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Dental Charges - interesting!
Recently my OH managed to get employment with some great Health benefits attached, including an all singing all dancing dental policy which pretty much covers everything at 100%.
This was timed nicely, as I had to have four root canals done and it could have worked out rather expensive if we didn't have the cover. As I wobbled up to the counter after a marathon 3 hour session, I was a little surprised to find out that even though I had 100% coverage, I would be getting charged. Why? Well as I have had it explained to me, an amount is set every year as a fair payment for treatments, and thus this amount would be payable under all dental schemes. However, Dentists may choose to charge more than this, thus the extra amount. My Dentist is very good, and runs a practice in Edgmont, Vancouver, but the downside is that he charges 15% extra for root canals and 10% extra for fillings. So if you are new and are coming over, it might be an idea to find out how much you are going to be charged, and how much of it is recoverable under insurance. |
Re: Dental Charges - interesting!
Also, some insurance policies cover up to the published provincial association rates from last year or even the year before, rather than the most recent list.
Also, most benefits policies now either have a deductable on some of the costs, or an employee copay. My policy was recently changed, I now pay 20% but the deductable was dropped, and at least the insurer is working now from the most recent provincial cost list, rather that a year out of date one... Anyway, coverage is better than none, and you are lucky to get immediate coverage and not have to wait 6 months like some! Cant say I was thrilled that my employer could just unilaterally change the coverage without any consultation though. Always worth asking about for dentists, some are definitely better value than others. |
Re: Dental Charges - interesting!
Can you buy supplemental insurance to cover the extra costs?
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Re: Dental Charges - interesting!
Originally Posted by Oink
(Post 9176106)
Can you buy supplemental insurance to cover the extra costs?
If two people in a family have work benefits coverage its possible that the difference not covered by policy #1 would be covered by policy #2. Not sure if that applies if the fees charges exceed the statute guides, but they should cover any deductable or copayment. |
Re: Dental Charges - interesting!
Originally Posted by iaink
(Post 9176111)
:confused:Thats what we were talking about wasnt it?
If two people in a family have work benefits coverage its possible that the difference not covered by policy #1 would be covered by policy #2. Not sure if that applies if the fees charges exceed the statute guides, but they should cover any deductable or copayment. |
Re: Dental Charges - interesting!
I had a head bashing moment with optical coverage.
The policy covers 80% of costs up to a maximum of $450 ( I think thats the max amount) I buy a years worth of contact lenses at considerably more than $450 . So I was expecting $450 back ( 80% of total cost up to max of $450) what I got back was 80% of $450. No amount of explaining seemed to convince them they were wrong , my point being that if that is the way they are going to calculate it then you are NEVER going to get $450 worth of coverage :banghead: |
Re: Dental Charges - interesting!
80% of a maximum of $450 is what I would have expected, but then I expect the worst from insurance coverage.
Up until recently my plan covered up to $250 for optical, but didnt cover the actual eye exam! I dont need glasses (yet), so I was on the hook every time I got my eyes checked! |
Re: Dental Charges - interesting!
Originally Posted by Oink
(Post 9176134)
No, I didn't see anything about supplemental coverage in the two posts. I also have supposedly full dental insurance from work but like the OP I sometimes have to pay an extra cost. I also have to pay up front and get reimbursed later. :frown: I was just wondering if you could purchase extra insurance to cover the extra costs that the dentist charges?
I doubt a second plan in addition to what your employer provides would be cost effective. Its probably cheaper to just pay the shortfall rather than pay for a second policy. Many (most?) insurers now have online facilities for dentists, physios etc to pre register so that your claim is submitted directly and you dont have to pay whatever they cover up front. If your dentist hasnt done that you could encourage them to, or else go somewhere that does. |
Re: Dental Charges - interesting!
Originally Posted by iaink
(Post 9176153)
Anything that is not provincial sourced is "suplimental"
I doubt a second plan in addition to what your employer provides would be cost effective. Its probably cheaper to just pay the shortfall rather than pay for a second policy. |
Re: Dental Charges - interesting!
Originally Posted by Mental Mavis
(Post 9176040)
So if you are new and are coming over, it might be an idea to find out how much you are going to be charged, and how much of it is recoverable under insurance. |
Re: Dental Charges - interesting!
Originally Posted by Zoe Bell
(Post 9176139)
I had a head bashing moment with optical coverage.
The policy covers 80% of costs up to a maximum of $450 ( I think thats the max amount) I buy a years worth of contact lenses at considerably more than $450 . So I was expecting $450 back ( 80% of total cost up to max of $450) what I got back was 80% of $450. No amount of explaining seemed to convince them they were wrong , my point being that if that is the way they are going to calculate it then you are NEVER going to get $450 worth of coverage :banghead: Still better than a kick in the nads though I suppose. |
Re: Dental Charges - interesting!
Is it only me then that has a problem with how this is worded. I think it is false advertising. How can it be up to a maximum of $450 if they will never pay out $450?, surely then its up to a maximum of $360
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Re: Dental Charges - interesting!
