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rated:
I accidentally forgot to renew my dental insurance which isn't a big deal but I went to dentist thinking I still had it.  For a general cleaning with xrays it was 300$ per person.  My previous insurance paid out $109 for the cleaning and $36 for the services for less than 150$.  Is there a reason for the difference besides the fact he can charge what he wants? Going to negotiate a lesser amount but wanted to figure out the difference.  Is there an additional benefit that they get from insurance companies besides the 109 and 36$ mentioned above that I am missing?

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Consider a lower cost preventative plan that covers basic cleanings/X-Rays and provides the contracted discount on other... (more)

BeachBumm (Jan. 20, 2017 @ 1:56p) |

Dental insurance costs me $600 a year for self plus one standard plan or $900 self plus one for high. I have to pay the ... (more)

Seity (Jan. 20, 2017 @ 2:53p) |

I have found that for my FAMILY, assuming we only have cleanings and X rays (i.e. no cavities, emergencies or other prob... (more)

traderneal (Jan. 23, 2017 @ 11:46a) |

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rated:
Do you have old statement of benefits? That will clearly show what was paid to the dentist and how much was written off.

BTW - I have always wondered if it is cheaper to skip the dental insurance once every 2-3 years and just pay for the cleaning in the year you don't have insurance. And if your cleaning cycle is in December, then you could do one cleaning in July and then you would be back on insurance the following year. This obviously doesn't make sense if your teeth always need some work.

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FWIW, my dentist offers no cash-pay discount. It was definitely cheaper to have insurance than pay him by cash, there was a ROI just on the cleanings for the family!

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I contacted the insurance and they gave me the total they paid out and they stayed nothing else was paid. So that total was 146

If you don't mind changing dentists Groupon and hopping from dentist to dentist works well.

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tennis8363 said:   FWIW, my dentist offers no cash-pay discount. It was definitely cheaper to have insurance than pay him by cash, there was a ROI just on the cleanings for the family!
I don't mind paying more it but double what insurance pays is little much.

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PrincipalMember said:   Do you have old statement of benefits? That will clearly show what was paid to the dentist and how much was written off.

BTW - I have always wondered if it is cheaper to skip the dental insurance once every 2-3 years and just pay for the cleaning in the year you don't have insurance. And if your cleaning cycle is in December, then you could do one cleaning in July and then you would be back on insurance the following year. This obviously doesn't make sense if your teeth always need some work.

  dental insurance is so cheap so why are you even thinking not to get it?

I pay 8 dollars per paycheck and this is deducted from gross income so I really pay ~$5 per paycheck

This is very cheap if you ask me

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Pretty standard.  I happen to have a recent explanation of benefits right in front of me...

Dentist submitted $225, negotiated amount $131, insurance paid $95, I owe $36.

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sharpie130 said:   Is there a reason for the difference besides the fact he can charge what he wants?
 

  
Nope, that's the reason.

I'd say something along the lines of 'you always accept $xxx from the insurance company, may I please have the same discount?'. You don't have much leverage, except cancelling your next appointment and choosing a new dentist.

rated:
fleetwoodmac said:   
PrincipalMember said:   Do you have old statement of benefits? That will clearly show what was paid to the dentist and how much was written off.

BTW - I have always wondered if it is cheaper to skip the dental insurance once every 2-3 years and just pay for the cleaning in the year you don't have insurance. And if your cleaning cycle is in December, then you could do one cleaning in July and then you would be back on insurance the following year. This obviously doesn't make sense if your teeth always need some work.

  dental insurance is so cheap so why are you even thinking not to get it?

I pay 8 dollars per paycheck and this is deducted from gross income so I really pay ~$5 per paycheck

This is very cheap if you ask me
 

  
Overall, yes - it is one of the cheaper insurances. We have 2 dental plans with our employer - the cheaper one - similar cost as yours but most of the good dentists are not on that plan. So we go with the more expensive plan and in that case, if all we did was a cleaning once in the middle of the year, then I would save like $100 per-year for a family of 3. I have done this a few times but lately spouse's teeth seem to require more attention - so I don't take a risk for such a small amount.

rated:
fleetwoodmac said:   
PrincipalMember said:   Do you have old statement of benefits? That will clearly show what was paid to the dentist and how much was written off.

