My husband needs to get full dentures but our insurance only covers $1,000...?!
Question: My husband needs to get full dentures but our insurance only covers $1,000!.!.!.!?
has anyone had experience with getting full dentures that aren't so expensive!? Is there somewhere he can get it done that won't cost $5000!?!?!?!?Www@Answer-Health@Com
Answers:
You have two choices that can provide reasonable priced dentures!. If you live in a state that licenses "Denturist" to practice you will find that they are the "real" denture specialist!. Not only are their fees usually 50% less than a Dentist, the Denturist does every procedure with his or her own hands, and that includes actually creating the dentures!. Now, if there are no Denturist for you to see I would suggest that you contact your states Dental College, "Out Patient Clinic"!. Dental school clinics offer dental services to the public for fees ranging from free to very low, depending on you financial situation!. Good luck and I wish you well!.!.!.And, when you contact someone about the dentures be sure and ask them about doing "Immediate Dentures", and let me caution you, going to one of the places that advertises "One Day Dentures", is very very risky!.Www@Answer-Health@Com
I would encourage you to visit this website: www!.healthsavings!.ourperfectcard!.com I signed up online over 3 years ago for all my dental work and they have saved me thousands of dollars!. All services are included from root canals, cleanings!. xrays, cosmetic surgery, orthodontics!.!.!.etc!. Dentures are included also, but I don't know exactly how much you will save, but I'm sure its a good price!. They even had my very affordable plan active in 2 hours and able to use it the same day!. Good Luck and Hope this HelpsWww@Answer-Health@Com
try a dental schoolWww@Answer-Health@Com
Be careful relying on that $1,000!. If your husband goes to a dentist and has a denture consult and any x-rays, the fee for those things is going to come off that $1,000!. I have had alot of patients come in for a denture consult and a panoramic, which is the normal xray we take for patients wanting full dentures, and when I give them a treatment plan, they want to know why they are not getting $1,000 coverage for their treatment!. I have to remind them that the consult and xray will come off of that $1,000, which means that they actually only have about $925!.
Also remember, that your insurance doesn't just pay $1,000 from the start!. They pay a percentage of each procedure!. I am assuming that your husband is also getting extractions!. This is an example of how an insurance payment breakdown would work with a $1,000 maximum, 100%preventative/80% basic/50% major coverage, and taking into consideration an insurance companies allowable fees (If he goes in-network)!.
Consult/xray: $75 Insurance pays: $75
Each extraction: $200 Insurance pays:$160
Denture:$800 Insurance pays: $400
So you can see, that if this is close to what your husbands insurance pays, the maximum would be used up by the time the insurance pays for the consult, xray, and dentures!. Meaning that you would be completely out of pocket for the extractions!.
One thing that I have seen patients do to maximize their insurance, is to have the consult/xray and the dentures made in December and then the extractions done in January!. This only works if your insurance starts over on January 1 of each year!. You would then be able to use insurance benefits for 2 different years!.
I am assuming that the reason that the total is because of all the extractions he will need!. He might be able to get the extractions done at a dental school, however he may find that going this route doesn't work with his schedule!. I know at the dental school in my state, you have to make quite a few trips and sometimes wait all day to get extractions done!. Many people, especially those who work full time jobs, can't do this!.
If you are more concerned with the cost, and are possibly willing to sacrifice quality, your best choice would be to go in-network!. If your insurance doesn't have an in-network/out-of-network fee schedule, then you would just have to call around and ask fees of different dentists!. The insurance is still only going to pay a certain amount, but depending on the dentist you go to, your out of pocket may be lower if you either go in-network or go to a dentist who charges lower fees than other dentists!.Www@Answer-Health@Com
Also remember, that your insurance doesn't just pay $1,000 from the start!. They pay a percentage of each procedure!. I am assuming that your husband is also getting extractions!. This is an example of how an insurance payment breakdown would work with a $1,000 maximum, 100%preventative/80% basic/50% major coverage, and taking into consideration an insurance companies allowable fees (If he goes in-network)!.
Consult/xray: $75 Insurance pays: $75
Each extraction: $200 Insurance pays:$160
Denture:$800 Insurance pays: $400
So you can see, that if this is close to what your husbands insurance pays, the maximum would be used up by the time the insurance pays for the consult, xray, and dentures!. Meaning that you would be completely out of pocket for the extractions!.
One thing that I have seen patients do to maximize their insurance, is to have the consult/xray and the dentures made in December and then the extractions done in January!. This only works if your insurance starts over on January 1 of each year!. You would then be able to use insurance benefits for 2 different years!.
