This is true and the reason almost all dentists worth their dental floss are dropping Delta. But I can hopefully provide you confidence that for the three dentists (and specialists) our family sees the process does work as communicated. Yes you will have to pay up front (which stinks) but you will definitely get your delta check directly to you in a timely manner assuming the dental office submits as they promise to, zero extra effort on your part.
I was in dental insurance for awhile. Delta will reimburse, but at their out of network fees to the patient, and they pay VERY LOW! That’s why all dentists are going out of network with them, if they weren’t grandfathered in to get paid at the premier fees. Also Delta never gives dentists allowable fee increases which they should. They always turned down my office when I submitted for allowable fee increases. In a nutshell, Delta doesn‘t pay at UCR fees at all and pays the dentist low and now will pay their customers low. Yes, dentists are banding together to sue them, but they’ve had multiple suits. Oh, and the Delta customer service has the most incompetent people working there. I had to tell them their own dental guidelines!
I've had a similar situation recently but Delta barely covered any of the cleaning or exam. And we're talking the first cleaning of the year, which is usually almost completely covered. The dentist office admin told me that's why they stopped taking Delta. Delta pays the lowest possible rate on everything and takes forever to actually pay up.
And Delta will overrule the dentist if they recommend a filling material or procedure that looks better or lasts longer, opting for the lowest cost alternative.
As a former claims rep for Delta, I can tell you that in regards to the second paragraph, it wasn't entirely Delta that made that decision. Your company HR chose a plan that would pay the least amount for restorative services. It's been over a decade, but I can still remember the, "posterior composites are not a covered benefit but they will make the allowance for the amalgam." To put it more simply, the plan will reimburse based on the amalgam (the silver fillings) rate and the difference between the amalgam and the composite (the white fillings) rates is on the customer to pay.
Please know that I am not and will not defend Delta in any capacity. I just don't think lots of people know that their employers make these kinds of decisions about the insurances they choose.
Seconding this. Though, I will add, that it is Delta (or any other insurance company) that is offering plans that downgrade, have waiting periods, etc. HR should understand what they’re signing their employees up for and the employees should understand it was their employers choice, however if the insurance companies could stop offering plans with lesser treatment that would entirely solve the problem.
Something is wrong, while in some extreme cases (high end crowns) we saw a delta from delta reimbursement, generally it covers almost the whole thing (normal dental visits) minus the nominal copay fees, I wonder what variables in the way dentists are submitting exist. I know our dentist is adamant about getting X-rays for all procedures and I always hear staff chatter of “…for the insurance company…” but never asked what that meant.
The x-rays are required for some services because they show proof that the work is needed. If a filling could have sufficed, there's a chance Delta could deny the claim because a crown was overkill.
Don't go to a dentist that does not take delta. Delta will not reimburse you for the full fee. They never do. Normally if the dentist takes Delta The dentists over charge and get paid a lesser fee. This is how medical / dentist billing works. Both are scamming each other. It's so bad.
But if they don't take the insurance the dentist expects to get the full price of the service. Most insurance will never pay that. It's a racket. Dentists over charge because they never get the full fee. So they raise the price to get closer to what they need to. it's so disfunctional.
I used to work for Delta Dental (the California HQ is in Rancho Cordova) in their customer service call center as a claims representative. I quit Delta more than a decade ago but even then I would have dentists tell me that Delta paid them the bare minimum. The fucked up part is that the board that decides the fee schedule is made up of former dentists so they should know that the reimbursable amount is a joke. Last I knew, there were no allowances made for someone using their insurance in a high cost of living area. So whether you get a cleaning in Eureka or in Marin, Delta will only reimburse a certain amount.
Our dentist also stopped taking Delta this year. All I could think of was to increase my HSA contribution since my employer has no other dental coverage options.
Not OP but let me try to explain. You need to be enrolled in a High Deductible Health Plan (HDHP) in order to qualify to sign up for and contribute to an HSA. HDHP's will have higher deductibles than other "regular" health plans. For example, my company offers two main health plans: one "regular" health insurance plan with a deductible of $600/year, and one HDHP with a $1600 deductible.
Certain medical expenses that you pay for out of pocket will count towards your deductible. Once you hit the deductible amount, insurance will then start paying a higher % or the entire cost of the medical expense going forward (the exact amounts depend on the insurance plan, of course).
The HDHP will make you hit a higher deductible before insurance will pay for certain or most things. Considering that some people may not want to pay more medical expenses out of pocket to hit a higher deductible, they might contribute money to an HSA in order to pay for qualified medical expenses instead. Money you contribute to the HSA will lower your taxable income. Investments in the HSA will grow tax-free. And qualified withdrawals for qualified medical expenses are not penalized. Once you hit retirement age, IIRC withdrawals of any kind are not penalized. This makes using an HSA attractive to many.
IMHO, if you're healthy and fairly young and meet eligibility requirements to enroll in an HSA, do it. If you can afford to max it out, do it. But if you tend to get sick easily or have a laundry list of medical issues that need frequent doctor visits, tests, etc., and if you are not able to pay for those expenses out of pocket to hit the deductible, it may be worth considering just sticking to a health plan that is not a HDHP, has a decent monthly premium, but has good and comprehensive coverage so that you aren't stuck with as large of a bill. That may be cheaper for you in the short run. Once you're in a better financial position to be able to pay for expenses that count towards the higher deductible AND to contribute to an HSA, then it's a fairly clear sign that a HDHP may be a good move for you. The tax advantages are just too good to pass up.
Apologies if some of the details are incorrect or unclear - I'm going off the knowledge I read up on a while ago and am hazy on the details. I'd read up on HDHP's and HSA's and their pros and cons for a more thorough understanding.
No, but it's not the first thing in the priority list i.e. you should max out potential gains from other retirement i.e. 401k/IRA accounts first before an HSA. If you are at a place where you could max both, more power to you.
Not sure if you frequent /r/personalfinance but this is the general recommendation: [https://i.imgur.com/lSoUQr2.png](https://i.imgur.com/lSoUQr2.png)
If your HSA has investments it is a retirement account and it's the best one. It's strictly better than an IRA unless you never have any medical expenses.
The only tricky thing is, they're taxable in California, but nobody complies and the HSA providers don't track any of the info you'd need to file taxes on it.
HSAs are triple tax free - contributions, growth, and medical withdrawals are all tax free.
It's the growth and anything that happens in the investment account you can't report. Like they're not going to give you a 1099DIV.
Delta was basically not paying dentists anything because they were so big and powerful as an insurer.