Originally Posted by Zoe Bell
(Post 9176226)
Is it only me then that has a problem with how this is worded. I think it is false advertising. How can it be up to a maximum of $450 if they will never pay out $450?, surely then its up to a maximum of $360
You have a 20% deductible, so they pay out 80%. Say my car is covered for $15000, they wont pay out $15000 if I total it, I have to cover the deductible... same thing innit? Its a bit smoke and mirrors I agree, but thats insurance companies I guess, this is no better or worse than most of their wording. All a question of grammar and punctuation I expect...something I probably should refrain from commenting on. |
Re: Dental Charges - interesting!
ok then..orthodontics (braces) my kids have 50% coverage up to a max of $2500..so if the treatment is $6000 i will get $2500 back and pay the rest and not 50% of $2500?
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Re: Dental Charges - interesting!
When our new benefits were explained to us I got the impression that I could get up to $2000 back total on orthodental, at 50%, for each kid under 19 , but thats my plan....If in doubt ask your insurance provider. They all have 800 numbers...
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Re: Dental Charges - interesting!
Originally Posted by iaink
(Post 9176298)
When our new benefits were explained to us I got the impression that I could get up to $2500 back on orthodental, at 50%, for kids under 19 (over a two year period IIRC), but thats my plan....If in doubt ask your insurance provider. They all have 800 numbers...
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Re: Dental Charges - interesting!
Originally Posted by iaink
(Post 9176153)
I doubt a second plan in addition to what your employer provides would be cost effective. Its probably cheaper to just pay the shortfall rather than pay for a second policy.
Individual dental plans. The insurance companies expect to collect $100 in premiums for every $65 they pay out. You are much better off putting the premium money aside each month in a savings account and paying your bills from this account. Better is a pooled plan. Some industry associations or chambers of commerce offer these. The premiums are a little lower because the risk is spread more thinly. The real advantage of employer sponsored group schemes is that the employer pays most of the premium, and it is not a taxable benefit for the employee. |
Re: Dental Charges - interesting!
Originally Posted by HGerchikov
(Post 9176316)
Our insurance recommends that you get the dentist to send in the proposed treatment plan before you get the work done - they then send us back a detailed list of what is covered, what isn't and why. That way we always know in advance exactly how much we are on the hook for. I would suggest you do this even if they don't ask for it.
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Re: Dental Charges - interesting!
Originally Posted by iaink
(Post 9176341)
Good advice for any major proceedures. Ortho is an expensive business for sure.
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Re: Dental Charges - interesting!
Originally Posted by iaink
(Post 9176232)
Its a maximum of $450 because if you are lucky enough to have 100% coverage, then they will pay out $450.
You have a 20% deductible, so they pay out 80%. Say my car is covered for $15000, they wont pay out $15000 if I total it, I have to cover the deductible... same thing innit? Its a bit smoke and mirrors I agree, but thats insurance companies I guess, this is no better or worse than most of their wording. All a question of grammar and punctuation I expect...something I probably should refrain from commenting on. Say my contact lenses cost $1000 per year , I should be able to get $450 back . 80% of $1000 is $800 , but they will only pay a max f $450 , so I should be entitled to $450 , otherwise if they work it out as 80% of $450 then the maximum payout is not $450. |
Re: Dental Charges - interesting!
Most policies list the maximum amount covered in one section and the co-pay in another.
They should say the maximum amount covered is $450 and the co-pay is 80%. If they say they will pay $450 then the document is wrong. I would be surprised if it does say that and no one else has noticed. |
Re: Dental Charges - interesting!
Interesting stuff on the charges then!
In the Dentist's case, it is nothing to do with the policy limits, and more to do with his desire to increase revenue! As much as anything, I think it's definitely worth talking to the receptionists up front to see the scale of fees. Re the $450 issue, as far as I can see it would be mathematically impossible to ever achieve that limit! Harsh! |
Re: Dental Charges - interesting!
Originally Posted by Mental Mavis
(Post 9177044)
In the Dentist's case, it is nothing to do with the policy limits, and more to do with his desire to increase revenue!
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Re: Dental Charges - interesting!
Small consolation, but I think anything which isn't covered by insurance is tax deductable?
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Re: Dental Charges - interesting!
up until last March me and the family covered under OH's health insurance from work. He now works for himself so didn't bother with insurance. Knowing I needed a crown I had the work done before he handed his notice in and my contribution (health only covered 50%) was $800 as the crown was costing $1600 and the insurance would pick up the other $800.
However, OH now needs a crown! Dentist says he has special rates for non insured like us and it was only going to cost $800!! Durr! Confusion, as this was exactly the amount I'd paid with insurance however the Dentist won't be receiving his other $800 from the insurance company. I've never understood this whole insurance business but I'm completely confused now!:huh: |
Re: Dental Charges - interesting!
Originally Posted by Zoe Bell
(Post 9176139)
I had a head bashing moment with optical coverage.
The policy covers 80% of costs up to a maximum of $450 ( I think thats the max amount) I buy a years worth of contact lenses at considerably more than $450 . So I was expecting $450 back ( 80% of total cost up to max of $450) what I got back was 80% of $450. No amount of explaining seemed to convince them they were wrong , my point being that if that is the way they are going to calculate it then you are NEVER going to get $450 worth of coverage :banghead: I would have expected $450 back too! Something not quite right with that! |
Re: Dental Charges - interesting!
