Dental insurance that covers braces for kids in CA
#16
Re: Dental insurance that covers braces for kids in CA
It will depend how much work your child needs. They are all different. Health care here is a private industry, there is no standard coverage that any insurance company has to offer you, or, if you are in a group insurance plan there is no standard or level of benefit that the employer has to offer you. If you buy more extensive coverage, then you will pay a higher premium. By a significant amount. But that doesn't mean they pay everything. Look carefully at the copays, deductibles, out of pocket expense, and lifetime limits. It's a business like any other here.
#17
Re: Dental insurance that covers braces for kids in CA
I'm a member (shareholder) of the company so our CPA has me up as paying for the health insurance but it's 100% deductible so no real difference, Looking at $28,000 PA though, it's madness but no deductibles and a max of $8000 out of pocket. The USA's health system certainly is an eye opener.
#18
Re: Dental insurance that covers braces for kids in CA
As others have said, the standard dental plan will cover up to $1,500 per year, $2,000 if you are really lucky and have a gold plated plan. You usually have to pay 50% of the cost, and they kick in the other 50% up until you hit their maximum. After that the costs are 100% yours. If your spouse also works and has dental coverage, then you can claim on both plans and get the maximum under each plan. This is different from medical where you can only claim on one plan.
Again, as others have said, if you can, it is best to plan out any work over a number of years so that you can benefit from the maximum annual amount they will pay.
I agree with Nutmegger always ask what the cash or self pay cost is for any dental of medical procedure. For a recent medical procedure I found out that the self pay cost was significantly less than the co pay required by my insurance company, so I went that route and saved a 4 figure sum. I still got all the appropriate paperwork, just a much smaller bill.
Again, as others have said, if you can, it is best to plan out any work over a number of years so that you can benefit from the maximum annual amount they will pay.
I agree with Nutmegger always ask what the cash or self pay cost is for any dental of medical procedure. For a recent medical procedure I found out that the self pay cost was significantly less than the co pay required by my insurance company, so I went that route and saved a 4 figure sum. I still got all the appropriate paperwork, just a much smaller bill.
#19
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Joined: May 2018
Posts: 233
Re: Dental insurance that covers braces for kids in CA
In all seriousness though, are you meaning not to go through insurance whatsoever?
Last edited by Mic1; Jun 19th 2021 at 6:54 pm.
#20
Re: Dental insurance that covers braces for kids in CA
It's to do with the insurance system. Insurers will only pay certain, agreed rates to doctors and dentists, plus the costs and delays associated with insurance wrangling often make it cost efficient for dentists to take a cash payment from you instead. Suppose, for example, that your max insurance benefit is $1,500 and your procedure costs 6k. That's 4,500k left for you to pay. Suppose the dentist is able to save expense by charging you 4,000k total? And they get their money at once. I didn't do orthodontics that way, but I absolutely did a root canal that way and I can assure you I didn't go down an alley to get it done It's just another product of the health insurance industry.
https://www.absolutedental.com/three...r-dental-care/
#21
Re: Dental insurance that covers braces for kids in CA
Yes.
It's to do with the insurance system. Insurers will only pay certain, agreed rates to doctors and dentists, plus the costs and delays associated with insurance wrangling often make it cost efficient for dentists to take a cash payment from you instead. Suppose, for example, that your max insurance benefit is $1,500 and your procedure costs 6k. That's 4,500k left for you to pay. Suppose the dentist is able to save expense by charging you 4,000k total? And they get their money at once. I didn't do orthodontics that way, but I absolutely did a root canal that way and I can assure you I didn't go down an alley to get it done It's just another product of the health insurance industry.
https://www.absolutedental.com/three...r-dental-care/
It's to do with the insurance system. Insurers will only pay certain, agreed rates to doctors and dentists, plus the costs and delays associated with insurance wrangling often make it cost efficient for dentists to take a cash payment from you instead. Suppose, for example, that your max insurance benefit is $1,500 and your procedure costs 6k. That's 4,500k left for you to pay. Suppose the dentist is able to save expense by charging you 4,000k total? And they get their money at once. I didn't do orthodontics that way, but I absolutely did a root canal that way and I can assure you I didn't go down an alley to get it done It's just another product of the health insurance industry.
https://www.absolutedental.com/three...r-dental-care/
#22
Forum Regular
Thread Starter
Joined: May 2018
Posts: 233
Re: Dental insurance that covers braces for kids in CA
Yes.
It's to do with the insurance system. Insurers will only pay certain, agreed rates to doctors and dentists, plus the costs and delays associated with insurance wrangling often make it cost efficient for dentists to take a cash payment from you instead. Suppose, for example, that your max insurance benefit is $1,500 and your procedure costs 6k. That's 4,500k left for you to pay. Suppose the dentist is able to save expense by charging you 4,000k total? And they get their money at once. I didn't do orthodontics that way, but I absolutely did a root canal that way and I can assure you I didn't go down an alley to get it done It's just another product of the health insurance industry.
https://www.absolutedental.com/three...r-dental-care/
It's to do with the insurance system. Insurers will only pay certain, agreed rates to doctors and dentists, plus the costs and delays associated with insurance wrangling often make it cost efficient for dentists to take a cash payment from you instead. Suppose, for example, that your max insurance benefit is $1,500 and your procedure costs 6k. That's 4,500k left for you to pay. Suppose the dentist is able to save expense by charging you 4,000k total? And they get their money at once. I didn't do orthodontics that way, but I absolutely did a root canal that way and I can assure you I didn't go down an alley to get it done It's just another product of the health insurance industry.
https://www.absolutedental.com/three...r-dental-care/
#23
Re: Dental insurance that covers braces for kids in CA
I think that paying for a dental plan and it only covers up to a max of $1,500 in any one year is pretty poor value.
