Tuesday, May 22, 2018

Dental Insurance Basics

Recently, the dental insurance carrier we've linked to in our sidebar list of Product Links notified us that they're soon discontinuing new sales. Fortunately, we have a backup carrier with similar products, so no big deal. But it reminded me that we haven't talked about how individual dental insurance coverage works. Please keep in mind that this information is fairly generic, you should absolutely see your own plan documentation for specifics.

Dental insurance is a way to transfer some of the risk of tooth-related expenses to an insurance company. Be aware that this is often a dollar-for-dollar transfer, and may actually mean only a discount in actual dental fees.

Dental health often gets short shrift when discussing insurance. I once had a client that died of a toothache, so the subject is more serious than one might at first believe. There are generally two types of individual dental coverage: insurance plans and discount plans.

Full blown dental

Dental insurance plans are available from a number of carriers, all of which have their own plan design, network of providers (if applicable) and pricing strategy. But there are benefits that most (if not all) carriers cover, and we'll consider these.

Benefits tend to fall into one of three broad categories: preventive, basic, and major. Pricing is generally per person, with a maximum family premium.

■ Preventive services
These are generally covered at 100%, and include items such as semi-annual routine exams and cleanings, and fluoride treatments for juveniles. Sometimes, this category of benefits will include periodontal (gum health) exams, as well.

■ Diagnostic and Basic services
These services are often subject to a deductible, and are more intrusive than preventive care items. Fillings are generally considered in this category; one new technique is called "composite," which replaces older-fashioned metallic fillings with ones that more closely match actual tooth material and color.

X-rays are also often assigned to this category. Many practices have moved to digital versions of these cameras, meaning that results are available instantly.

Simple extractions can also fall under this definition of covered services.

■ Major services
In addition to a deductible, this level of services is usually subject to co-insurance (often 50%), which requires the patient to more directly share in the cost of care. Root canals are found in this category, as are dentures and crowns. Today, the latter may be fabricated in the dentist's office for immediate installation.

Onlays and space mantainers, surgical extractions and other dental surgeries would also fit in this category and are usually subject to an annual maximum benefit amount. They almost always require one to be insured for at least a year before these benefits are even available.

Discounts ahead

As one might imagine, dental plans such as those described above can be expensive, and may be off-putting to budget-conscious consumers who nonetheless acknowledge the value and importance of dental health. A dental discount plan may be the ideal product for people in that situation.

■ How they work
Dental discount plans generally have no waiting periods, deductibles or annual maximums. They are simple to understand because they're not truly insurance products, but offer access to dental care providers at a reduced cost.

Typically, one pays a fee for access to a network of dentists and other dental-related providers willing to provide service at a reduced rate. These services can range from simple cleanings to gum surgery and dentures. One thing to keep in mind is that, unlike a traditional dental plan, payment for services rendered is due at the time of the visit; there is generally no bill-me-later option (although payment plans may be available for major benefits).

One More Thing

Most of these plans don't cover orthodontia, but one may be able to use a Health Savings Account for those services. That means Uncle Sam is helping to pay for your son's or daughter's braces, which helps reduce your net cost.

Dental insurance isn't for everyone, but it can be a cost-effective way to shift at least some of the dental health burden to a third party. It's important to know, however, exactly what's covered, and at what level. Discount plans, while less comprehensive, may offer a value in reducing net out-of-pocket dental expenses.

Monday, May 21, 2018

Or Else ... What?

Our friend Jeff M sent us this intriguing (and, frankly, puzzling) item:

"Treasurer directs Blue Cross NC to cut state health plans’ rates by 15 percent"

As I mentioned in the title of this post, what possible stick could the Treasurer wield to enforce this edict? One supposes that he could direct his staff to simply not pay the premium - that'll show 'em! The problem there is that then the policy gets cancelled for non-payment, and suddenly there are a lot of newly uninsured  North Carolinians.

I reached out to FoIB Michael Bertaut, an economist with Louisiana Blue Cross, for his take:

"This is pretty fascinating....”oh every Doc and hospital is getting a 15% pay cut on the entire state group!, screw with us and we’ll pay you Medicaid rates!

I just don't see this ending well.

Friday, May 18, 2018

CAHU Comes Through

Lord knows I've had my issues with agents' associations, but sometimes they really do get things right.