Originally Posted by Jingsamichty
(Post 9177785)
Small consolation, but I think anything which isn't covered by insurance is tax deductable?
and btw you want expensive , Ben had a dental implant that wasn't covered by insurance , holy 4 figure sum , batman !!!!! |
Re: Dental Charges - interesting!
Originally Posted by Zoe Bell
(Post 9176751)
It's not smoke and mirrors , it's factually incorrect , they claim they will pay a maximum f $450 , but given their calculation methods explain how you will ever get a payout of $450 .
Say my contact lenses cost $1000 per year , I should be able to get $450 back . 80% of $1000 is $800 , but they will only pay a max f $450 , so I should be entitled to $450 , otherwise if they work it out as 80% of $450 then the maximum payout is not $450. I wish we had an insurance system like the UK where you can pay 20 GPB or whatever a month, like my 79 year old Dad does and all of his dental costs are covered. |
Re: Dental Charges - interesting!
Originally Posted by shelley748
(Post 9177859)
Welcome to Canada and you know whats worse? There are hardly any consumer watchdogs here to cover things like there are in the UK you can bang your head against a brick wall!
I wish we had an insurance system like the UK where you can pay 20 GPB or whatever a month, like my 79 year old Dad does and all of his dental costs are covered. This link is a classic example: http://www.calgaryherald.com/columni...567/story.html They appear to have no concept that the way the US does things isn't the only way in the world to do things. I had private health insurance in the UK; used it, and never had any of the issues described in this argument. The way insurers act in Canada is appalling. I never witnessed anything like it in the UK. Claim was made, insurer paid out; nothing like the bullshit and litigation that is the norm here. But, as others have noted, if it isn't done the North American way it can't be done. |
Re: Dental Charges - interesting!
Originally Posted by shelley748
(Post 9177859)
Welcome to Canada and you know whats worse? There are hardly any consumer watchdogs here to cover things like there are in the UK you can bang your head against a brick wall!
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Re: Dental Charges - interesting!
Originally Posted by Jingsamichty
(Post 9177785)
Small consolation, but I think anything which isn't covered by insurance is tax deductable?
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Re: Dental Charges - interesting!
Originally Posted by Almost Canadian
(Post 9177877)
The more time I spend in this country, the more I lament the fact that everything here is compared to how it is done in the US.
This link is a classic example: http://www.calgaryherald.com/columni...567/story.html They appear to have no concept that the way the US does things isn't the only way in the world to do things. I had private health insurance in the UK; used it, and never had any of the issues described in this argument. The way insurers act in Canada is appalling. I never witnessed anything like it in the UK. Claim was made, insurer paid out; nothing like the bullshit and litigation that is the norm here. But, as others have noted, if it isn't done the North American way it can't be done. |
Re: Dental Charges - interesting!
I go to a dentist in Mexico twice a year for checkups. The cost...US$20 !
If I need any other work: A root canal cost me US$350 A crown is US$240. I send all the claims to Sun Life who pay what they would pay in Canada and that usually covers the whole thing. My dentist was trained in Loma Linda, CA. The orthodontist was trained at UCLA. He teaches orthodontistry in the US in the summer months. The facilities are state of the art, much more modern than the dentist that I used to use in Nova Scotia. No wonder I don't use a dentist in Canada any more. |
Re: Dental Charges - interesting!
Are there any reductions for seniors with no job benefits cover? I fear I will have to get all my teeth pulled out and acquire a set of wallies before I come over :(
Granma Nessie |
Re: Dental Charges - interesting!
Originally Posted by Granma Nessie
(Post 9178978)
Are there any reductions for seniors with no job benefits cover? I fear I will have to get all my teeth pulled out and acquire a set of wallies before I come over :(
Granma Nessie |
Re: Dental Charges - interesting!
Originally Posted by iaink
(Post 9178995)
There is some welfare provision, but your circumstances, and teeth, have to be pretty poor. Options covered will not be at the sophisticated dentistry end of the available treatment spectrum either.
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Re: Dental Charges - interesting!
Originally Posted by Almost Canadian
(Post 9179020)
Are we talking NHS dentistry here?:p
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Re: Dental Charges - interesting!
Originally Posted by iaink
(Post 9176341)
Good advice for any major proceedures. Ortho is an expensive business for sure.
Originally Posted by macadian
(Post 9176353)
The only thing that comes close is the 'Brinks-MAT' robbers....:D
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Re: Dental Charges - interesting!
Originally Posted by Clematis
(Post 9180603)
Two kids currently in braces just waiting to see if the third needs them as well. We are lucky we both have insurance through work and we're covered 100%, unfortunately it does not include ortho so we are having to cover that ourselves. ;)
Yeah, fat chance of that.:( |
Re: Dental Charges - interesting!
Originally Posted by iaink
(Post 9180626)
Rather like my failed attempt to have offspring #1 say "Tomaahtoe", perhaps I could persuade the kids that crooked teeth are an essential part of their british heritage....
Yeah, fat chance of that.:( |
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