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Dental care on a budget in NYC


catnip
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Derek and I have CapDent (part of Healthplex). I think it's $159 a year for an individual (but we have the family plan). You get diagnostic/preventive services (cleanings/exams with x-rays) included, and other services are billed at a discount. We have been very happy with the dentists in their plan. Our hygienist and dentist are pretty fanatical about dental health! :D

 

https://www.healthplex.com/

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Dental Insurance 101:

 

Be sure that the plan you get covers what you need. For example, it your treatment requires crowns or root canals and these are not covered by a given plan (or not covered adequately) the insurance coverage could be useless to you.

 

Also, be aware of loopholes such as a calendar year maximum and deductibles. Some plans cap payments at $1000… if you need more work… again such a plan can prove to be inadequate for your needs.

 

Some plans pay a fixed amount per procedure, others pay at a percentage, and sill others allow for reduced rates. Check out the insurance fee schedule and how it compares to the dentist’s actual charges. Regarding percentages, they usually vary among different types of treatment options. For example, a filling may be paid at 80 percent, but a crown at only 50 percent. Remember the term “full dental” does not mean a plan pays at 100 percent.

 

Be sure that your dentist participates in the plan or you may have to change providers, or possible pay higher fees for using an out of network provider. When work is done at a dental school it often takes much longer to complete... if time is valuable to you this may not be a viable option...

 

Some plans that pay dentists reduced rates include “incentives” for the dentist not to provide the most expensive types of treatment. If a more costly therapy is what is indicated for your particular situation, you could end up on the short end of the equation. Beware.

 

With any insurance risks are involved. The insurance company is hoping you will pay the premium and never actually use it. That is one reason for a deductible. It’s referred to as a ‘disincentive’ to actually use the insurance. Even if you are in reasonably excellent dental health you can never predict that unforeseen accident or dental emergency situation.

 

Still, use common sense. Often the insurance premiums are higher than what your out of pocket expenses would be in an average calendar year. In such a case it might be to your advantage to forgo an expensive policy. In such a situation a discount plan (which may prove to be inadequate for someone else) could prove to be perfect for your circumstances. Nonetheless, that is part of the risk involved in selecting any insurance plan.

 

Everything is costly. (Especially in NYC.) Still, if you brush, floss, and do all those hygienic things we are all supposed to do and are in excellent dental health it is often better to pay as you go without insurance. And if you are disciplined enough, put the extra cash aside for a rainy day… for that unanticipated dental emergency… and if you have a little luck… you may even have something left over for… well… some “diversion” to boot…

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Dental Insurance 101:

 

Be sure that the plan you get covers what you need. For example, it your treatment requires crowns or root canals and these are not covered by a given plan (or not covered adequately) the insurance coverage could be useless to you.

 

Also, be aware of loopholes such as a calendar year maximum and deductibles. Some plans cap payments at $1000… if you need more work… again such a plan can prove to be inadequate for your needs.

 

Some plans pay a fixed amount per procedure, others pay at a percentage, and sill others allow for reduced rates. Check out the insurance fee schedule and how it compares to the dentist’s actual charges. Regarding percentages, they usually vary among different types of treatment options. For example, a filling may be paid at 80 percent, but a crown at only 50 percent. Remember the term “full dental” does not mean a plan pays at 100 percent.

 

Be sure that your dentist participates in the plan or you may have to change providers, or possible pay higher fees for using an out of network provider. When work is done at a dental school it often takes much longer to complete... if time is valuable to you this may not be a viable option...

 

Some plans that pay dentists reduced rates include “incentives” for the dentist not to provide the most expensive types of treatment. If a more costly therapy is what is indicated for your particular situation, you could end up on the short end of the equation. Beware.

 

With any insurance risks are involved. The insurance company is hoping you will pay the premium and never actually use it. That is one reason for a deductible. It’s referred to as a ‘disincentive’ to actually use the insurance. Even if you are in reasonably excellent dental health you can never predict that unforeseen accident or dental emergency situation.

 

Still, use common sense. Often the insurance premiums are higher than what your out of pocket expenses would be in an average calendar year. In such a case it might be to your advantage to forgo an expensive policy. In such a situation a discount plan (which may prove to be inadequate for someone else) could prove to be perfect for your circumstances. Nonetheless, that is part of the risk involved in selecting any insurance plan.

 

Everything is costly. (Especially in NYC.) Still, if you brush, floss, and do all those hygienic things we are all supposed to do and are in excellent dental health it is often better to pay as you go without insurance. And if you are disciplined enough, put the extra cash aside for a rainy day… for that unanticipated dental emergency… and if you have a little luck… you may even have something left over for… well… some “diversion” to boot…

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