Case in point: the California Association of Health Underwriters.

Seems that CAHU [gezundheit!] is sponsoring  "a Health Insurance Awareness and Agent Awareness Campaign" to explain to people the folly of government-run health "care."

From CAHU:

"As the experts in our industry we have an obligation to educate consumers and employers regarding health insurance. This includes helping to shed light on what all of these terms in relation to “Single Payer” actually mean. The general public are hearing very different terms used interchangeably."

Absolutely spot on.

The event is next Tuesday (May 22nd) in Sacramento (click here for details).

[Hat Tip: FoIB Shari G]

Thursday, May 17, 2018

May Health Wonk Review is up

Jason Shafrin, our favorite health care economist, hosts this month's compendium of health care polity, policy and wonkery.


Really, and quite well done!

Wednesday, May 16, 2018

Midweek Trifecta

Trying out something new, a variation on our "LinkFest" posts. This time out, focusing on 3 new (well, to me, anyway) insurance products:

The folks at Pacific Life have rolled out an intriguing underwriting coup:

"Up to $500,000 Life Insurance Death Benefit with No Medical Exams"

Of course, there's still an application and, one presumes, medical records required, but a half million of cover without blood or urine (or more)?


Our friends at the General Agent Center have a new "mini-med" plan available to supplement existing major med policies. What's interesting about this offering is that it covers:

"Office Calls -  ANY licensed practitioner of the healing arts (Physician's, Chiropractor's, Acupuncturist's, Naturopaths)"

Generally, plans like this require one to see an MD or similar, have never seen one that explicitly covers acupuncturists.


I must admit, this one looks awfully familiar, but new packaging may do wonders:

"[T]here’s a different kind of plan that could solve problems for both fully-insured plans — which are better for large claims — and self-insured plans — which are better for small claims. It’s called a national plan."

By grouping together employers from all over the 58 states, they appear to stop-loss carriers as one mega-employer, with concomitantly lower rates.


Tuesday, May 15, 2018


So it looks like even more fissures have opened up as Hawaii's Kilauea volcano continues to spew and smoke. More than a couple of dozen homes have already succumbed, and more are expected to be damaged or destroyed.

Here in Ohio, we get asked a lot about tornado, flood, and even earthquake coverage, but when it comes to volcanoes, well, let's just say that no one comes here for the tropical clime.

But that hasn't stopped FoIB Jeff M from helping out by tipping us to this:

"One possibility is the Hawaii Property Insurance Association, a nonprofit collection of insurance companies created by state lawmakers in 1991 to provide basic property insurance for people who are unable to buy coverage in the private market"

Turns out that lava insurance is a lot like flood insurance (and not just because they both "flow"). Turns out that:

"Few insurance companies will issue policies for homes in Leilani Estates because it is in an area deemed by the U.S. Geological Survey to have a high risk of lava."

Which sounds a lot like "flood plains," no?

And just as there are special plans available for flooding, it seems that the HPIA can help out with lava.

But, Aloha State citizens best not count on their regular homeowner's policies:

"If policies specifically exclude lava damage, the fire coverage will not apply."

As always, we strongly suggest consulting with your own agent to see if you're covered, or can be.

Oh! And:

Monday, May 14, 2018

Gruesome MVNHS© "Tricks"

[A rare content warning: The procedure described in this post is not for the faint of heart. HGS]

Britain's Much Vaunted National Health System© has a sordid history of baby-killing (most recently here), but these are children that have at least been born. This item, which I took a long time considering whether to even post, is egregious even by MVNHS© standards:

"A premature baby was decapitated inside his mom's womb when a doctor in Scotland detached his body from his head during a botched birth."

On the one hand, this is tragic, but it's probably very difficult to get just the right amount of force. And had the process stopped there, this would have been a horrible mistake, but at least understandable.

What happened next, though, is indefensible, and underscores the complete lack of compassion (let alone oversight) rampant in such national health "care" schemes:

"[T]he first-time mom was then forced to undergo a C-section to remove the head — which was sewn onto the tot's body so she could hold him and say goodbye."

The Political Hat (who tipped us to this travesty) paraphrased it thus: "Sorry I killed your baby, but here... I sewed its head back on so you can give it a kiss before we throw it in the furnace."