Category: Ameriplan
Discount Plans Can Extend Insurance Coverage
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In my last post, I started with the premise that Dental Insurance was a SCAM. Some readers have told me that this might have been a little strong. Dental Insurance can help to defray costs, but as my example showed, it is still much more expensive than other options. For people who need the peace of mind that Dental insurance brings, can discount plans be combined with insurance to reduce costs? Lets take a look.
Lets start with the same scenario and my dental insrance, adding in the discount plan to see what the costs savings could be. There are several ways this could play out, but lets say that the dentist only bills the discount price to the insurance company. I am going to throw in an Anterior Root Canal just to make the numbers come out good. To review, here is the scenario and the costs for the dental procedures:
| 2 Exams: | @ | $70.00 | = | $140.00 |
| 2 Cleanings: | @ | $115.00 | = | $230.00 |
| 2 Single surface Cavities: | @ | $174.00 | = | $348.00 |
| 1 Double surface Cavity: | @ | $227.00 | = | $227.00 |
| 1 Bicuspid Root Canal: | @ | $1032.00 | = | $1032.00 |
| 1 Anterior Root Canal: | @ | $902.00 | = | $902.00 |
| 1 Crown: | @ | $1365.00 | = | $1365.00 |
| ======== | ||||
| Total: | $4244.00 |
This is the total cost of the services provided. Now lets factor in insurance for the same procedures:
| Annual Insurance Cost: | $578.76 | |||
| 2 Exams: | @ | N/C | ||
| 2 Cleanings: | @ | NC | ||
| 2 Single surface Cavities: | @ | $174.00 | = | $348.00 |
| 1 Double surface Cavity: | @ | $227.00 | = | $227.00 |
| 1 Bicuspid Root Canal: | @ | $1032.00 | = | $1032.00 |
| 1 Anterior Root Canal: | @ | $902.00 | = | $902.00 |
| 1 Crown: | @ | $1365.00 | = | $1365.00 |
| Insurance Pays: | ($1500.00) | ($1500.00) | ||
| ======== | ||||
| Total Out of Pocket Expense: | $2952.76 |
A total savings of $1291.24. Pretty good, but still a lot out of pocket. So now lets throw in a discount plan and see what the total becomes:
| Annual Insurance Cost: | $578.76 | |||
| Annual Discount Plan Cost: | $240.00 | |||
| 2 Exams: | @ | N/C | ||
| 2 Cleanings: | @ | NC | ||
| 2 Single surface Cavities: | @ | $70.00 | = | $140.00 |
| 1 Double surface Cavity: | @ | $80.00 | = | $80.00 |
| 1 Bicuspid Root Canal: | @ | $425.0 | = | $425.0 |
| 1 Anterior Root Canal: | @ | $375.00 | = | $375.00 |
| 1 Crown: | @ | $550.00 | = | $550.00 |
| Subtotal of Procedures: | $1195.00 | |||
| Insurance Pays (after Deductible): | ($1145.00) | ($1145.00) | ||
| ======== | ||||
| Total Out of Pocket Expense: | $888.76 |
So you have saved $3355.24 over paying full price, and $2064.00 over using insuarnce alone. Of course, this leads to the obvious question, “What if I didn’t have insurance?”
| Annual Discount Plan Cost: | $240.00 | |||
| 2 Exams: | @ | $14.00 | = | 28.00 |
| 2 Cleanings: | @ | $47.00 | = | $97.00 |
| 2 Single surface Cavities: | @ | $70.00 | = | $140.00 |
| 1 Double surface Cavity: | @ | $80.00 | = | $80.00 |
| 1 Bicuspid Root Canal: | @ | $425.0 | = | $425.0 |
| 1 Anterior Root Canal: | @ | $375.00 | = | $375.00 |
| 1 Crown: | @ | $550.00 | = | $550.00 |
| ======== | ||||
| Total Out of Pocket Expense: | $1935.00 |
Hmmmm. A pretty good savings over paying full price, or even insurance, but maybe I shouldn’t be too hasty about canceling my insurance! Obviously, if you had fewer procedures done, you would save less, and there would be a break even point somewhere. I guess further analysis would be required to determine that point, but clearly, the discount plan makes a HUGE difference in your out of pocket expenses.
But wait! Sorry, I couldn’t resist that. The other side of this is that in some regions, I have heard, dentists must charge the insurance companies the same amount for all patients. If this is true, where does this apply? More research on this is required, but when I find out, I will pass it on. Of course, any dentists out there who can answer this question can comment below.
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