Dental Insurance

[Nomad]

My husband will retire in April/May. He works for a fairly large state agency.
He has regular health and separate dental insurance.
He is going to a meeting, I think in about a week, to discuss the insurance policies.
We know that we can continue the health insurance for a large fee.
At this moment, I'm concerned about our dental insurance.
Unsure if we can continue with our dental insurance.  Assuming that we can, I'm thinking maybe we should assuming it would be a smooth transition, without additional paperwork i.e. disclosure that I have Sj. Syndrome.
Can a person with Sj. Syndrome typically even get dental insurance?
I get a cleaning three times a year, and I think it pushes $175 for those visits!!!!!!
Anyone have any knowledge or experience with this type of thing?
Thank you.

[cccourt1942]

After my husband died, I still had my insurance with his company. He was on Medicare but paid for supplementary...and had vision and dental care.  When I turned 65, (he was retired from Exxon) the company kept me on same.  In fact, it was all done by mail. I still can't believe it.  Anyway..after a year I dropped the vision. KEPT the dental.  Never used the dental 4 times a year as is allowed/encouraged...until SjS dx.  The dentist and hygienists comment each time I am there how wonderful it is that I come in that often.

My monthly fee for supplementary which includes drug coverage is 89 bucks.  It went up from 77 dollars two years ago.  I believe it almost pays for my cleanings alone...the premium that is.  I have several meds which cost 200.00 and one for more for a 3 month supply...and the remaining are anywhere from 25 to just under 200 for 3 month supply.   I pay 20%.   My company drug plan was seamless...which was important to my husband and then for me.  AND..I hadn't even been dxed at the time I turned 65.

I was never asked about any dental condition...but I didn't have any dental condition at the time. 

I think it's worth it.  I just don't know how much your husband's premium it is..and for both of you.  Does your husband have dental issues?  That could help your decision. 

I put $ amounts in to give you an idea to compare to.  Remember: No dental or anything else (but drugs) once you hit medicare age.

Sjoldier c3

[Jenny]

We have a very inexpensive plan with Humana One. I think it's under $200 a year for the two of us. We have to go to certain dentists as it's an HMO, all of which are large, multi office, group dentists. Two regular cleanings a year are free, as are X-rays and Floride treatments. Everything else is pre-negotiated and is about half of their normal price. Best of all, they don't ask about Sjogrens or any other medical condition.

[jazzlover]

I've never had a dental insurance company ask about pre-existing conditions.

[warmwaters]

If it's a carry over from your husband's employer, it's probably COBRA, and you can have if for 18 months.  You'll pay what the employer pays for it, not the discounted rate that most employees pay. 

[Jasper]

Your husband needs to find out exactly what type of insurance he is being offered. If it is COBRA, as Warmwaters discussed, then it is temporary for 18 months.

However, if your husband works for the state, he may, depending on his benefits, be eligible for retiree health benefits through the state. If this is the case, then he would have those benefits indefinitely.

Whether he gets retiree health insurance benefits depends entirely on the state and the employee contracts. Some federal, state, and local governments offer these benefits while others do not.

The policies may be higher than what he is now paying. COBRA will definitely be higher. If he gets retiree health benefits, the cost may be higher than what he is now paying, but it may be cheaper than the market rate (if you were to try to find a policy on your own).

Also, just because the insurance policy costs more, does not mean it is not a good policy. It may be well worth the extra cost to have good insurance.  Paying more may seem like a bad deal, but sometimes paying less is definitely a bad deal.

If you decide to try the market place, compare the policies very closely. Sometimes (often) those with a cheaper price tag, have very high deductibles and/or co-pays. Those high deductibles will add up as will the high co-pays. Sometimes it is better to pay up front for a good policy as opposed to paying through the nose later on with a policy that has high deductibles and co-pays.

Also, check to see what the insurance companies cover and what procedures you will need pre-authorization for. Some of the "cheaper" insurance companies charge lower policy fees up front because they won't cover tests and treatments that you need. They save money by not paying for needed treatments and tests.

Check the drug co-pays. Some insurance companies have very high drug co-pays or cost sharing amounts. Also, check that the medications you are on and/or may be on, are covered under the policy.

Best of luck.

PS: I don't have dental insurance but I am thinking of getting it. I have to wait and read the policy when open enrollment rolls around. Many dental policies have caps on the amount they will cover in a year, such as $1000 or $2000 per year and/or $500 for a cap, etc., so it may not be worth it to get the policy. So far, I have done okay without dental insurance, but if the policy is good enough, I may opt in to dental insurance this year.

[irish]

A lot of times you get what you pay for. If you need a lot of dental work that is more complicated and have to see a group of dentists that accept a lower paying insurance like Humana, I would investigate thoroughly. Sometimes this can be a group with less experience, ie., as opposed to a more experienced group of dentist who may not go with Humana.

I am not saying that they are bad dentists, I am saying that sometimes things are not as they seem and it pays to check them out big time. Can sound so great and come back to haunt us. Good luck. Irish