BTW - I have always wondered if it is cheaper to skip the dental insurance once every 2-3 years and just pay for the cleaning in the year you don't have insurance. And if your cleaning cycle is in December, then you could do one cleaning in July and then you would be back on insurance the following year. This obviously doesn't make sense if your teeth always need some work.

  dental insurance is so cheap so why are you even thinking not to get it?

I pay 8 dollars per paycheck and this is deducted from gross income so I really pay ~$5 per paycheck

This is very cheap if you ask me

  It's very likely that your employer is subsidizing your dental insurance.  My company paid $800/year for my dental coverage.  You've got a guaranteed benefit of two cleanings per person per year.  Do you really think your insurance would cost less than that?

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fleetwoodmac said:   
PrincipalMember said:   Do you have old statement of benefits? That will clearly show what was paid to the dentist and how much was written off.

BTW - I have always wondered if it is cheaper to skip the dental insurance once every 2-3 years and just pay for the cleaning in the year you don't have insurance. And if your cleaning cycle is in December, then you could do one cleaning in July and then you would be back on insurance the following year. This obviously doesn't make sense if your teeth always need some work.

  dental insurance is so cheap so why are you even thinking not to get it?

I pay 8 dollars per paycheck and this is deducted from gross income so I really pay ~$5 per paycheck

This is very cheap if you ask me

  What someone pays for dental at their company is entirely irrelevant to anyone else, besides their co-workers

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supersnoop00 said:   
fleetwoodmac said:   
PrincipalMember said:   Do you have old statement of benefits? That will clearly show what was paid to the dentist and how much was written off.

BTW - I have always wondered if it is cheaper to skip the dental insurance once every 2-3 years and just pay for the cleaning in the year you don't have insurance. And if your cleaning cycle is in December, then you could do one cleaning in July and then you would be back on insurance the following year. This obviously doesn't make sense if your teeth always need some work.

  dental insurance is so cheap so why are you even thinking not to get it?

I pay 8 dollars per paycheck and this is deducted from gross income so I really pay ~$5 per paycheck

This is very cheap if you ask me

  It's very likely that your employer is subsidizing your dental insurance.  My company paid $800/year for my dental coverage.  You've got a guaranteed benefit of two cleanings per person per year.  Do you really think your insurance would cost less than that?

  I thought companies always subsidize healthcare premiums

I guess I was wrong

rated:
Lower rates for insurance patients is basically a bulk discount. He gets listed as in-network on their website and gets more clients, and in return gives the insurance company (and patients) a lower price than they would charge a walk-in. Not surprising.

rated:
IMHO HMO Dental insurance is nice to have simply because it puts caps on what your dentist can charge you. I've found lower cash prices for some services like crowns and root canals. But not having to call around or haggle for simple things like cleanings, fillings, etc. is very convenient.

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Stubtify said:   IMHO HMO Dental insurance is nice to have simply because it puts caps on what your dentist can charge you. I've found lower cash prices for some services like crowns and root canals. But not having to call around or haggle for simple things like cleanings, fillings, etc. is very convenient.
  IMO, PPO is better than DHMO's because with DHMO's you can only go to certain dentists and anything else aside to general cleaning requires pre-approvals.  With PPO, you can find out your out of pocket cost before the procedure as well.  You just need to ask the dentist's office and they can enter the diagnostic code and they'll get a print out of what your portion will be.  With HOMO you cannot change dentist mid-month and the a not whole of dentists are part of HMOs.

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ach1199 said:   
Stubtify said:   IMHO HMO Dental insurance is nice to have simply because it puts caps on what your dentist can charge you. I've found lower cash prices for some services like crowns and root canals. But not having to call around or haggle for simple things like cleanings, fillings, etc. is very convenient.
  IMO, PPO is better than DHMO's because with DHMO's you can only go to certain dentists and anything else aside to general cleaning requires pre-approvals.  With PPO, you can find out your out of pocket cost before the procedure as well.  You just need to ask the dentist's office and they can enter the diagnostic code and they'll get a print out of what your portion will be.  With HOMO you cannot change dentist mid-month and the a not whole of dentists are part of HMOs.

How much dental work are you having done that you need to switch dentists mid-month? 

PPO plans I've seen have been ~$500 a year over a similar HMO plan. That's not an insignificant amount. 

I'm also of the belief that dentists will bill you for unneeded services if they know your insurance will cover it. 

