I just got a notice from Hawai’i Dental Service telling me my current dental plan is being discontinued because it doesn’t conform to the Affordable Care Act’s requirements. I think that’s a bit of a fudge. According to the American Dental Association dental plans for children are required by the ACA, but plans for adults are not. Nonetheless, HDS is doing this. They’re offering me a new plan which will cost me $43.80, an increase of $14.66 per month.
WHAT?!?
But wait. What’s this? My former plan only covered $600 of expenses at dentists/periodontists in a given year. This new one will cover $1,000. It pays 100% of costs for cleaning twice a year. The old plan paid only 50%. The old plan paid 50% of the costs for crowns or gold restorations, once every seven years. The new plan pays only 30% but places no time limit on them (good thing, since I’ve got a cracked tooth and two crowns already. Who knows when I’ll need another one?).
All in all, the new plan looks like a better deal for the extra $176 per year.
I just did a quick search, and I could find no evidence that the ACA has changed any requirements regarding adult individual dental plans at all.
I could understand them saying this if you had a family plan, that included children, but I was under the impression you do not have any minor children on this plan.
So yeah, I’d say this was some kind of mistake.
My guess is that they just overhauled all their plans, because they had to overhaul their family/children plans because of the ACA… and then just blamed the ACA on their discontinuing plans.
It’s not very honest.
Of course, from what I’ve generally seen, dental plans have never been very wonderful, as far as premium cost vs. coverage. And it seems like many people only find them worthwhile if they’re given as part of their pay as a benefit, at least partially paid by their employer. To buy one yourself on the individual market, you have to have had figured out the financials and realized that you are someone who actually needs enough dental work to make the numbers justify the premiums, copays, & deductibles. So I think most people in your situation will more than likely be, in any given year, to benefit from the better coverage, even though you have to pay a bit more from it.
That’s not to say I think it’s ideal of course. But at the very least, for the average person in the market for that particular plan, it doesn’t sound like it’s going to cost most people more in the long run.
Some years back, I left one job & kept the dental on COBRA even while I had started another job with health insurance benefits. I was allowed to keep the dental on COBRA for the full 18 months because my new job didn’t offer any dental coverage. It was well worth the $22/month I paid, even though it wasn’t a terribly wonderful plan, simply because I was having a lot of dental work. I easily breezed through a $50 deductible, which was not too bad. In the 2 years I was covered under this plan, I had my dentist’s office schedule my dental work to make sure I hit my yearly limit of $1500, but no more, before scheduling the next work after the year restart. I think I hit the yearly limit both years. And at the end of it, when I added everything up, including premium payments, copayments, and coinsurance payments, I found that I had saved over $900 altogether over 2 years. That was more than 2 months rent for me at the time.
Now of course I understand how this works. Clearly the insurance company probably did not make out very well on me. But if they were going to make out on me, I probably wouldn’t have kept the dental on COBRA in the first place. The idea was, of course, that my former co-workers, many who barely used their dental plans provided by the employer, were subsidizing my dental care.
Did I feel bad about that? I think some people think I should’ve felt bad about that.
But the fact is my former co-workers were largely much younger than me. At that company I left, I was the 2nd oldest person in the whole place at the time, and I was only in my 30s. I figure someday those people would be older, and they would be the ones benefiting from some young whippersnapper being on their company’s dental plan but not using it as much as them. It’s just a fact of life with these things.
But of course, insurance companies see it as it’s their job to make sure they make as much money as they can, and paying out as little as they can.
Without laws like COBRA, or requirements that employer plans can’t refuse to cover certain employees… The insurance companies would surely just never sell insurance to people who would actually need it or use it. Seems like a no brainer if your goal is to make money.
The scary part is that people actually think they should be able to refuse insurance to people who actually are likely to use it. Which makes me think that people don’t understand what the heck insurance is about at all.
Like this is a comment I saw on the Healthcare.gov blog comments:
“When profit margins shrivel away for companies in a free enterprise economy, they are left with few options but to reduce operating costs or raise prices on what they sell. The Affordable Healthcare Act fails to address this critical issue. That along with removing the pre-existing condition option, it’s a sure bet that insurance companies will drastically raise their rates to continue making money. This is what happens when you have expanded government.”
They make the case, pretty damningly, that there’s an inherent flaw in for-profit health insurance. But then they somehow think it’s because there’s too much government involvement.
Now I would’ve thought that the purpose of the health care industry, including health insurance companies, would be to facilitate the providing of health care.
But clearly some people don’t see it that way. They believe the purpose of the health care industry is to make profit. Regardless of whether any health care is actually provided or not.
That it’s just another game where people can “get a piece of the action”, on the wave of a desired & needed service.
I often think of great lines from the movie “Nuns on the Run”… Eric Idle’s character says in that movie, all seriously, “Whenever there’s a deep human need, there’s money to be made.”
I should have said that it’s $43.80 because I’m old. 😉
There’s a sliding scale of premiums which increases after five years. If you’re between 21 and 24 it’s $28.40. If you’re between 50 and 54 it’s $37.70.