Dental Insurance - I'm so confused!

[psophia17]

N has 20 teeth, and 16 cavities.

Because I'm a SAHM with no employment, we qualify for province-sponsored dental coverage for kids that covers up to $700 of treatment, which leaves us with $1375 out of pocket. I'm trying to figure out if abandoning the province-sponsored coverage for traditional dental insurance is a terrible idea or not.

Anyone good at this stuff?

For stand-alone dental coverage, a family is covered at $63/month or $719/year

The plan has a sliding scale for reimbursement. After a three-month no-claims waiting period and calendar year deductible of $100, it covers up to:
Year 1: 60%, $500 per person
Year 2: 70% $750 per person
Year 3 and up: 80% $1,000 per person

So this means...for the first three months they pay nothing, no matter what, and for 9 months after that we pay $100 and they pay 60% of everything, but no more than $500? I think?

If we got dental insurance, we couldn't have the BC-sponsored coverage anymore, so the total would be the $2027 for the treatment, before sorting out how much insurance would be paying for...can anyone help me figure out what we'd have to pay if we got regular dental insurance?

x-posted elsewhere because I suck at this stuff and need all the help I can get.

(edited to try and insert an ashamed of myself smiley for all N's cavities...don't worry, R hasn't got a sign of cavities anywhere, so it's got to be genetic!)

[gatorruth]

Well, I'm no dentist, but a good friend of mine is a non-practicing dentist, and her hubby is our families dentist. That said, I was in the same boat- trying to figure out if no dental ins. vs. dental ins. made more sense. Our dental ins. works out to be $1K per year for our family of 4. We can choose any dentist we want. We had the same dental ins co. last year, but had their crappy DMHO (DON"T DO A DMHO!). It was horrible... but it did eliminate the good dental ins. waiting period. They pay 100% of the preventative treatment for all 4 of us twice a year. I asked my friend how much it would cost (best guess) and she told me about $980, so that itself was worth the $1K in copays... Then, if you need any additional services (IE: cavities or a crown--which I need both-- soon) then you should certainly get the dental ins. I guess it's best to call your dentist and ask them what they recommend- the billing person has to deal with this stuff all the time...

Good luck!

[schums]

Basically, you'll be paying over $2000 the first year if you go with the private dental insurance. It only covers $500 of your costs, so your portion of the dental bill is $1527 plus $719 for the insurance itself. Comes out to $2394 out of YOUR pocket. Of course, this provides coverage for your whole family, but to get $500 of coverage, you'll have to have bills per person of $1000, so if you max out the coverage, you're getting $2000 of coverage, spending $2000 and paying $716 in premiums.

With the government sponsored plan, you're only paying for the remainder of the work done, or $1375. For a short term plan, this sounds to me like the way to go.

I didn't run all the numbers, but it looks like the private plan is going to cost you a bunch out of pocket until you get to year 3.

HTH,

[psophia17]

Thank you! That's what I had worked out, but your explanation is much more streamlined than mine.

[bubbaray]

I suck at the numbers stuff.

But, have you looked into this?

http://www.bcdental.org/bcda/news/mediaArchive-detail.jsp?item=35

You might ask at your Public Health Unit. I know they offer free fluoride varnish to kids without dental coverage -- I've seen the posters. I don't know if there is an income cut-off or not. Your public health nurse will probably be able to help with that.

The UBC School of Dentistry also has a free program, for kids.

http://www.dentistry.ubc.ca/community_development/special_children/


Good luck! :)

[psophia17]

Thanks Melissa!

I emailed about the first one, and I'll call about the second one tomorrow, but I don't think we will qualify for it, since N isn't school-aged, but I'll see what they have to say.

We've been getting the flouride varnish at the Community Health office for a while, and I think it's been great for R, but not much help for N...I'll call the nurse tomorrow, too, to talk about our treatment options. I didn't think of that before...