Friday, February 20, 2009

Insurance Rant

This pissed me off so much, I just had to write about it (insert Mr. B rolling his eyes here :-) )
Ok, so, a few days ago (or more), I blogged about the bait and switch routine from the company that will now be providing MY medical coverage (Mr. B is medically covered through his job; it was cost prohibitive to cover me; one of the downsides of Mr. B working for a much smaller firm than KPMG). Got that all worked out, though, and, it won't be so bad once I get my doc to write me a generic prescription for my allergies.
On to dental. Again, we're currently covered through KPMG's COBRA plan. A decent Aetna Dental PPO which we've been very happy with.
Mr. B took on the job of finding new dental insurance and ended up selecting a plan through Ameritas. Ameritas offered both a PPO and a non-PPO. Mr. B checked to see if our dentist (Randy) is one of their providers. Only for the non-PPO (which as an aside is odd because he was a provider with Aetna's PPO, I don't understand why dentists agree to be in some plans and not others). Anyway, Mr. B definitely signed us up for the Ameritas NON-PPO (more expensive, too, but not much). In fact, the monthly premium wasn't too much more than what we're currently paying for the Aetna PPO.
The other day the plan documents and our policy show up in the mail. First thing Mr. B noticed; all of the information said PPO! 2nd thing; we received two ID cards. One had Mark's name on it, the other simply said "Dependent". Hello, my name is Dependent! I think not. Lastly, and most worrisome and annoying and the primary cause of this rant was this disclaimer: "Type One Procedures (such as cleanings and routine exams; (in other words, preventative procedures that are typically covered before deductible in most dental plans)) will not be covered until after being enrolled in the plan 3 months". Ok, problem; my next cleaning is scheduled for 24 March.
It gets better (worse): "Type Two Procedures (such as x-rays, fillings) will not be covered until after being enrolled in the plan 6 months". And, finally the shoe drops. "Type Three Procedures (such as anything major; root canals, crowns, etc.) not covered until after being enrolled in the plan 12 months". HELLO? The potential for needing these procedures are the reason why people have insurance IN THE FIRST PLACE! (Yes, I am yelling here!)
I got my back up about this and decided, yesterday, to do some more research on dental plans. To my dismay, I discovered that there ain't much to be had out there. Aetna won't cover individuals in NC (only through employers OR if you get their medical insurance, too (nice)).
Most of the plans I found were as bad, if not worse than the Ameritas one (and Randy was not a provider). Also, dental coverage is not as regulated as medical, meaning, they can pull shit that medical insurers cannot (for example, if you've been continually covered under a medical plan, a new insurer cannot not cover pre-existing conditions; however, I guess it amounts to a hill of beans that Mr. B and I have been continually covered by dental insurance our entire adult lives).
I got to thinking about it. Last year we each had two cleanings/exams and that was it (maybe an x-ray or two). We paid just under $1,000 (for the year) in premiums. I bet if I went and dug out the EOBs, they did not add up to $1,000.
Mr. B, since he's been going to Randy 20 years and feels he has a decent professional relationship with him, is going to call Randy, let him know what's going on, and see if he can't get Randy to agree to charge us what he was charging Aetna (preferred rates) AND also perhaps give us a discount on top of that for paying cash at the time of service. At this point, this seems the most reasonable thing to do. Hey, I did not fall off the dumb dumb truck (nor did Mr. B); we are not willing to pay over $1,000 a year in premiums for, basically, nothing. We can easily afford our routine cleanings/exams. And, if God-forbid something major was required, we can pay for that, too. With all the money we'll save from not paying $80+ a month for squat. BTW, this plan also has a maximum annual cap of what it would pay out of $1,000 a year per person, so, even IF something major happened (a year from now), it's not as though the plan would cover much, anyway (after having received a full year of premiums for nothing in return).
But, as wise people have said, "Don't get mad, get even".
Mr. B told Ameritas yesterday to take a hike and we will in essence, self-insure. I think we have a much better plan, anyway :-)
Mrs. B.

1 comment:

Margot said...

I think you'll be glad you dropped dental insurance. Taking really good care of your teeth (yes, brush 15-20 seconds each side and floss)cuts way down on the in between cleaning emergency visits.

Yes, your dds may give you a discount if you hand over a solid check that he doesn't have to run thru an insurance company.

Except for some of the TRW years we've never had dental insurance.