Child Needs Orthodontics NOW

[Bob L]

Good afternoon fellow agents --

I have only done a few standalone DVH plans in my career, so I defer to your experience and wisdom for help.

Our great nephew, retired from the US Army, will lose his kids' dental coverage tomorrow night. I have looked high and low for a plan that will cover children's orthodontia without a waiting period, and have failed to find anything that will pay more than 15% of the cost.

Any ideas? I know this seems like adverse selection but truth is he didn't know this was coming until literally three days ago. All help appreciated.

 

[Bob L]

Forgot to mention that he's in Texas.

 

[adjusterjack]

Is he old enough for a Medicare Advantage plan that has dental?

If not, and if he's desperate enough, he can look for a dental college where he might get significant discounts for cash, or shop around for an orthodontist that gives significant discounts for cash.

After I retired I found that dental insurance or dental discount plans were pretty much rip-offs and got the best deals with dentists that gave significant discounts for cash. I would have ended up spending the same amount of money plus premiums on my implants that I actually spent without paying premiums.

For the last few years I have been getting my cleanings at a dental hygiene college 4 times a year for free. Dental insurance typically allows for two free cleanings but if you want them more frequently you'll pay $100 to $200 each.

 

[scagnt83]

Does he own a business? He could find group coverage that covers it y1.

What about discount plans? I think MoO still has a dental discount plan. Better than nothing.

Ameritas pays 15% day1 on child ortho. 50% starting y2.

If cost is that much of a concern, Id wait until y2. Hard to see how its suddenly out of the blue for this medical necessity.

Some dentists are great sales people. But Im no dentist, so thats not medical advice, lol.

 

[scagnt83]

After I retired I found that dental insurance or dental discount plans were pretty much rip-offs and got the best deals with dentists that gave significant discounts for cash. I would have ended up spending the same amount of money plus premiums on my implants that I actually spent without paying premiums.

I agree.

Insurance gives providers an excuse to jack up costs. Its also a huge admin burden, so it cuts man hours to not have to file the paperwork and deal with the back and forth.

I pay cash for my personal dental services and save hundreds a year vs. having insurance.

I cant tell you how many times the dentist has said to me "well, thats not really necessary so we dont have to do that since you dont have insurance".... lmao. When I ask how it benefits me its usually not a real medical benefit. All those xrays they take, its about double what they need medically per ada guidelines. Just bill it to the insurer... and why not, they pay it!

Even group plans have become expensive these days. A family can easily spend $150 a month on group coverage.

 

[scagnt83]

Good afternoon fellow agents --

I have only done a few standalone DVH plans in my career, so I defer to your experience and wisdom for help.

Our great nephew, retired from the US Army, will lose his kids' dental coverage tomorrow night. I have looked high and low for a plan that will cover children's orthodontia without a waiting period, and have failed to find anything that will pay more than 15% of the cost.

Any ideas? I know this seems like adverse selection but truth is he didn't know this was coming until literally three days ago. All help appreciated.

Tell him to look on GroupOn.

Ive used it for dental services in the past and it saved me hundreds. I paid $200 for a procedure plus cleaning, that would have been $900 cash, no telling how much through insurance.

(even the $900 would have been cheaper than paying Ins Premiums + 50% OOP expenses of a tier3 procedure + Annual Deductible)

 

[scagnt83]

BTW. You need to look at the lifetime max on the Child Ortho. That will likely make him not very concerned about insurance.

Ameritas for example is $1k lifetime max per child.
15% covered year 1.
50% y2+.

So anything over $2k, he will be paying regardless.

He should probably look at financing, not insurance. Some orthos will set up payment plans. Or he could try CareCredit or some other credit provider for healthcare services.

 

[goillini52]

Good afternoon fellow agents --

I have only done a few standalone DVH plans in my career, so I defer to your experience and wisdom for help.

Our great nephew, retired from the US Army, will lose his kids' dental coverage tomorrow night. I have looked high and low for a plan that will cover children's orthodontia without a waiting period, and have failed to find anything that will pay more than 15% of the cost.

Any ideas? I know this seems like adverse selection but truth is he didn't know this was coming until literally three days ago. All help appreciated.

If he retired from the Army, can't he keep his dental benefits through Tri Care?

 

[Bob L]

Thanks to everyone who replied. I'll pass these ideas on to him. You guys are super helpful.

He's way too young for Medicare, and his Army benefits won't help for his kids now that he's out. (He missed some sort of deadline due to the Army's computers being down.)

 

[RickyBA]

Good afternoon fellow agents --

I have only done a few standalone DVH plans in my career, so I defer to your experience and wisdom for help.

Our great nephew, retired from the US Army, will lose his kids' dental coverage tomorrow night. I have looked high and low for a plan that will cover children's orthodontia without a waiting period, and have failed to find anything that will pay more than 15% of the cost.

Any ideas? I know this seems like adverse selection but truth is he didn't know this was coming until literally three days ago. All help appreciated.

I use this discount plan. You can be a broker for it too. [EXTERNAL LINK] - - Group Enrollment