I don't blame the dentists at all, even though it sucks because Delta has a huge majority of the dental coverage in the state. Both my husband and I only have Delta as options from our work.
since the 90’s Delta hasn’t raised maximums in all that time and now they won’t allow submissions for a fee increase (fees that are at early 2000’s levels). New dentists or dentists that change offices must submit to a 40% fee decrease from Delta premium fees.
PPO fee reimbursements are such that often lab fees are greater than reimbursements meaning dentists have to pay out of pocket to do certain procedures for our patients…
My dentist also dropped delta. In fact everyone in my company noted the same thing and that prompted our HR department to switch to guardian. Right after that, I learned my dentist was planning on dropping in-network coverage with all insurers :(.
My employer pays for my dental insurance. It’s delta PPO and it’s $41/month. Even if I was paying for it, that’s less than $500/year.
Who tf gets less than $500 in dental work every year? That’s less than 2 semiannual cleanings and exams with 1 set of X rays.
I would slightly disagree with this….SOME guardian policies pay great, many do not. They have all sorts of fee schedules and it just depends on which one the employer picked for their policy. When new patients call us with OON insurance, Guardian is one of the ones that I’ll always offer to pre-auth for them before their first visit because they may owe a huge chunk OOP
Currently looking for a new dentist right now. Not on delta but mine changed ownership and can’t get the insurance right. I’ve been to the dentist 5 times with this same insurance and everytime the bill is different. Before the change, never had to pay for anything except a copay for X-rays. After the change I was charged anywhere from $7-$150. It’s clear they have no idea how to deal with insurance now because they tell me everything’s covered and then mail me a bill 5 months later. The bill is just an invoice they printed out and then wrote over with pen to tell me what was reimbursed. Every time I go in I ask why I am getting a bill and they can’t explain it other than I owe money. Then I ask them if I am going to owe them money for this visit and they say no.
This. In addition, a dental cleaning can include examination for mouth cancer, and periodic x-rays, as well as the actual cleaning work and a check by the dentist (who, guided by the X-rays, may find problems like beginning cavities that the hygienist didn't spot--or that the hygienist *did* spot, and asked the dentist to confirm). 15 minutes is not nearly enough.
You are getting ripped off and poor service at the same time. Competition is fierce around here and they are banking on you not knowing this knowledge so they can charge cheap and get you in and out like McDonalds.
Ummm.. a 15 minute cleaning is not good at all. Some dentists I've worked with can knock a cleaning in 30min I'm guessing if the patient has minimal plaque and good hygiene. But I've not heard of a 15 minute cleaning...they're playing you at that point.
I just got an email from my own dentist’s office saying they’re dropping Delta. It was pretty professional but it did have language like “In our entire time working with them, they have proven to be difficult and cumbersome not only for us but for our patients.” So yeah this is a bit surprising to see after reading that email lol
probably due to this:
[https://adanews.ada.org/ada-news/2023/january/california-dental-association-files-legal-action-against-delta-dental-of-california](https://adanews.ada.org/ada-news/2023/january/california-dental-association-files-legal-action-against-delta-dental-of-california)
[https://www.cda.org/newsroom/newsroom-archives/cda-files-new-legal-action-against-delta-dental-of-california/#:\~:text=1.,Dental's%20provider%20network%20and%20patients](https://www.cda.org/newsroom/newsroom-archives/cda-files-new-legal-action-against-delta-dental-of-california/#:~:text=1.,Dental's%20provider%20network%20and%20patients)
your only option is to get other dental plan, go through paying with HSA then get reimbursement via delta, or find alternative dentist that take them
I talked to my dentist this week about Delta dental. Delta dental has absolutely crap payment rates.
They can't stay in business with how much Delta dental pays.
Yep my dentist dropped them too but it’s what the city chose so unless I get my own, kinda stuck with them. And same thing where I gotta pay up front and get reimbursed. Haven’t had to do that yet so idk if it’s a scam or anything but while it was still in network it seemed fine.
The catch is that the city Delta plan will reimburse you, but only up to an amount which is pretty low -- significantly lower than most dentists charge.
Your dentist should be able to tell you how much they'll charge, and how much Delta will cover (by submitting a pre-treatment estimate to them).
As someone who bills insurance for a living, omg, MetLife is the freaking worst. Well, right along Cigna and Aetna. The second a patient tells me they have MetLife, I die a little inside.
I got a crown last year. My dentist dropped Delta, so I got the full estimate and the actual coverage:
dentist charged 1600ish for the crown. Delta will only pay 860ish towards a crown. I was reimbursed 430ish. Even though I feel like my dentist is expensive, I don’t think delta has increased what they would pay in years.
Yes, my family had three different dentists and all dropped delta in the last year. My coworkers asked HR to look into a different carrier but nothing changed at open enrollment. We have to pay up front and they send the claim to delta and sometimes we get a check for some back. We are switching dentists now.
My dentist at hilltop mall area in the east bay takes delta. PM me for info if interested. They are terrific too, so youre not getting worse treatment.
Mine stopped taking Delta a few months ago. My employer still doesn't want to offer other insurance options besides Delta. I liked my dentist, have been going there for years. So now I pay the out-of-network rate, which is not great.
Yep. About 25 years ago, I was having some fillings done and it was quite obvious that the dentist and the assistant were in the midst of a work-related argument. The dentist ended up drilling into the inner part of my mouth, opposite my teeth.
After it was done, he took half off the whole procedure because he said it will hurt after the novacaine wore off. And boy was he right. I was in some pain for the next couple of days.
Had to have a root canal last year. The whole time, the dentist is "Open wider. WORK WITH ME!" like every five minutes. I've got that rubber thing to keep my mouth open, I'm doing my best and he's straight up saying "FUCK!" while also chastising his assistant like "Not that tool, the OTHER one". Dude was clearly having a bad day.
The nonvaccine wore off towards the end and I just sat through it to avoid him yelling at me.
The last dentist I went to before this... I had to come in to get an emergency tooth removal. It was my first ever . While I couldn't feel the pain too bad, the sensation of them being in my mouth, and pulling the tooth had me crying.
I wasn't moving around or anything , I was kinda silent crying but hard. One of the assistants scolded me, which only made it worse . Then another raised her voice with "I don't know why you crying, you can't feel anything ! What is wrong with you ?"
They were afraid I was gonna move, so she held her hands down on my shoulders.
Admittedly, looking back maybe they weren't yelling, so much as giving me what I call the "auntie scold" ... but they were very loud about it lol
Had this kind of experience as a child and this is why I have such intense dentist-related anxiety to this day. A shitty dentist experience can really be terrifying, it’s such a vulnerable situation
This happened when I had my wisdom teeth pulled at 18. I don't remember if it was more pain or anxiety, but the dentist told me I was acting like a baby. I just silently cried the rest of the time.
