The Transition Network

New York City Chapter

Guaranteed to Make You Smile (Dental Insurance & Low Cost Care)

(Posted March 1, 2018)

Guaranteed to Make You Smile (Dental Insurance & Low Cost Care)


By Shirley Petersen & Barbara Alpern



Some dental plans now cover implants!!  Who knew dental insurance could be cost effective? 

 Like many of us, I've taken my teeth for granted.  A cleaning twice a year, maybe an occasional cavity, and I'm on my way.  As I got older, I had some issues, so when I signed up for Medicare, I also signed up for dental insurance.  The premiums seemed reasonable, and my dentist and oral surgeon are in their network.  I've found that the cost of the insurance is about the same as three cleanings and exams annually, so it pays for itself.
 
Then, I found myself grinding my teeth and lost three teeth in three years.  I soon learned how expensive implants are in NYC. Fortunately, after a year of coverage, my plan covered a significant portion of the cost of the implants.  In my experience, I was able to save thousands of dollars. 
 
The real VALUE of dental insurance is the negotiated rate with the dentist.  Like Medicare, the doctor or dentist accepts an agreed upon rate for a procedure such as an implant or crown.  In many cases, it can be 50% less than the dentist's going rate.  
 
My experience is with an AARP dental plan, but there are many other dental plans available for purchase by individuals who are 50+. They generally cost between $30 and $75 per month.
 
Barbara Alpern has researched important details about dental insurance and other options for lower cost dental care. Here is what she found:

 
Options for Dental Insurance and Lower Cost Dental Care

 
If the cost of dental work is overwhelming and you’re interested in finding out about insurance options and organizations in New York City offering lower cost dental services, review the summaries of resources below.

Dental Insurance

Before enrolling in any plan, there are a few things you should know.

1.   Verify that the dentist you want to see is in the plan’s network, or that the plan you select has adequate coverage for out-of-network services. (To verify network participation, contact the dentist’s office, since directories are not always up to date.)

2.   If you know you may need certain services performed, be sure the plan covers those services (e.g., not all plans cover dental implants). 

3.   Beware of any fee schedules posted on the plan’s website. These are usually estimates and can vary based on the provider’s contract and the zip code for the dentist’s office. Contact the dental plan to verify how much it will cover for major procedures you may need.

4.   Many plans have an annual maximum and stop paying claims in that plan year once the maximum is reached. The maximum is generally $1,000 -$2,000. You then have to pay out of pocket, but will continue to benefit from the significantly lower fees negotiated by the insurer for in-network care.

5.  Make sure you are aware of any waiting periods (often 6 months to a year for certain complex services) or minimum contract periods (usually at least one year, depending on plan type).
 
Dental PPO (Preferred Provider Organization): PPOs offer reduced fees for services provided in network, and many offer some level of coverage for out-of-network services. They generally have a waiting period for certain services and a minimum contract period of at least one year. Most plans do not have a waiting period for preventive care. You usually have to meet a deductible, and then you pay a percentage of the cost - which depends on the services provided. Most PPOs also have an annual maximum.
 
DHMO (Dental HMO – also known as a Prepaid Dental Plan): DHMOs are similar to medical HMOs. There are usually no waiting periods, deductibles, or annual maximums. They generally do have a contract period of at least one year. You pay a flat amount (co-pay) for services rendered, based on a discounted fee schedule agreed to contractually by its network providers. However, you must use network providers for all services. Preauthorization for certain procedures may be required.
 
AARP sponsors two PPO plans and an HMO administered by Delta Dental, which you can view at www.aarphealthcare.com/insurance/dental-insurance.html

You can find a comprehensive list of dental plans available in your zip code by going to an online insurance broker site, such as: https://www.dentalinsurance.com/di/web/quote/plansummary.aspx

You may also be able to buy inexpensive dental insurance through https://nystateofhealth.ny.gov/individual/searchAnonymousPlan/search which is the enrollment website for Affordable Care Act health insurance. Some of these dental plans are available only if you are under 65.
 
If you have a long relationship with a private dentist, but do not currently have dental insurance ask your dentist if they will continue to accept payment by you at your former insurance plan’s rates in return for advance payment in full. They may say yes.

Lower Cost Dental Services

While dental insurance can help defray some of the costs of maintaining a healthy smile, your out-of-pocket expenses can still be high if you need services like crowns and implants. If you are concerned about the cost of the services you need, Columbia University College of Dental Medicine and New York University College of Dentistry provide clinics staffed by dental students and graduate dentists who are completing fellowships. They are closely supervised by faculty with advanced training in all dental specialties. You will pay an initial registration fee: $92 at Columbia, $120 at NYU. Then, after an initial evaluation, a treatment plan along with associated costs will be discussed with you before any work begins. Expect to make more frequent and longer visits to have your procedures completed than at a private dentist, in return for services at substantially reduced fees.
 
Columbia offers emergency dental care during regular clinic hours (9-5 Monday to Friday). NYU provides walk-in dental urgent care/emergency services until 8pm Monday to Thursday, and on most Saturdays and Sundays.
NYU participates in some private dental insurance plans, and both dental school clinics will provide you with the information you need to file a claim if you have dental insurance covering out-of-network care.

Dental Schools

Columbia University College of Dental Medicine
Vanderbilt Clinic 622 W. 168th Street (west of Broadway) 212-305-6100
http://dental.columbia.edu/page/patient-care

New York University College of Dentistry
Dental Clinic 345 E. 24th Street (at First Avenue)
212-998-9800
http://dental.nyu.edu/patientcare.html

Dental Urgent Care

New York University College of Dentistry Emergency Services/Urgent Care
345 E 24th Street, Suite 207,
212-998-9458  
https://dental.nyu.edu/patientcare/emergency-services-urgent-care.html
 
There are also a number of hospitals in the New York area that offer dental clinics staffed by residents under the supervision of licensed dentists. These clinics also charge lower fees for major dental procedures than private dentists do.

Some Hospital-based Dental Clinics

New York Presbyterian Hospital at Weill Cornell Dental Dept.
525 East 68th Street New York, NY 10021   
Phone: (212) 746-5115

Maimonides Medical Center Department of Dentistry
4802 Tenth Avenue Brooklyn, NY 11219
Phone: (718) 283-7428

Mount Sinai Hospital Medical Center Department of Dentistry
One Gustave L. Levy Place New York, NY 10029: 
Phone: (212) 241-6031

New York Methodist Hospital Dental Medicine
506 Sixth Street Brooklyn, NY 11215
Phone: (718) 780-5410

New York Hospital Queens Dental Service
56-31 141st Street Flushing, NY 11355
Phone (718) 670-1210
 

 
Barbara Alpern was an employee benefits consultant for 26 years until she retired in 2014.  She focused on implementing health care plans for Fortune 500 companies.  Barbara joined TTN in 2014, and was an active member of the Caring Collaborative Council, the Program Committee and the Peer Group Committee, until becoming Chair of the NYC Chapter in July, 2016.


 

Shirley Petersen
is a retired financial services executive whose experience includes global intellectual property licensing and marketing, sales team management, and extensive international travel. She is a longtime TTN member and has served on the Volunteer and Program committees.  She is also a dedicated Fortune Society volunteer.





 

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