crown, the best restoration that could you could ever get on a back tooth. All you will ever get is milled zirconia crowns sent for fabrication in China. That is all any dentist can afford to do on Cigna PPO fees.

Don’t kid yourself. Dentists know who is on those low-paying PPO plans. And don’t even get me started on DMO plans, which are a complete joke.

By the way, academic inflation in the US is part of the problem. My wife attended a spartan university in El Salvador. What she had to do for her bachelor’s included a thesis. Her undergrad education was far superior to mine, at a fraction of the cost, even when adjusted for cost of living down there.

He daughter’s husband is a physician trained in El Salvador. There the degree can be obtained in SIX years after high school graduation. Kids that wash out of medical school are tracked to be nurses and other auxiliaries. The schools are no-frills, without all the grandiose lecture halls and sports facilities that cost so much in the US. No dorms, either. Kids just rent a bedroom in someone’s house.

There is no reason why it could not be so here. Higher academia is rotten to the core in the US. They like to build little kingdoms for themselves at students’ expense.