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doveroftke said:   
sharpie130 said:   Is there a reason for the difference besides the fact he can charge what he wants?
  
Nope, that's the reason.

I'd say something along the lines of 'you always accept $xxx from the insurance company, may I please have the same discount?'. You don't have much leverage, except cancelling your next appointment and choosing a new dentist.

  Probably going this route tomorrow.  I've been a client for last 4 to 5 years so hopefully he gives me the discounted rate.  I actually moved slightly further away but still went to him since he is pretty good.  There is also another dentist that is nearby and will switch if he doesn't give me a discount at all.

rated:
Insurance companies have negotiated discounts with dentists. You obviously only get these discounts if you go through the insurance companies. May be worth calling and asking if he'd accept the same fee your insurance company paid out. Assuming you've been with your dentist for a few years I'd think the dentist would be fine with that.

rated:
My employer's dental insurance costs about $700/year and has a maximum benefit of $1500.

Cleanings and dentist inspection costs about $180 cash. Twice a year = $360. Xrays every other year are maybe $80. You can say you don't want to see the dentist and and save $40 also.
This is in a high cost of living area outside Boston.

I've only ever had 1 cavity my entire life. I'm way ahead by not buying dental insurance.

rated:
johnm4 said:   My employer's dental insurance costs about $700/year and has a maximum benefit of $1500.

Cleanings and dentist inspection costs about $180 cash. Twice a year = $360. Xrays every other year are maybe $80. You can say you don't want to see the dentist and and save $40 also.
This is in a high cost of living area outside Boston.

I've only ever had 1 cavity my entire life. I'm way ahead by not buying dental insurance.

  This has always confused me.  I feel like I'm really just paying for the rates.  Our insurance is about $1100 year and max pay out is $1500.  I guess the benefit though is that limit is per person and the cost of the policy doesn't change if you have one person on it or the whole family.  Not allowed to cancel at our jobs either so full family has double coverage.

rated:
buzolich said:   
johnm4 said:   My employer's dental insurance costs about $700/year and has a maximum benefit of $1500.

Cleanings and dentist inspection costs about $180 cash. Twice a year = $360. Xrays every other year are maybe $80. You can say you don't want to see the dentist and and save $40 also.
This is in a high cost of living area outside Boston.

I've only ever had 1 cavity my entire life. I'm way ahead by not buying dental insurance.

  This has always confused me.  I feel like I'm really just paying for the rates.  Our insurance is about $1100 year and max pay out is $1500.  I guess the benefit though is that limit is per person and the cost of the policy doesn't change if you have one person on it or the whole family.  Not allowed to cancel at our jobs either so full family has double coverage.

  
There are a few things at play here: 
1) My employer pays about 75% of the cost of health insurance, but does not pay ANY of the cost of dental insurance.
2) The dental insurance might be a good deal if I had bad teeth and needed work often.
3) I pay for my dental myself and use my Flexible Spending Account for the tax benefits.  I wouldn't otherwise use the full amount of my FSA.  However, if I had other medical expenses and would use the full FSA amount, then the pretax dental insurance option might be more attractive for the tax savings.

I suspect also, that dental expenses are much "flatter" than medical expenses.  That is, people generally spend a certain amount on cleanings and fillings every year, and the bumps are maybe a few extra needed services.  Compare that to medical expenses where the costs vary widely and randomly due to unexpected illnesses and accidents.  So the dental insurance is really mostly prepaying for the expected services with a pretax plan.

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BrianGa said:   Lower rates for insurance patients is basically a bulk discount. He gets listed as in-network on their website and gets more clients, and in return gives the insurance company (and patients) a lower price than they would charge a walk-in. Not surprising.
  Consider a lower cost preventative plan that covers basic cleanings/X-Rays and provides the contracted discount on other services. https://www.cigna.com/individuals-families/dental-plans/mycigna-...

rated:
Dental insurance costs me $600 a year for self plus one standard plan or $900 self plus one for high. I have to pay the difference between what the insurance pays and what the dentist charges. It's stupid expensive to add the kids who are too young to need anything but cleanings anyway. Unless we know we'll be having work done that will more than cover the cost of the plan, it's not worth buying. There is no cash discount at the dentist.

rated:
I have found that for my FAMILY, assuming we only have cleanings and X rays (i.e. no cavities, emergencies or other problems) that it is almost a wash between insurance and paying the dentist directly.

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