FEDVIP Dental Questions (and a few other question) (McLean, Tysons Corner: insurance, how much)

[kiplingif]

Hello all.
I just got a new job and now can get insurance through FEDVIP. My general impression is that MetLife Dental is a good one to go with. Anyone have any suggestions for a good dentist to go with in the Tysons Corner/McLean area? The search engine on the MetLife site tells me Big Smiles Virginia PC is the closest spot to me that is covered by MetLife. There are a bunch of dentists listed, and they all have an address in the Corporate Ridge complex. But I can't seem to find a review of any of the dentists or the company. Anyone know the scoop?

I am also open to other suggestions in the area. My only real preference is a female dentist because they have smaller hands

As an aside, what is the scoop on the HMO versus PPO thing? HMOs are "bad", right? I am in my late 20s and in great health. I figured that since you can't be denied coverage for pre-existing coverage, it makes sense to go with a super cheap plan just to cover catastrophic stuff and then I can switch during a later years open season as I age or if things come up and I need better coverage. Any suggestions for that? All I really know of by "rep" is Blue Cross Blue Shield.

To summarize my questions:
1. Any thoughts on Big Smiles Virginia PC based in Corporate Ridge in McLean?
2. Any suggestions for a dentist covered by MetLife that is in the general McLean area?
3. If MetLife secretly sucks and I am being duped, any other suggestions?
4. Which PPO federal health care plan should I go with that is relatively cheap and will just make sure I can get help if something randomly catastrophic happens?

Thanks!

[airjay75]

I can't speak too much to your first two questions, but on your second two questions, since you are new to the FEHB and FEDVIP programs, I would highly recommend using checkbook.org's guide to the federal health plans (https://www.checkbook.org/newhig2/hig.cfm). Your agency may offer free access to the website - if not, I think it costs $10 to access the guide. I believe they have a pretty good tool to recommend both health and dental plans depending upon what you expect your expenses to be and what you're looking for in a health plan.

On MetLife, I don't think it secretly sucks or anything. I know several co-workers who have it, and they are pretty satisfied. If I'm not mistaken, there is a standard and a high plan. Unless you anticipate a lot of dental work, the high option will likely be a waste of money. Another thing to keep in mind is that many of the FEHB plans offer some amount of dental coverage and, by law, dental providers will actually have to go to your FEHB plan with a claim before your FEDVIP carrier will be required to pay. I know some coworkers that have very good teeth and never need any dental work beyond their 2 cleanings - some of those coworkers don't even bother with FEDVIP coverage.

On FEHB, it's hard to answer what plan is best for you. It sounds like you are young, in good health, and don't anticipate many medical expenses in the coming year. I view myself in a similar situation. My personal opinion is that going with the standard BCBS plan would be a complete waste of money. I personally like the high deductible plans (HDHPs) with health savings accounts (HSAs). I am personally with GEHA's HDHP this year and plan to stick with it next year. They will fund your HSA for you in the amount of $62.50 per month (which amounts to 50% of the $1500 deductible for the year). You can fund it with additional money if you like which will be taken out of your paycheck on a very tax-advantaged basis (no income or payroll taxes on that money). If you end up having medical expenses (or dental expenses not covered by insurance), you can use the money in the HSA for it. If you don't, the money is yours to keep in an HSA to use in the future (even if you decide to go off of a HDHP in the future). If you don't anticipate dental expenses beyond 2 cleanings a year, you might also like Aetna's Healthfund HDHP - it is similar to GEHA's HDHP but it provides 100% preventative dental coverage for dentists in Aetna's network (which has a lot of overlap with MetLife).

Of course, there are a lot of other types of plans. The consumer directed health plans (CDHPs) are similar to the HDHP plans, but you will not get to keep the money in your reimbursement account if you switch to a different insurer - those plans, however, can provide a pretty good deal if you stick with them from year to year. I wouldn't necessarily rule out HMOs either. A lot of people love Kaiser, and I believe there is a new HMO this year called Virginia Innovations or something like that which I believe is based in the Inova system.

And, of course, most Feds (I believe 40%) just go with the BCBS standard plan because they don't like the complexity of the other types of plans. You will pay more for it, but it will be a more traditional sort of plan where you simply have your copays for most medical procedures.

Hope that is somewhat helpful.