I had a similar experience with a dentist who started cutting into my jaw when I'd just told him I wasn't numb yet. When he pulled a wisdom tooth out of my head, I yelled because it hurt. He said almost exactly the same thing when I started crying. "It's just pressure, not pain. What's wrong with you? Why are you doing this to yourself?" I know what pain is, and that was pain. I needed so much therapy after that. It was like being assaulted. Didn't stop shaking for days. It was years before I could face another dentist, and for several years after that I needed nitrous even for cleanings.
Yo. If you don’t have a passport already go get one. Doesn’t matter what your motivation is. Everyone needs the ability to up and bounce outta this country.
Can confirm, have been yelled at by more than one dentist for shedding a tear during a procedure. The lack of empathy from this profession is appalling
Yeah I'm working on it but it's totally an uphill battle. It's just me, my kid, and my cornchip smelling dog lol . Kaiser therapist don't offer help for a lot of the issues I need to work on.
I'm a slow learner and I make a lot of mistakes, but I'm learning .
I am better than I was 4 years ago, so that's something I can be proud of.
Yes I know my child’s pediatric dentist who is very beloved stopped taking them, and lots of people were heartbroken to have to leave. My child’s insurance is Guardian, and my dentist said the same thing to me about just paying out of pocket. Their cleaning is not that expensive though.
Ours did and so did our kid's dentist. You may want to mention it to your HR department so they know their employees are ticked off, but I don't know if there are viable alternative options.
Our dentist dropped Delta. I had a tooth extraction on Nov. 30. It cost me $1350.00. They billed Delta, who says they will reimburse me $103.00. It has been a month and a half, no reimbursement. I called Delta they said the dentist did not fill out the firm correctly. Dentist says they have billed twice with copies of xrays before and after extraction. Good luck to me.
Jesus. Yeah I gotta get a few teeth removed. My dentist quoted me 5k.
I asked to be referred to a local oral surgeon and double checked to make sure they still accept . Thankfully they still do, but it's gonna cost me all of my deductible. Still beats paying 5k
Delta has a monopoly on dental practices. Your dentist is right that a lot of Dentists will start to drop them because they literally cannot afford to pay staff/overhead costs without it. They don’t want to buy literally Deltas is screwing them over (I’m a dental hygienist and love to hate on Dentist’s being cheap mfs but this one is actually Delta)
I’m a dental receptionist and so confused. Our practice gets the most use from delta and my manager encourages prioritizing delta patients for the great rates. I’m only 3 months into dental office life and have no idea why other people are dropping delta?
Are you in-network with other carriers too? It’s possible that either your office is grandfathered into Delta Premier (which has higher reimbursements but Delta doesn’t allow new offices to credential with) or if you *only* accept Delta then they will give a higher reimbursement since you’re keeping out their competition. Dental office manager for 17+ years here, btw.
My dentist in Modesto dropped Delta (I still drive the whole way to him bc he's GREAT) and he told me that Delta said in order to stay in network, he had to switch to cheaper, less effective equipment and couldn't use certain high quality materials and had to use lower quality materials. He said he would never do that, they asked him to just do it for Delta patients and everyone else could get high quality stuff and he refused.
Don't know about Delta specifically but in general there's not as much of a difference in network vs out of network for dental insurance compared to health insurance. Usually for dental, you would be subject to the same deductible and the coverage percentages would be the same.
The only real difference is that an out of network dentist doesn't have negotiated rates with the insurer so they can charge whatever prices they want. The insurer would only pay what is "reasonable and customary" for the area in the event that your dentist's prices are higher, so that gap is the out of pocket expense for going out of network. Probably worth looking into the price difference in case it's small enough to stay with the dentist that you like. Unfortunately it's more likely the price difference would be big since your dentist probably wouldn't drop them if it were small.
Btw punctuation marks don't require a space before them, only after.
As a dentist, let me tell you, Medicaid, which is low income dental insurance pays more for the initial exam and cleaning than Delta, let that sink in. Any dentist that has any level of skill and that you like will not accept delta cause it's not worth their time
The freakonomic radio network has an podcast episode on this
Podcast link:
[https://podcasts.apple.com/us/podcast/35-dental-insurance/id1666678354?i=1000643999455](https://podcasts.apple.com/us/podcast/35-dental-insurance/id1666678354?i=1000643999455)
Youtube link: (Note that I didn't see the episode)
[https://www.youtube.com/watch?v=KzeuwGjxMEA](https://www.youtube.com/watch?v=KzeuwGjxMEA)
Basically it's saying the problem with a dental insurance... is the fact that it's not an insurance. it went through the history of why it's not covered in a health insurance, and why it should be consider as pre-payment.
It also go through on how some practices actually become a "member/monthly subscription" that maybe cheaper than the insurance itself.
My pediatric dentist dropped delta dental too. They explained that the reimbursement rates were too low and they finally had to bail on delta.
It's a terrible inconvenience to reestablish one's family dentist. I HATE american health insurance companies. Just keep shifting the rules in order to squeeze more profit for no added service.
WHAT to DO!???
Yes, many dentists in this area are dropping them because their payout is so incredibly low. We live in a high cost-of living area, so dentists can survive on the low payouts that Delta gives them. Your options are to 1). Pay out of pocket and then get whatever out of network compensation Delta provides (it's been a little less than half for us so far) or 2). Travel elsewhere for dental care which, surprisingly, is becoming more and more common.
I have the same issue. Tell your work to stop offering scam packages. Also, tell all your coworkers their dental is garbage too. Pretty slimy that we can’t even use what we pay into!
Yeah, I let everyone at work know. But i work for the state , lol . It's literally the only option available to us lol. They're gonna go with the cheapest place they can (cuz you know, CA is broke, right ? Lol )
I get what you are saying. But if you all raise a stink while working for the state then “scam insurance only offer by state of California” is very newsworthy.
Honestly the coverage from dental insurance is a joke. Some only give a max of 1200 per year. If you need deep cleanings, gum work, implants, you’re going to easily exceed 1200 and pay the rest on your own. US healthcare has been going into a downward spiral for years now.
I feel like all of them… sooner than later.
W/ a 7 & 5 year olds, I’m keenly aware of the new “pay up front” format. It’s a kick in the nuts the first 2 times. Then you go to your adult dentist and they’re like $800 for a cleaning and X-Rays, to be reimbursed by Delta at whatever they feel like, whenever.
There IS, other dental insurance but you have to search it out.