I pay cleaning at $150 a pop, a simple filling is approx $300, a crown is anything between $800 and $1,200 and a root canal can set you back $1,500. It soon adds up if you have anything apart from a clean or a filling. Personally, as a private individual paying for my own insurance, i could never see the point of paying $70 a month for dental insurance when it was only going to pay for $1,500 worth of treatment max.
I pay cleaning at $150 a pop, a simple filling is approx $300, a crown is anything between $800 and $1,200 and a root canal can set you back $1,500. It soon adds up if you have anything apart from a clean or a filling. Personally, as a private individual paying for my own insurance, i could never see the point of paying $70 a month for dental insurance when it was only going to pay for $1,500 worth of treatment max.
#24
Re: Dental insurance that covers braces for kids in CA
No. it’s the same as when you decide not to claim for something on your homeowners insurance because one more claim and they are going to drop you! You just get whatever it is fixed and the company doesn’t need to know.
#25
DE-UK-NZ-IE-US... the TYP
Joined: Mar 2010
Posts: 2,854
Re: Dental insurance that covers braces for kids in CA
what you pay is probably a % of the total, so maybe your employer pays 90% and you pay 10%. Depending on the size of the employer or if they use a PEO the rate they get can also be significantly lower than a smaller employer gets or an individual. No insurance company is going to pay out up to $1500 on a premium of $72 a year… it’s probably close to $720 a year.
I always look at the total cost and add it when comparing compensation offers, anything they pay for benefits you are not getting as cash. I had one employer where I had them pay me the cost of the benefits I did not take because my wife had better ones from her.
I always look at the total cost and add it when comparing compensation offers, anything they pay for benefits you are not getting as cash. I had one employer where I had them pay me the cost of the benefits I did not take because my wife had better ones from her.
#27
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Joined: May 2018
Posts: 233
Re: Dental insurance that covers braces for kids in CA
Understood doing that on homeowners insurance. But, let's say with car insurance, (definitely in the UK), you are walking a thin line if you have an accident, cover costs yourself but don't make the insurance company aware - it becomes part of your driving history regardless of whether you filed a claim. Therefore, aside from braces, if you were to start doing this with your health/dental provider on other treatments, are you not at risk of this coming to light further down the road, resulting in claims being thrown out for future associated issues? In effect, you're covering up your previous medical history.
Last edited by Mic1; Jun 20th 2021 at 7:26 am.
#28
Heading for Poppyland
Joined: Jul 2007
Location: North Norfolk and northern New York State
Posts: 14,526
Re: Dental insurance that covers braces for kids in CA
Yup that what we did. My wife and I both had dental from our employers, $0. Then when we retired, we chose to go without dental insurance. We each pay a couple of hundred each year for cleaning/check up, big deal. The main point is, even if you have a couple of root canals etc, dental costs are not going to bankrupt you or otherwise ruin your life - unlike medical costs.
#29
Re: Dental insurance that covers braces for kids in CA
Understood doing that on homeowners insurance. But, let's say with car insurance, (definitely in the UK), you are walking a thin line if you have an accident, cover costs yourself but don't make the insurance company aware - it becomes part of your driving history regardless of whether you filed a claim. Therefore, aside from braces, if you were to start doing this with your health/dental provider on other treatments, are you not at risk of this coming to light further down the road, resulting in claims being thrown out for future associated issues? In effect, you're covering up your previous medical history.
Dentistry seems to be treated differently in that they don't consider the health of your teeth to be part of your physical health unless, as I said, they get knocked out or something. Quite wrongly imo, but there it is. Part of the for-profit way of doing things.
Additionally, if you are part of a group plan through your employer, no account is taken of your individual health. That's what group plans are for. There are procedures that need to be pre-approved by insurance sometimes, and the doctor's office normally handles this. Claims in a group plan, to my knowledge, cannot be turned down for an individual due to a pre-existing condition. Health questions may be asked and you should answer them honestly, but this is so that the actuaries can reassess (along with claims made by the group) what they are charging your group plan owner every year.
Last edited by Lion in Winter; Jun 20th 2021 at 1:29 pm.
#30
Lost in BE Cyberspace
Joined: May 2010
Location: San Diego, California
Posts: 9,651
Re: Dental insurance that covers braces for kids in CA
Understood doing that on homeowners insurance. But, let's say with car insurance, (definitely in the UK), you are walking a thin line if you have an accident, cover costs yourself but don't make the insurance company aware - it becomes part of your driving history regardless of whether you filed a claim. Therefore, aside from braces, if you were to start doing this with your health/dental provider on other treatments, are you not at risk of this coming to light further down the road, resulting in claims being thrown out for future associated issues? In effect, you're covering up your previous medical history.
These days there is no 'previous medical history' taken into account when you apply for a health insurance plan. That's one of the great aspects of the Affordable Care Act (Obamacare)
You can't compare health insurance with, say car insurance. There is no legal requirement for you to have health insurance (even the small penalty for not having health insurance has been removed). Millions don't have it (they don't want it), millions don't have it (they can't afford it).
There's no risk of not reporting medical treatment and then it coming to light further down the line.....
Another point is that you are most unlikely to go the cash route for the majority of medical issues. You are paying a fortune in monthly premiums, deductibles and out of pocket expenses, why would you opt to pay out additional thousands to pay cash?
Dental insurance is different - it's capped at $1,500 (maybe $2,000 if you are lucky) and if you get a discount to pay cash then sometimes it pays to do so as in the example given above.