Chris Tann (ctann) wrote,
Chris Tann

The joys of health insurance - part 9, dental "insurance"

As part of my return to the land of the self-employed, I have had to once again purchase my own health insurance. In this marvelous internet age, that is far less of a chore than it would have been a few years ago - lets you compare health insurance companies, and find the best plans.  In the end, I picked a medical plan very similar to that my last employer provided. The difference? My employer-sponsored plan cost the company in the region of $700/month, buying direct costs less than $200/month. True that my portion under the employer-sponsored plan was only $50-ish/month, but it just irks me to see some middle man pocketing $500/month, even if it is not coming out of my pocket...

Anyway, on to the point of this blog, dental insurance. Last time I was self-employed, I picked up a cheap dental plan, which was a mistake. So, this time I did a lot of shopping, and decided to pick (what I thought was) a decent dental plan. It still has lots of restrictions, waiting periods, and copays, and costs close to $800/year, but after carefully working out the expected return, I figured that it would pay out a little more than we pay in.

Well, I guess that should be a hint, shouldn't it. Dental insurance companies are not, in fact, in the business of providing any sort of accessible dental services, or anything like that. They are in the business of making money - in other words, ensuring that they pay out less than the subscribers pay in.

So, after my first routine dental checkup, I got my statement from the insurance company. True, they only pay out 70% for services, and there is a $50/year co-pay - that I was expecting, and had taken into account in my calculations. However, there is a little catch that they do state, but that makes it almost impossible to really calculate your costs and benefits in advance - they only pay out on what they say is a "reasonable and customary cost for services". My dentist is pretty reasonable, and I after a little checking, it looks like he charges right around the average for San Jose. However, my insurance company expects him to charge half of that! So that is the basis that they pay 70% on. The bottom line? They paid out only 40% of the cost, rather than the 70% I was expecting. Take out the deductible, and that comes down to fifty bucks they paid out.

So, that changes the balance in my equations. On calculating 70% of actual costs, I figured we would be a little in front, or maybe break even. When they are only paying 40%, its definitely a no-win situation. Couple that with the fact that there is an 18-month waiting period for major items such as crowns, it really doesn't seem worth it.

Hmm, I just had an idea. Maybe I will reverse-insure. I'll take the $65/month I would have paid in dental insurance, and buy lottery tickets. One big win, and my teeth will be covered for life! Now that's more my kind of idea!


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