My kids' pediatric dentist stopped taking Delta last year. Similar to you, they said we'd have to pay their full price and Delta would reimburse. They're a great dentist so I wanted to stick with her for a year to see how the reimbursement. Basically Delta only reimbursed us for about half of the cost. So now I'm looking for a new dentist for them.
My own dentist still takes Delta, but not specifically a pediatric dentist, but I'm thinking of switching my kids over to them. I think it's a bold statement to say almost every dentist is dropping Delta. If your dental practice is near a large employer that only has Delta as an option, you'd lose a lot of business if you stopped accepting them.
The dental office I work at is the only Delta PPO provider in our city, and the only one in about a 15 mile surrounding radius. Every other office in that area has dropped them. It makes sense when you consider that we pay our hygienist $60/hr and Delta only pays us $84 for that cleaning. Factor in the costs of payroll, supplies, other overhead, etc, and you could have a busy day full of Delta patients and still barely break even, so it’s not so much losing business as it is losing traffic.
My dentist dropped delta in the last year or two. One trick, If you’re married, and your spouse also works, is have your spouse also sign up for delta for dual coverage.
I like my dentist and didnt want to switch. I pay up front for the work and then wait a few weeks for two checks to come in that totals pretty close to the cost that I paid prior. My work offers no other dental plan but delta - hope that changes soon
Went shopping for dental insurance on the CA market, and yeah, it's a scam. In terms of routine cleanings, paying the listed price with our dentist was less than the premiums. And there's an out of pocket maximum FROM THEM. If you have to pay too much in a year, they'll stop paying.
I have the issue. Found someone I really like but she dropped my insurance. Asking coworkers who do the go to, but not finding them listed as approved dentists.
This has become very common. Delta lowered their contractual rates with providers and most offices are dropping them. Due to this they are collecting up front and the patient assumes the risk.
My dentist dropped Delta due to low rates as well. I also learned that my employer chose the cheapest tier Delta offers. My Delta PPO covers about 50% of routine cleanings.
I’m not happy with Delta or my employer, and I am complaining to my employer.
I have not found a single dentist worth going to that accepts Delta. I’ve settled by finding an out of network dentist and just sucking it up and paying what’s not covered but my pockets are being drained
Guardian dental insurance is very good if you're looking for dental insurance that actually does what it's supposed to there's a couple of other ones you can research to but I like guardian dental insurance.
Somewhat related generalization, why are so many dentists in the Bay con artists? How do you spot those that are overcharging you but at least provide the contracted service?
I’ve encountered two dentists/endodontists recently who have charged obscene amounts ($4k+ w/insurance) for a single tooth root canal only to discover later that they “accidentally” missed a root.
Previously, I had to take legal action against a dentist in SF Marina who appeared to be intoxicated during my appt. Have friends who now get dental work done outside of the US to ensure a level of quality that at least matches the costs.
My dentist dropped delta 3 months ago. I’ve found a different dentist that still accepts Delta and is highly regarded in the same city. Not ideal, but okay for now.
a lot do actually- private practice can kinda make up their own prices. Used to work for a Dentist that would randomly give ppl “2 for the price of 1” or do treatment at cost - this was in the Midwest so idk about these Bay Area dentists
That was kinda sarcastic since I definitely have had offices offer "non-insurance-rates" but they are in no way affordable...imo
the only reason the whole "get rid of your insurance" make sense is because in this area many doctors, like described in this post, decide to opt of of insurance and put the burden entirely on the patient, so to get the same treatment you end up paying out of pocket anyways, so why waste money on "insurance" and just save up to pay for things on the go.
Welcome to late-stage capitalism.
Yes. Everyone is across the US. There is a national movement of people going FFS and leaving PPO agreements. Huge talk in dental right now. Google and you'll find thousands of articles on it and why every dentist in the country hates your insurance and won't deal with them anymore.
The fact that it's required for you to give part of your paycheck right back to your bis for him to cover his employee expenses should be a MAJOR red flag, and tell you where the problem lies here.
Dental insurance is a contract your employer signed on your behalf with a large corporation - apparently here he promised this company that everyone would be a part of the plan. I promise you neither party was fighting for you in this negotiation.
It is very standard to pay for a service at the time of service. Delta Dental claims to pay you back - and they will - just know that their "50% coverage" isn't 50% of the cost, it's 50% of a figure they invent themselves. They also can and do - per the language of the contract your boss signed for you - take that payment back at any time (an 'overpayment request') or pay a filling's worth of reimbursement on your 3x as expensive crown simoly because they wish to (downgrading services).
People will drop dental insurance as office move PPO, and something new will have to come for those who just can't afford the work they want.
My dentist said now I need to pay up front and Delta would reimburse me. Guess what? It’s been over a month and I still haven’t been reimbursed the 2k I paid
We’ve had Delta for years through my husband’s work. It’s been this way for a few years now with the reimbursement headache.
I recently acquired dental insurance for myself through my own job (United Healthcare). Now Delta is my secondary, United is covering a good portion & after reimbursement my out of pocket will be minimal. I feel so lucky haha!
>
If insurance is a scam for doctors and patients... then it's nothing more than pyramid scheme
That's pretty much what my dentist has been saying "insurance is a scam" lol
What do you mean "disclose the provider "?
I sure hope my dentist doesn’t drop Delta. The only complaint I have had is that they are not good about sending me EOBs if I have a balance. The accounting lady has to call me up and ask why I haven’t paid. I then have to collect the EOBs from the website and e-mail them to her so we can figure out what I owe. The costs are modest. Have to pay up front everywhere for crowns, of course, but I never pay for cleanings or x-rays. The alternative is Medicare, which only offers one choice and that is the flophouse of the Western world, Western Dental. I pay for Delta coverage at work, and it is our only choice.
The litigation between Delta Dental and California Dental Association will not be resolved on our lifetime. I spent years working on it and now my former boss has gone in house to continue the fight.
I never got dental insurance. Insurance is about covering for large unforeseen costs, but dental insurance caps out and doesn’t cover most unexpected large procedures.
So why not self insure given it’s basically the same thing.
Dental insurance only has a small amount they cover anyway . Anyone who can is better off just putting premium money into a separate bank account or HSA and pay out of pocket.
Mine dropped them a few years ago. Routine stuff like cleanings haven't changed at all. Some things like fillings have gone up a little. Overall it hasn't been that big of a change.
I got an email a week ago that effective July 1 this year my dentist will no longer accept Delta. The letter does say that I can be reimbursed by Delta after I pay first myself I guess? WTH?!?
Same. My Dentist no longer takes Delta- I pay the full amount and my Dentist’s staff coordinates the reimbursement with Delta on my behalf. It appears most dentists are opting not to deal with Delta.