[boyd888]

Dental insurance is not like regular medical insurance. You pay $315 a year to get your two 'free' cleanings and xray (a $300 value I guess). If you need any actual dental work done your "insurance" is going to cover 50% or less of the cost and it maxes out at $1500 in payout. A coworker had a chipped tooth and paid over $400 out of pocket to get it fixed. $315 isn't that bad (the one offered by my employer is over $450), but unless you are going in religiously for your cleanings twice a year you are better off with a discount dental plan or paying cash.

HMOs are not bad and as a young healthy person I'd go with the cheapest - they will all cover you in the case of something catastrophic. I had to go to an optometrist: if I had PPO I could head right there, but with the HMO I had to get a referral first from my primary care physician. No big deal.

[Carlingtonian]

I have GEHA dental through FEDVIP and go to Dr. John Schehl in McLean. Pretty happy with the practice. The only annoying thing is that they whenever an appointment is approaching, I get a text and about 3 e-mails to remind me.

[slduvall]

Originally Posted by boyd888

Dental insurance is not like regular medical insurance. You pay $315 a year to get your two 'free' cleanings and xray (a $300 value I guess). If you need any actual dental work done your "insurance" is going to cover 50% or less of the cost and it maxes out at $1500 in payout. A coworker had a chipped tooth and paid over $400 out of pocket to get it fixed. $315 isn't that bad (the one offered by my employer is over $450), but unless you are going in religiously for your cleanings twice a year you are better off with a discount dental plan or paying cash.

HMOs are not bad and as a young healthy person I'd go with the cheapest - they will all cover you in the case of something catastrophic. I had to go to an optometrist: if I had PPO I could head right there, but with the HMO I had to get a referral first from my primary care physician. No big deal.

This is very true, unlike other insurance where once you meet your deductable, you get covered up to the amount of your plan, which can be 100K's in worst case scenerios.

Dental insurance on the other hand can be wiped out in one calander year with a crown or root canal. Some plans do pay up to 80% but 50% is common as well. Your preventive care is usually covered 100%. So for young teeth , I would take the cheapest possible, as long as it covers preventive care. I wouldn't pay more than $350 a year for it at your age, since that is about how much you would pay for cleanings.

[airjay75]

I definitely agree with some of the above thoughts on dental insurance. Really, I think dental insurance is better viewed as prepaid dental care than it is insurance. The one additional benefit is the negotiated rates if you're using an in network dentist. But, even then, the dental insurance is likely going to save you money only if you're having significant work done.

[kiplingif]

Thanks for all the input everyone. I had some dental issues in the past, and unfortunately didn't make enough to afford dental insurance the past few years. Before moving out here, I went to a "low-income" county dentist who wasn't the best. I figured I'd bite the bullet and pay for the high plan for MetLife for one year to fix up everything that was wrong and then reassess.

As for the FEHB, it looks like I need to do a little more reading. I think I saw a comparison calculator somewhere, so I will look into that!

Thanks again for everyone's input so far.

[jbakerman]

I'm a 10 year fed and take great interest each year in open season. After being with MetLife High for the past few years I'm planning on changing to the Aetna PPO for dental. I have required significant dental work in the past so the High choice wasn't unreasonable, but the premiums in MetLife High vs. Aetna PPO are almost $600 apart for the year (family coverage) and the pay ratios for out of network (my dentist is very limited in-network) are not tremendously different from MetLife for out of network - it helps too for us that our kids are in network w/ Aetna. I can vouch that MetLife has provided great service w/ quick claim management -- the one year I had GEHA for dental they were very, very slow in processing reimbursements, but I had no issues with them otherwise.

[kiplingif]

airjay75, I actually looked at the Kaiser standard plan. $45.38 every two weeks is not bad at all and I live about 5 minutes from the Tysons Corner hospital. I think I will go with them! Seems like a reasonable price and is convenient. I am just reading through the manual to make sure it all makes sense. It does include some dental, but doesn't look that awesome. So I think I will still get a separate dental plan. I will run through comparisons on those next.

jbakerman, glad to hear you have liked MetLife! Did your regular healthcare plan have any dental and was it ever a headache coordinating the two? Or was it completely separate each year and either run by MetLife or by GEHA?

[jbakerman]

I have Aetna Open Access Basic under FEHB. There are some modest dental benefits but nothing beyond a regular cleaning. Our dentists have never had a problem coordinating the benefits. Their software basically does it all for them, looking at the primary first (FEHB) and then applying the FEDVIP benefits.