Thursday, October 22

20 Years With No Dental Checkup: Needs Dental Plan Now for Braces and Tooth Colored Filings. Confused about Aetna and Delta Dental Insurance

Q: I'm self employed, 33 years old, and have not had dental insurance for 20 years! I am looking for supplemental dental insurance. I recently canceled Aetna Dental because they would not allow me to have tooth colored fillings. Can you imagine, they only paid for metal fillings! Who in this day and age still wants metal fillings? I have not been to the dentist since I was 9 and my current dentist said I need 15 cavities filled. I was quoted $140-$200 per tooth colored filling by my dentist. Then recently I purchased Delta dental insurance and am still waiting on my package. My dentist said Delta will pay 50% of the cost of fillings. I would also want braces pretty soon. The cost of braces is $4,500 and I am not yet sure that Delta will pay any part of the cost. So I would mainly need a plan that would cover braces. Is there a plan that can help me with my braces?

J. X., Wichita, KS

A: First off, J. X., Congratulations for being able to stay out of the dentist office for 20 years! Quite a feat. I mostly recommend seeing a dentist regularly, but if you are able to maintain your teeth in good shape just with proper nutrition, brushing and flossing, more power to you! Just make sure you stay away from sugary foods!

Regarding braces, I'm quite sure Delta will not help you with the braces, at least not immediately. As far as I know, their individual plans either don't cover braces or they have a 1-2 year waiting period for braces which makes no sense for you. You need a plan that can help you cover your braces sooner.

Regarding your 15 fillings, you need to look in your documentation for Delta Dental. Their plans have low annual maximums. Typically, the annual maximum would be $1,000 - $1,500 per year at most. So you could have at most 5-6 fillings done. And remember, you need 15.Also, look into the documentation to see if there are waiting periods.

You need a plan that has high annual maximum, or, better, no annual maximum. There are a few out there. I would suggest to go with one of the discount dental plans to either supplement or completely replace Delta. Dental discount plans differ from Delta or Aetna in that they have no waiting periods, no limits on services and, most importantly, they do not dictate you what services you can or can not have done. This decision is left to your dentist and yourself.

So you decide what kind of fillings you want, and how much dental work do you want done at any given time. You will find several companies like Ameriplan, GE Wellness, etc that have large networks of providers. In choosing a discount plan, make sure you have a participating provider close to you. Also make sure they go by the published discount fee schedules.

--Dental Cool

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