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A question: Are you saying that PM will pay something for your tooth implants? Most dental insurance pays zero for anything involving dental implants. Thanks.
PM will pay - depending your level of coverage - up to $501 toward any crown. Whether the crown is on your existing tooth or an implant is irrelevant. My plan will pay $501.
I've posted above the link to 350 procedures - read through it. The actual dental code is D6058 under Major Procedures on page 9 - and reads as follows: "Abutment supported porcelain/ceramic crown." Note that directly above that code is a line reading: "Implant Supported" followed by a list of 21 procedures, including D6058.
PM will not pay for the actual implant and abutment, which together cost about $2,500 or thereabouts I believe. It also won't pay for a bone graft required for an implant, but it will pay for bone grafting to preserve an existing tooth.
Apparently it is becoming more common for dental insurers to pay for some implant related procedures:
PM will pay - depending your level of coverage - up to $501 toward any crown. Whether the crown is on your existing tooth or an implant is irrelevant. My plan will pay $501.
I've posted above the link to 350 procedures - read through it. The actual dental code is D6058 under Major Procedures on page 9 - and reads as follows: "Abutment supported porcelain/ceramic crown." Note that directly above that code is a line reading: "Implant Supported" followed by a list of 21 procedures, including D6058.
PM will not pay for the actual implant and abutment, which together cost about $2,500 or thereabouts I believe. It also won't pay for a bone graft required for an implant, but it will pay for bone grafting to preserve an existing tooth.
Apparently it is becoming more common for dental insurers to pay for some implant related procedures:
Thanks. It looks like PM is a good dental plan. I'm impressed with their coverage. This is a helpful tip cause I gave up looking at dental plans years ago because they never made any fiscal sense...this is the first plan that I've seen where it seems worth investing in.
One plan the OP should consider is the iDental style plans. If they would need major work, like a crown; insurance policies like that one could offer some savings. You do not have to have the plan forever; only when you need it for the year at about $125/yr. So if you were getting a $1,000 treatment or more; you could see a substantial savings. But, of course, you would have to check with your dentist first.
My dentist fought back against these plans by offering his own 'plan' and cutting out this form of 'insurance' - which is more like joint purchasing plan.
Now many dentist have closed because of the corona virus. So it is important to start a communication with the dental office on whether they are open, whether they offer treatment, and whether or not they have their own insurance or if they honor any of the insurance plans.
OP: I never bought a dental insurance plan but did buy a dental discount plan maybe 15 yrs ago and it came in handy and I saved some money. In earlier years of my life I may have had some employer dental insurance but don't remember it all. I know I helped put some dentists children thru college.
For the last 10 yrs and I'm 82 soon I've been my own dentist (no dental visits) as I've changed my habits so much and all the STUFF I use to clean my teeth. I've posted in the Dental forum on what I've been doing.
Dental "insurance" is the financial opposite of most other insurance. It tends to pay well for inexpensive preventive services, and poorly or not at all for expensive services as described above. And it's full of gotchas. $501 for a crown? Go price one. In my area, they're easily double that. Then there's the annual caps.
Consumers Checkbook does an annual analysis of benefit options for Federal employees. The Feds don't pay for dental insurance - it's all out of the employes' pockets. Their conclusion for years has been that it's more like a pre-payment plan for routine services, and that the catastrophic (big expense) coverage isn't worth it. And that's for plans with favorable group rates. Purchases in the individual market will be even worse.
Well, Physicians Mutual insurance I have (for now) has no networks and no annual caps. Those were two biggees for me. As I said, my plan pays about 25%-40% for a procedure, so unless one expects ongoing expensive procedures, I agree, it doesn't pay.
I have read of some families who find discount plans very useful. When I worked, I had very good employer dental coverage for only $4/mo., with a $5,000 cap on annual expenses. Could see any dentist. It was a great deal. Plans available to the public are a whole 'nother story.
As I said, I had a 'feeling' last year, which is why I bought the policy last July. Turns out, a front tooth broke unexpectedly two months after I bought the policy. No way to cap it, had to be pulled, partial flipper made, then I broke the flipper. The policy had coverage for the extraction and flipper repair, a couple office visits and a cleaning. Through May 2020, my premiums have totalled $522.50, policy paid $330, so right now the insurance company is ahead by $192.50.
Going forward, because of the possible two crowns and some periodontal procedures in fall, the policy would possibly pay off for me after about 16 months of coverage - their reimbursement $1,002 (crowns) plus $330 paid so far for unexpected issues plus another $160 for fall cleaning = $1,492 would be their payout v. premiums paid of $760. So, I would be ahead about $732 - in 16 months - if go through with the implants. If I don't do the implants, then by November 1 the policy has cost me a net of $270.
It is very hard to see the sense in dental insurance, I agree.
Last edited by Ariadne22; 05-26-2020 at 01:45 PM..
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