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.

I think this is correct.

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.

Good advice for any major proceedures. Ortho is an expensive business for sure.

The only thing that comes close is the 'Brinks-MAT' robbers....

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.

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.

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!

There is certainly a bit of that. I find the young dentists are more likely to over-treat. My dentist is turning 60. We have made an arrangement that he will treat me if I arrive in agony, begging for help. Otherwise he just sends me to the hygienist.

Small consolation, but I think anything which isn't covered by insurance is tax deductable?

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!

I would have expected $450 back too! Something not quite right with that!

only if it excedes more than a certain % of your income

and btw you want expensive , Ben had a dental implant that wasn't covered by insurance , holy 4 figure sum , batman !!!!!

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.

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.

And if you suggest an alternative way, there's the old "if it ain't broke, don't fix it" response.