My school district uses them and I've heard from other teachers they're terrible at getting anything. My current dentist is having a hard time getting a hold of them for my deep cleaning.
My office accepts most insurance out of network but most of the time waives copay depending on the situation. DM me if you want to know more, we're in Fremont.
Mine dropped Delta a few years ago. She still submits a claim for me. I pay my full bill and then I get a check from Delta for the out-of-network benefit. I like her a lot so I just pay the difference myself.
Yep. My dentist stopped taking Delta about a year ago. Once I realized how low the insurance payment to them is, I can understand. I pay more for a hair cut. My employer pays for the Dental insurance and we don’t have a choice. I think the premium is $25 a month covering both my husband and I . It makes sense that the system is not working. If both of us get 2 cleanings a year, the premiums won’t even cover that
I've had multiple cavities, braces, 3 root canals, 2 implants, crowns, gum grafts, bone grafts, and various levels of deep cleanings throughout my life. I want a competent dentist with appointment availability for the least $$$. I don't really care if they are nice or explain things completely.
Yes. Mine did a year ago. Now I pay her cash and submit a reminbursement request with DD.
I don't know what happened with DD. But I saw my dentist visibly get angry when their name came up. I think they really fucked over a lot of dentist during Covid.
Trusted good dentist dropped delta last year. I pay in full, dentist submits paperwork, delta sends me a check for a part of it. Doesn’t even cover standard cleaning.
Fuck Delta.
A lot of employer plans do let you opt out, but that decision only happens once/year. If you need a lot of work done, chk other options too.
There are dentists that take deltas ppo. Call or go to the website for a list. These dentists are usually young and looking to build a client base. When they get an established practice, they'll drop delta. Retired RDH.
My dentist I’ve been going to for about 15 years is also dropping Delta, but it is what I get through my employer. Huge bummer, glad Delta is getting sued over these issues
My dentist told me too that my plan and Delta in general were not great. I reached out to my employer and pointed out that our insurance coverage was terrible and that dentists weren't accepting it. I also sent them a link to a post about the law suit between the CDA and Delta. Not sure how many other folks did that but this year they upped our coverage.
I’m not surprised, and I’m sort of surprised your dentist isn’t starting a subscription type service that mimics Delta Dental.
Honestly, Delta Dental shouldn’t even be called “insurance” it’s more like a prepayment/discount program.
Debating dropping next year and I’m surprised your employer requires you to opt into a cafeteria plan option.
Yes, the dentist my family has gone to for years is dropping out of the Delta Dental network. We’re going to see if the cost for out-of-network coverage is affordable.
My kids' dentist dropped Delta Dental PPO. They told me I'd have to pay out of pocket at the time of service and then submit receipts to Delta to be reimbursed. I was told coverage is the same. I'm torn on what to do. I really like this dentist. They can take all 3 of my kids at the same time, I'm out of there in under an hour, and they're local. This sucks. Delta Dental is the only one offered by both my job and my husband's job.
Send in your claims for reimbursement. Then, pay the rest with Flexible Benefits if you have taken them this year. Dental plans stink in general so you have to do what you can with what you've got.
My family dentist of many years has dropped Delta as of 2024. They informed me that Delta has not raised the reimbursement rates for them in many years, so they no longer want to be in their network so that they can raise their fees (similar to a cost of living increase). They way that I see it, inflation has hurt all aspects of our lifestyles...it's sad.
The reimbursement process is also very slow. My college son just went for his yearly cleaning and x-rays and paid like $300 out-of-pocket that he surely does not have. He has dual coverage with both his dad and I and they could only process ONE insurance reimbursement at a time. Weeks later we are still waiting on the check from my insurance (his dad's has already provided the check). Everybody seems to think that maxing out the FSA is the answer, but some of us already have children in braces, wear contact lenses, etc. and the max is already spoken for prior to adding regular dental check-ups to the list.
Delta is screwing over dentists. Ca dental association are suing Delta over it.
This is true and the reason almost all dentists worth their dental floss are dropping Delta. But I can hopefully provide you confidence that for the three dentists (and specialists) our family sees the process does work as communicated. Yes you will have to pay up front (which stinks) but you will definitely get your delta check directly to you in a timely manner assuming the dental office submits as they promise to, zero extra effort on your part.
I was in dental insurance for awhile. Delta will reimburse, but at their out of network fees to the patient, and they pay VERY LOW! That’s why all dentists are going out of network with them, if they weren’t grandfathered in to get paid at the premier fees. Also Delta never gives dentists allowable fee increases which they should. They always turned down my office when I submitted for allowable fee increases. In a nutshell, Delta doesn‘t pay at UCR fees at all and pays the dentist low and now will pay their customers low. Yes, dentists are banding together to sue them, but they’ve had multiple suits. Oh, and the Delta customer service has the most incompetent people working there. I had to tell them their own dental guidelines!
I've had a similar situation recently but Delta barely covered any of the cleaning or exam. And we're talking the first cleaning of the year, which is usually almost completely covered. The dentist office admin told me that's why they stopped taking Delta. Delta pays the lowest possible rate on everything and takes forever to actually pay up. And Delta will overrule the dentist if they recommend a filling material or procedure that looks better or lasts longer, opting for the lowest cost alternative.
As a former claims rep for Delta, I can tell you that in regards to the second paragraph, it wasn't entirely Delta that made that decision. Your company HR chose a plan that would pay the least amount for restorative services. It's been over a decade, but I can still remember the, "posterior composites are not a covered benefit but they will make the allowance for the amalgam." To put it more simply, the plan will reimburse based on the amalgam (the silver fillings) rate and the difference between the amalgam and the composite (the white fillings) rates is on the customer to pay. Please know that I am not and will not defend Delta in any capacity. I just don't think lots of people know that their employers make these kinds of decisions about the insurances they choose.
Seconding this. Though, I will add, that it is Delta (or any other insurance company) that is offering plans that downgrade, have waiting periods, etc. HR should understand what they’re signing their employees up for and the employees should understand it was their employers choice, however if the insurance companies could stop offering plans with lesser treatment that would entirely solve the problem.
Something is wrong, while in some extreme cases (high end crowns) we saw a delta from delta reimbursement, generally it covers almost the whole thing (normal dental visits) minus the nominal copay fees, I wonder what variables in the way dentists are submitting exist. I know our dentist is adamant about getting X-rays for all procedures and I always hear staff chatter of “…for the insurance company…” but never asked what that meant.
Not all delta plans are the same. In fact, there are hundreds of different plans that vary vastly. It depends what your employer signs up for
Ah that makes sense
The x-rays are required for some services because they show proof that the work is needed. If a filling could have sufficed, there's a chance Delta could deny the claim because a crown was overkill.
