Hacker News Reader

Comment by mrfusion | Hacker News Reader

Check out self paid dental insurance. I spent hours going over the plans and basically couldn’t find any scenario where I’d come out ahead.

View on HN

It’s very difficult to sell “insurance” for something 100% of people will need.

At the end of the day, it’s just a marketing plan for the covered dentists.

In the US, it's just a way for employers to offer tax free income to employees.

And nowadays, it's morphed into a crazy scheme where large Dental Service Organizations (DSO) offer super cheap cleanings to the insurance, and then treat their dentists and hygienists like sales staff who try to push bullshit like fluoride treatments and sealants with 1,000% markups that you have to pay for out of pocket.

It's crazy what the situation is, I stopped going to certain dental practices and had to find an independent one I could trust. I'd almost rather forego the employer provided insurance cleanings and pay cash just to makes sure the incentives are aligned and the dentists and hygienists aren't trying to scam me.

Our family dental plan is the cost of about 10 cleanings a year, so it’s not a great deal, but we exceed that number and have also used the reduced fee for fillings a few times.

Dental’s historic lack of insurance and relative ease of opening a clinic has obviously made it much more cost-competitive than medical care, so we kind of feel like we are contributing to a future problem by using dental insurance, but it’s hard to turn down the savings now.

>...so we kind of feel like we are contributing to a future problem by using dental insurance, but it’s hard to turn down the savings now.

I agree. It feels awful to make a rational choice in your best interest and to see the mess it can cause at scale. The reason health insurance is such a mess in the US was from a tit-for-tat battle of people operating in a rational way (providers, insurance companies, and drug companies).

Insurance companies have pre-negotiated rates for everything. I didn't like paying for my dental insurance, and asked my dentist what the cost would be for 2 cleanings/year with no insurance. Something like $120/cleaning and another $75 for x-rays periodically. No cash discount because they'd run into legal issues by offering a better rate for non-insured patients.

My insurance is around $10/month. Since I get my teeth cleaned 2x/year, the rational choice is to buy my insurance and realize I breakeven after the first cleaning. But it feels bad. If my dentist is getting $40/cleaning through insurance, I'd rather be able to pay him $45/cleaning and keep insurance out of it all.

If the dentist is getting $40/cleaning from insurance, why couldn't he bill a cash patient $50 for it and have everyone (but the insurance company) come out ahead?

Maybe my mistake was acknowledging I have insurance. The billing person said they run into issues with the insurance company if they let covered individuals bypass the insurance.

This blog post describes some of the mechanics in a bit more detail.

http://selfpaypatient.com/2014/01/03/insured-patients-can-sa...

What I don't understand is when teeth became luxury bones and seeing things became a nice to have. Why again are seeing and eating not considered part of health insurance?

Exactly my experience. I just pay cash for the four cleanings I get a year. It's only $60 per quarter.

You get 4 cleanings a year? Is that typical? My dentist recommends one every 6 months.

Not typical in the US. Dentists won't even suggest it. Parent might be referring to a family of 2.

Yes. I'm paranoid.

Reply on news.ycombinator.com