I am assuming that the reason that the total is because of all the extractions he will need!. He might be able to get the extractions done at a dental school, however he may find that going this route doesn't work with his schedule!. I know at the dental school in my state, you have to make quite a few trips and sometimes wait all day to get extractions done!. Many people, especially those who work full time jobs, can't do this!.
If you are more concerned with the cost, and are possibly willing to sacrifice quality, your best choice would be to go in-network!. If your insurance doesn't have an in-network/out-of-network fee schedule, then you would just have to call around and ask fees of different dentists!. The insurance is still only going to pay a certain amount, but depending on the dentist you go to, your out of pocket may be lower if you either go in-network or go to a dentist who charges lower fees than other dentists!.Www@Answer-Health@Com
You have four options with dental!.
1!. Visit a local dental school!. You can get many procedures done for a reduced price if you're willing to let them practice on you!. You can find one here: http://www!.yourhealthplanadvisor!.com/Den!.!.!.
2!. Insurance - Depending upon the policy: cost $30-$60 per month!. You pay a $50 deductible first, they have an annual maximum that they'll pay per year of $750 - $1500, they have a waiting period up to 18 months for major work and then you're paying 50% of the charges!. Example - average cost for a full upper denture in my area is $1353!. With the best insurance in my area you pay $677 after paying 12 months of premium (around $600)!. Advantage - you can use any dentist with most plans!.
4!. Discount plans - Cost - $5-$12 per month!. No deductible, no annual maximum and no waiting periods!. Also, hardly any dentists will accept the plan and when they do you MIGHT get a 10% discount, which is about the same discount you can get by paying cash!. Example - average cost for a full upper denture in my area is $1353!. With discount plans you pay around $1200!. Be very wary of these plans because most are scams!. The people that sell these plans have little or no knowledge about health & dental insurance and do not need a license to sell them!. The plans are not regulated by the state so you have no recourse when you have problems!. Some states are starting to ban these plans from being sold!. Here is an informative link http://www!.insurancejournal!.com/news/wes!.!.!. concerning these plans!.
5!. Fee for Service discount plans - Cost $7-$15 per month payable annually!. No deductible, no annual maximum and no waiting periods!. Many dentist will accept the plan (check providers first before signing up with any plan)!. When you use the plan there is a set fee that the dentist will charge you!. Example - average cost for a full upper denture in my area is $1353!. With fee for service plans you pay as little as $518!.
I'm an insurance agent and my personal plan is the fee for service plan!. I got mine here http://www!.dpbrokers!.com/default!.aspx!?lo!.!.!. specifically the Aetna Dental Access plan but which one you get depends upon your area and comparing the fee schedule to find the best for what you need covered!.Www@Answer-Health@Com
1!. Visit a local dental school!. You can get many procedures done for a reduced price if you're willing to let them practice on you!. You can find one here: http://www!.yourhealthplanadvisor!.com/Den!.!.!.
2!. Insurance - Depending upon the policy: cost $30-$60 per month!. You pay a $50 deductible first, they have an annual maximum that they'll pay per year of $750 - $1500, they have a waiting period up to 18 months for major work and then you're paying 50% of the charges!. Example - average cost for a full upper denture in my area is $1353!. With the best insurance in my area you pay $677 after paying 12 months of premium (around $600)!. Advantage - you can use any dentist with most plans!.
4!. Discount plans - Cost - $5-$12 per month!. No deductible, no annual maximum and no waiting periods!. Also, hardly any dentists will accept the plan and when they do you MIGHT get a 10% discount, which is about the same discount you can get by paying cash!. Example - average cost for a full upper denture in my area is $1353!. With discount plans you pay around $1200!. Be very wary of these plans because most are scams!. The people that sell these plans have little or no knowledge about health & dental insurance and do not need a license to sell them!. The plans are not regulated by the state so you have no recourse when you have problems!. Some states are starting to ban these plans from being sold!. Here is an informative link http://www!.insurancejournal!.com/news/wes!.!.!. concerning these plans!.
5!. Fee for Service discount plans - Cost $7-$15 per month payable annually!. No deductible, no annual maximum and no waiting periods!. Many dentist will accept the plan (check providers first before signing up with any plan)!. When you use the plan there is a set fee that the dentist will charge you!. Example - average cost for a full upper denture in my area is $1353!. With fee for service plans you pay as little as $518!.
I'm an insurance agent and my personal plan is the fee for service plan!. I got mine here http://www!.dpbrokers!.com/default!.aspx!?lo!.!.!. specifically the Aetna Dental Access plan but which one you get depends upon your area and comparing the fee schedule to find the best for what you need covered!.Www@Answer-Health@Com