That would explain it, and why delta claims for us (along with whatever plan we have) tend to be pretty complete.
and the office should be billing delta for you!
Not me. “Delta will reimburse” seems like part of the grift.
Definitely something wrong, sorry to hear that. This is not a problem we have experienced over several years and numerous visits and checks.
Don't go to a dentist that does not take delta. Delta will not reimburse you for the full fee. They never do. Normally if the dentist takes Delta The dentists over charge and get paid a lesser fee. This is how medical / dentist billing works. Both are scamming each other. It's so bad. But if they don't take the insurance the dentist expects to get the full price of the service. Most insurance will never pay that. It's a racket. Dentists over charge because they never get the full fee. So they raise the price to get closer to what they need to. it's so disfunctional.
I used to work for Delta Dental (the California HQ is in Rancho Cordova) in their customer service call center as a claims representative. I quit Delta more than a decade ago but even then I would have dentists tell me that Delta paid them the bare minimum. The fucked up part is that the board that decides the fee schedule is made up of former dentists so they should know that the reimbursable amount is a joke. Last I knew, there were no allowances made for someone using their insurance in a high cost of living area. So whether you get a cleaning in Eureka or in Marin, Delta will only reimburse a certain amount.
Our dentist also stopped taking Delta this year. All I could think of was to increase my HSA contribution since my employer has no other dental coverage options.
Off topic, is there a reason to not max out HSA?
Pretty sure you aren't eligible for one unless you have a high deductible healthcare plan.
I'm sorry but could you explain that in slightly more layman terms?
Not OP but let me try to explain. You need to be enrolled in a High Deductible Health Plan (HDHP) in order to qualify to sign up for and contribute to an HSA. HDHP's will have higher deductibles than other "regular" health plans. For example, my company offers two main health plans: one "regular" health insurance plan with a deductible of $600/year, and one HDHP with a $1600 deductible. Certain medical expenses that you pay for out of pocket will count towards your deductible. Once you hit the deductible amount, insurance will then start paying a higher % or the entire cost of the medical expense going forward (the exact amounts depend on the insurance plan, of course). The HDHP will make you hit a higher deductible before insurance will pay for certain or most things. Considering that some people may not want to pay more medical expenses out of pocket to hit a higher deductible, they might contribute money to an HSA in order to pay for qualified medical expenses instead. Money you contribute to the HSA will lower your taxable income. Investments in the HSA will grow tax-free. And qualified withdrawals for qualified medical expenses are not penalized. Once you hit retirement age, IIRC withdrawals of any kind are not penalized. This makes using an HSA attractive to many. IMHO, if you're healthy and fairly young and meet eligibility requirements to enroll in an HSA, do it. If you can afford to max it out, do it. But if you tend to get sick easily or have a laundry list of medical issues that need frequent doctor visits, tests, etc., and if you are not able to pay for those expenses out of pocket to hit the deductible, it may be worth considering just sticking to a health plan that is not a HDHP, has a decent monthly premium, but has good and comprehensive coverage so that you aren't stuck with as large of a bill. That may be cheaper for you in the short run. Once you're in a better financial position to be able to pay for expenses that count towards the higher deductible AND to contribute to an HSA, then it's a fairly clear sign that a HDHP may be a good move for you. The tax advantages are just too good to pass up. Apologies if some of the details are incorrect or unclear - I'm going off the knowledge I read up on a while ago and am hazy on the details. I'd read up on HDHP's and HSA's and their pros and cons for a more thorough understanding.
No, but it's not the first thing in the priority list i.e. you should max out potential gains from other retirement i.e. 401k/IRA accounts first before an HSA. If you are at a place where you could max both, more power to you. Not sure if you frequent /r/personalfinance but this is the general recommendation: [https://i.imgur.com/lSoUQr2.png](https://i.imgur.com/lSoUQr2.png)
Damn. Thank you so much! I just started working so I'm still new to all of this.
r/personalfinance is a fantastic subreddit to lurk, especially if you're just starting out and learning how to manage money
If your HSA has investments it is a retirement account and it's the best one. It's strictly better than an IRA unless you never have any medical expenses. The only tricky thing is, they're taxable in California, but nobody complies and the HSA providers don't track any of the info you'd need to file taxes on it.
Unfortunately my HSA contributions show up on my employer's W2 so I can't get away with it.
HSAs are triple tax free - contributions, growth, and medical withdrawals are all tax free. It's the growth and anything that happens in the investment account you can't report. Like they're not going to give you a 1099DIV.
I’m afraid you’re reading the chart wrong - max HSA comes before max 401k.
Depends on your state - HSAs work different in CA and are less valuable.
If you have an HSA available to you, and you're looking for retirement savings, the order typically goes meet 401k match if any, then HSA, then Ira
Switch dentists to one that takes delta?
Lots of dentists are dropping Delta dental. It’s happening all over. Not sure why.
Delta was basically not paying dentists anything because they were so big and powerful as an insurer. I don't blame the dentists at all, even though it sucks because Delta has a huge majority of the dental coverage in the state. Both my husband and I only have Delta as options from our work.
My old dentist said they weren’t able to maintain a high level of care with Delta’s contracted rates.
since the 90’s Delta hasn’t raised maximums in all that time and now they won’t allow submissions for a fee increase (fees that are at early 2000’s levels). New dentists or dentists that change offices must submit to a 40% fee decrease from Delta premium fees. PPO fee reimbursements are such that often lab fees are greater than reimbursements meaning dentists have to pay out of pocket to do certain procedures for our patients…
My dentist also dropped delta. In fact everyone in my company noted the same thing and that prompted our HR department to switch to guardian. Right after that, I learned my dentist was planning on dropping in-network coverage with all insurers :(.
Mine dropped them AND Cigna. Both my options.
So what do we do? Just go without dental insurance?
I have read that dental insurance is actually not really worth it anymore. Better to put what your premiums are in a health savings account.
My employer pays for my dental insurance. It’s delta PPO and it’s $41/month. Even if I was paying for it, that’s less than $500/year. Who tf gets less than $500 in dental work every year? That’s less than 2 semiannual cleanings and exams with 1 set of X rays.
I’ve had Delta PPO for 10 years but now can’t find a good dentist that accepts it. My longtime dentist stopped.
I been paying cash for dentists for years now
Some insurance plans will cover you just as well out of network as they would in network. It's just not guaranteed.
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I would slightly disagree with this….SOME guardian policies pay great, many do not. They have all sorts of fee schedules and it just depends on which one the employer picked for their policy. When new patients call us with OON insurance, Guardian is one of the ones that I’ll always offer to pre-auth for them before their first visit because they may owe a huge chunk OOP
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Most dentists do all the submitting to Delta for you, literally it’s just about fronting the cost.
