Hi-
 
I'm an independent contractor, so I pay for my own health insurance. My health insurance provider here in Putnam County, NY sent me a letter saying they won't offer my health insurance policy in my geographic area beginning Jan 1 and I'll have to choose another. I'm guessing whatever I choose will be more expensive; maybe a lot more.
 
I haven't been carrying dental insurance, but I think I need to start. There's so much in the news about how dental health is related to general health that I don't get why they're handled separately when it comes to insurance (but I'm pretty sure it has to do with money somehow).
Does anyone here have good/bad experiences to share with health/dental insurance companies/policies in NYS?
 
Thanks-
 
-Susan

I'm fortunately on my wifes insurance that we get through her employment for the state. I think you need to check out the state run insurance exchange. We looked at it earlier this year when she was considering a job change. It's pretty daunting in NY, but you really don't have much of a choice if you want coverage. Best of luck.

Main problem with dental insurance is that it is highly subject to adverse selection, and generally comes with such high deductibles/copays that it should be looked at a dentist panel discount program. By adverse selection I mean that the buyer can choose to do many dental procedures at a time that is convenient to him. You can wait on a lot of the stuff that, while legitimate exercise of dental practice, is not immediately essential to your health. That means that a buyer can get dental insurance, then go to the dentist with a mouth full of problems he has neglected for a decade and want the insurer to pay for it all, and then has the option to drop the coverage the next year, or just stop paying the premium. 
 
Partly because of that issue, dental insurance actually covers a small proportion of the dentists' "usual and customary fee." That fee is established by what dentists in the area say they will charge a patient who can pay an unlimited amount of cash for retail work. Many patients of course never pay that cost in cash, and dentists on average do the work for a lot less. Dental insurance will typically ask you to pay half the cost of a procedure  and reimburse the dentist much less than half of that cost, so the insurance company is getting a huge discount from the dentist, and he benefits because you came to him for care that you otherwise would have foregone, and the co-pay you fork over more than pays for his time. The "free" benefits in most dental insurance plans like a free exam and x-rays once or twice a year, can typically be had for really for free without dental insurance. I get a flyer in the mail about once a month where a local dentist who is having a slow time hopes to recruit new patients by offering a free exam, x-rays and/or cleaning. Since there are a gazillion dental "problems" that you probably would not have noticed without the free exam, it is a ticket to an expensive show. 
 
Finally,  it is unusual to find dental insurance that does not have a relatively low annual benefit limit. The point of insurance after all is to have a source of payment for a catastrophic expense that you can not cover from savings. If some dental disaster occurs, that will cost tens of thousands of dollars, you will probably find your coverage quits. Often that limit is as little as 1000.00, which means after the dental insurance has paid the dentist that amount in a year, they pay nothing. Since the insurer is getting a discount, you will actually receive significantly more coverage measured in retail fees, but it is not difficult to imagine a scenario where you will get stuck. 

My dental insurance sucks. I pay $50 for a cleaning. Without insurance it would be $90 but i'd save $150 a month in premiums. The only reason I keep paying is in case I get all my teeth knocked out or something. I can only hope.

bitflipper
My dental insurance sucks. I pay $50 for a cleaning. Without insurance it would be $90 but i'd save $150 a month in premiums. The only reason I keep paying is in case I get all my teeth knocked out or something. I can only hope.

Yes, that's my experience as well.  I pay around 800 bucks a year for dental coverage (Delta Dental) for wife and self.  If one expensive procedure (e.g. replacement crown) happens, I come out ahead.  If not, I lose a little.  But there's a not-too-high max annual payout.  If you needed, say, two or three crowns, you'll still have to come up with quite a bit of cash.
 
One thing to check is this: how close does your dentist observe the customary charges.  I think my dentist recently said "screw it, I'm not going to let Delta Dental dictate my prices".  Other dentists may well cut their prices to be in line with what the insurance says they should be charging.  It's worth investigating.
 
I also pay about 120 bucks annually for vision insurance - again wife and self.  That definitely saves a few bucks.  I'd give up the dental before I'd give up the vision, even though I could easily underwrite the entire vision cost without much pain.

I've got pretty descent insurance still. My company has continued to pick up most of the increases. They keep foreshadowing that 2016 is probably not going to be a good year for insurance benefits though. Something to do with a cadelac law and hard choices that they will need to make.

Yep, at my job we will probably have to reduce coverage or raise rates because we are going to have to pay a fine for providing "to good" of a plan. We're really not sure what will happen since the rules change every time a lobbyist writes a check.

dmbaer
 
One thing to check is this: how close does your dentist observe the customary charges.  I think my dentist recently said "screw it, I'm not going to let Delta Dental dictate my prices".  Other dentists may well cut their prices to be in line with what the insurance says they should be charging.  It's worth investigating.

 
Actually your best chance of getting a good price on dental care may be to find a dentist who is not signed up to a plan. Every contract I have seen that practitioners have to sign to be on a health insurance panel requires that they charge uninsured customers, or other insurance companies at a minimum what they are billing as the full cost to the contracting insurance company. Giving you a discount below that violates their contract and can get them removed from the panel at least. Under the anti-kickback statute, it may even constitute a crime to routinely offer to waive co-payments for Medicare and Medicaid, although individual exceptions can be made if the patient is felt to be too poor to pay. The theory is that the practitioner is offering an inducement (bribe) to the patient, thus making it more likely that he, rather than another practitioner, gets the business, and costing the insurer more money (collusion with the patient to defraud the insurer). Since the co-pay is designed to deter patients from seeking service, anything that reduces that disincentive is going to mean more costs to the insurer, whose risk analysis and premium determination take that disincentive into account. Many patients presume that the co-pay is a way to collect money for the physician, but the money could more easily be rolled into the premium cost and passed on to the provider via higher claims payments. 
 

Hi,
 
This is one of the scariest things ever for me, now, as I approach 65 and will end up having to give up my work insurance for Medicare and all that, assuming I can not turn my work insurance to the secondary insurance or similar.
 
As for dental, I have had the same dentist for 35 years, and all's in great shape ... the chances of me seeing another dentist because of an insurance company are not likely ... and I have already been told that I can sue if they do not allow me to do so.
 
About 10 years ago, our insurance was going to force me to switch, and I went and discussed it with my dentist and he told me how to handle it, and specifically gave me a chart of how much the new dentist would charge to re-exam everything and re-invent the wheel, which would cost more than his own services. Like twice more!
 
I handed all the paperwork to the insurance person at the company, and never heard from them, but the following month there was an email to the whole company that they would accept dentists that had thorough and proper records for anyone.
 
See what happens when your dentist is a GREAT bass player (takes lessons from the guy in the group Oregon !!!) and does a lot of music around Portland ... Keith Collins!

Randy P
I'm fortunately on my wifes insurance that we get through her employment for the state. I think you need to check out the state run insurance exchange. We looked at it earlier this year when she was considering a job change. It's pretty daunting in NY, but you really don't have much of a choice if you want coverage. Best of luck.

Hi Randy-
 
The NYS (state, not stock) exchange is where I went to select the plan I've had this year, but they're no longer going to service my area. That was Health Republic and the next one up for me is Fidelis Care, which I'd never heard of. Thanks!
 
@all-
The dental insurance issue is a sticky one for me, and thanks for the insights. At least with health insurance, you know you have to pay a penalty if you don't have it, so there's an added incentive right there. It sounds like if you had to have any major work done and recently started on a plan, you wouldn't be saving all that much, if anything. I'll have to look into it more.
 
Thanks for the replies!
 
-Susan