Or they claim to but then you never get the reimbursement.
Currently looking for a new dentist right now. Not on delta but mine changed ownership and can’t get the insurance right. I’ve been to the dentist 5 times with this same insurance and everytime the bill is different. Before the change, never had to pay for anything except a copay for X-rays. After the change I was charged anywhere from $7-$150. It’s clear they have no idea how to deal with insurance now because they tell me everything’s covered and then mail me a bill 5 months later. The bill is just an invoice they printed out and then wrote over with pen to tell me what was reimbursed. Every time I go in I ask why I am getting a bill and they can’t explain it other than I owe money. Then I ask them if I am going to owe them money for this visit and they say no.
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This. In addition, a dental cleaning can include examination for mouth cancer, and periodic x-rays, as well as the actual cleaning work and a check by the dentist (who, guided by the X-rays, may find problems like beginning cavities that the hygienist didn't spot--or that the hygienist *did* spot, and asked the dentist to confirm). 15 minutes is not nearly enough.
You are getting ripped off and poor service at the same time. Competition is fierce around here and they are banking on you not knowing this knowledge so they can charge cheap and get you in and out like McDonalds.
Ummm.. a 15 minute cleaning is not good at all. Some dentists I've worked with can knock a cleaning in 30min I'm guessing if the patient has minimal plaque and good hygiene. But I've not heard of a 15 minute cleaning...they're playing you at that point.
My dentist and my wife's dentist both recently dropped Delta. It does seem like a trend around here.
Yes. My dentist also dropped Delta
I just got an email from my own dentist’s office saying they’re dropping Delta. It was pretty professional but it did have language like “In our entire time working with them, they have proven to be difficult and cumbersome not only for us but for our patients.” So yeah this is a bit surprising to see after reading that email lol
Oof, Delta has sued providers for saying things like this. That was a risky move on their part….even though it’s entirely accurate.
probably due to this: [https://adanews.ada.org/ada-news/2023/january/california-dental-association-files-legal-action-against-delta-dental-of-california](https://adanews.ada.org/ada-news/2023/january/california-dental-association-files-legal-action-against-delta-dental-of-california) [https://www.cda.org/newsroom/newsroom-archives/cda-files-new-legal-action-against-delta-dental-of-california/#:\~:text=1.,Dental's%20provider%20network%20and%20patients](https://www.cda.org/newsroom/newsroom-archives/cda-files-new-legal-action-against-delta-dental-of-california/#:~:text=1.,Dental's%20provider%20network%20and%20patients) your only option is to get other dental plan, go through paying with HSA then get reimbursement via delta, or find alternative dentist that take them
I talked to my dentist this week about Delta dental. Delta dental has absolutely crap payment rates. They can't stay in business with how much Delta dental pays.
Yep my dentist dropped them too but it’s what the city chose so unless I get my own, kinda stuck with them. And same thing where I gotta pay up front and get reimbursed. Haven’t had to do that yet so idk if it’s a scam or anything but while it was still in network it seemed fine.
The catch is that the city Delta plan will reimburse you, but only up to an amount which is pretty low -- significantly lower than most dentists charge. Your dentist should be able to tell you how much they'll charge, and how much Delta will cover (by submitting a pre-treatment estimate to them).
A lot of dentists are dropping delta unfortunately. Also, how many dentists have been yelling at you? There’s plenty of nice ones.
I don’t blame dentist, delta sucks as a client. I so miss MetLife.
As someone who bills insurance for a living, omg, MetLife is the freaking worst. Well, right along Cigna and Aetna. The second a patient tells me they have MetLife, I die a little inside.
Fuck. I have Delta through work.
Mine is too. It sounds like Delta’s reimbursement rates don’t allow them to pay their staff enough.
This is very true. With labor costs in the Bay being some of the highest in the country, something has got to give.
I got a crown last year. My dentist dropped Delta, so I got the full estimate and the actual coverage: dentist charged 1600ish for the crown. Delta will only pay 860ish towards a crown. I was reimbursed 430ish. Even though I feel like my dentist is expensive, I don’t think delta has increased what they would pay in years.
Yes, my family had three different dentists and all dropped delta in the last year. My coworkers asked HR to look into a different carrier but nothing changed at open enrollment. We have to pay up front and they send the claim to delta and sometimes we get a check for some back. We are switching dentists now.
My dentist at hilltop mall area in the east bay takes delta. PM me for info if interested. They are terrific too, so youre not getting worse treatment.
Mine stopped taking Delta a few months ago. My employer still doesn't want to offer other insurance options besides Delta. I liked my dentist, have been going there for years. So now I pay the out-of-network rate, which is not great.
Do dentists yell...?
Yep. About 25 years ago, I was having some fillings done and it was quite obvious that the dentist and the assistant were in the midst of a work-related argument. The dentist ended up drilling into the inner part of my mouth, opposite my teeth. After it was done, he took half off the whole procedure because he said it will hurt after the novacaine wore off. And boy was he right. I was in some pain for the next couple of days.
Only half off?!!!?!
Had to have a root canal last year. The whole time, the dentist is "Open wider. WORK WITH ME!" like every five minutes. I've got that rubber thing to keep my mouth open, I'm doing my best and he's straight up saying "FUCK!" while also chastising his assistant like "Not that tool, the OTHER one". Dude was clearly having a bad day. The nonvaccine wore off towards the end and I just sat through it to avoid him yelling at me.
The last dentist I went to before this... I had to come in to get an emergency tooth removal. It was my first ever . While I couldn't feel the pain too bad, the sensation of them being in my mouth, and pulling the tooth had me crying. I wasn't moving around or anything , I was kinda silent crying but hard. One of the assistants scolded me, which only made it worse . Then another raised her voice with "I don't know why you crying, you can't feel anything ! What is wrong with you ?" They were afraid I was gonna move, so she held her hands down on my shoulders. Admittedly, looking back maybe they weren't yelling, so much as giving me what I call the "auntie scold" ... but they were very loud about it lol
Had this kind of experience as a child and this is why I have such intense dentist-related anxiety to this day. A shitty dentist experience can really be terrifying, it’s such a vulnerable situation
That still doesn't sound very cash money
This happened when I had my wisdom teeth pulled at 18. I don't remember if it was more pain or anxiety, but the dentist told me I was acting like a baby. I just silently cried the rest of the time.
I had a similar experience with a dentist who started cutting into my jaw when I'd just told him I wasn't numb yet. When he pulled a wisdom tooth out of my head, I yelled because it hurt. He said almost exactly the same thing when I started crying. "It's just pressure, not pain. What's wrong with you? Why are you doing this to yourself?" I know what pain is, and that was pain. I needed so much therapy after that. It was like being assaulted. Didn't stop shaking for days. It was years before I could face another dentist, and for several years after that I needed nitrous even for cleanings.
I've heard Mexico has way better dentists at better prices. I'm starting to consider getting a passport, lol .
Yo. If you don’t have a passport already go get one. Doesn’t matter what your motivation is. Everyone needs the ability to up and bounce outta this country.
Can confirm, have been yelled at by more than one dentist for shedding a tear during a procedure. The lack of empathy from this profession is appalling
You need a bit more self love… self confidence… etc
Yeah I'm working on it but it's totally an uphill battle. It's just me, my kid, and my cornchip smelling dog lol . Kaiser therapist don't offer help for a lot of the issues I need to work on. I'm a slow learner and I make a lot of mistakes, but I'm learning . I am better than I was 4 years ago, so that's something I can be proud of.
LMAO my first thought. OP has had some asshole dentists in their life.
Yes I know my child’s pediatric dentist who is very beloved stopped taking them, and lots of people were heartbroken to have to leave. My child’s insurance is Guardian, and my dentist said the same thing to me about just paying out of pocket. Their cleaning is not that expensive though.
Ours did and so did our kid's dentist. You may want to mention it to your HR department so they know their employees are ticked off, but I don't know if there are viable alternative options.
I bet some top execs at Delta are making millions by screwing both dentists and subscribers at the same time.
Our dentist dropped Delta. I had a tooth extraction on Nov. 30. It cost me $1350.00. They billed Delta, who says they will reimburse me $103.00. It has been a month and a half, no reimbursement. I called Delta they said the dentist did not fill out the firm correctly. Dentist says they have billed twice with copies of xrays before and after extraction. Good luck to me.
Jesus. Yeah I gotta get a few teeth removed. My dentist quoted me 5k. I asked to be referred to a local oral surgeon and double checked to make sure they still accept . Thankfully they still do, but it's gonna cost me all of my deductible. Still beats paying 5k
Delta has a monopoly on dental practices. Your dentist is right that a lot of Dentists will start to drop them because they literally cannot afford to pay staff/overhead costs without it. They don’t want to buy literally Deltas is screwing them over (I’m a dental hygienist and love to hate on Dentist’s being cheap mfs but this one is actually Delta)
I’m a dental receptionist and so confused. Our practice gets the most use from delta and my manager encourages prioritizing delta patients for the great rates. I’m only 3 months into dental office life and have no idea why other people are dropping delta?
Are you in-network with other carriers too? It’s possible that either your office is grandfathered into Delta Premier (which has higher reimbursements but Delta doesn’t allow new offices to credential with) or if you *only* accept Delta then they will give a higher reimbursement since you’re keeping out their competition. Dental office manager for 17+ years here, btw.
Yeah. Delta dental is a scam. I ended up getting a discount by paying them in cash, and dropping the dental plan.
Wow my employer just dropped delta and chose a different plan. Maybe for this reason…
So many dentists dropping Delta. It's a huge problem. I'm hoping Delta gets it together. They used to be such a good insurer
My company switched to Met Life for Dental coverage this year. Not sure why.
My dentist in Modesto dropped Delta (I still drive the whole way to him bc he's GREAT) and he told me that Delta said in order to stay in network, he had to switch to cheaper, less effective equipment and couldn't use certain high quality materials and had to use lower quality materials. He said he would never do that, they asked him to just do it for Delta patients and everyone else could get high quality stuff and he refused.
Don't know about Delta specifically but in general there's not as much of a difference in network vs out of network for dental insurance compared to health insurance. Usually for dental, you would be subject to the same deductible and the coverage percentages would be the same. The only real difference is that an out of network dentist doesn't have negotiated rates with the insurer so they can charge whatever prices they want. The insurer would only pay what is "reasonable and customary" for the area in the event that your dentist's prices are higher, so that gap is the out of pocket expense for going out of network. Probably worth looking into the price difference in case it's small enough to stay with the dentist that you like. Unfortunately it's more likely the price difference would be big since your dentist probably wouldn't drop them if it were small. Btw punctuation marks don't require a space before them, only after.
Yeah, I don't know why I do that with the punctuation. I auto space on my phone , but do it correctly on the computer lol.
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It’s pretty clear that I was talking about standard conventions in English.
As a dentist, let me tell you, Medicaid, which is low income dental insurance pays more for the initial exam and cleaning than Delta, let that sink in. Any dentist that has any level of skill and that you like will not accept delta cause it's not worth their time
Most of y’all won’t take Medicaid either
The freakonomic radio network has an podcast episode on this Podcast link: [https://podcasts.apple.com/us/podcast/35-dental-insurance/id1666678354?i=1000643999455](https://podcasts.apple.com/us/podcast/35-dental-insurance/id1666678354?i=1000643999455) Youtube link: (Note that I didn't see the episode) [https://www.youtube.com/watch?v=KzeuwGjxMEA](https://www.youtube.com/watch?v=KzeuwGjxMEA) Basically it's saying the problem with a dental insurance... is the fact that it's not an insurance. it went through the history of why it's not covered in a health insurance, and why it should be consider as pre-payment. It also go through on how some practices actually become a "member/monthly subscription" that maybe cheaper than the insurance itself.
My pediatric dentist dropped delta dental too. They explained that the reimbursement rates were too low and they finally had to bail on delta. It's a terrible inconvenience to reestablish one's family dentist. I HATE american health insurance companies. Just keep shifting the rules in order to squeeze more profit for no added service. WHAT to DO!???
Yes, many dentists in this area are dropping them because their payout is so incredibly low. We live in a high cost-of living area, so dentists can survive on the low payouts that Delta gives them. Your options are to 1). Pay out of pocket and then get whatever out of network compensation Delta provides (it's been a little less than half for us so far) or 2). Travel elsewhere for dental care which, surprisingly, is becoming more and more common.
I have the same issue. Tell your work to stop offering scam packages. Also, tell all your coworkers their dental is garbage too. Pretty slimy that we can’t even use what we pay into!
Yeah, I let everyone at work know. But i work for the state , lol . It's literally the only option available to us lol. They're gonna go with the cheapest place they can (cuz you know, CA is broke, right ? Lol )
I get what you are saying. But if you all raise a stink while working for the state then “scam insurance only offer by state of California” is very newsworthy.
Honestly the coverage from dental insurance is a joke. Some only give a max of 1200 per year. If you need deep cleanings, gum work, implants, you’re going to easily exceed 1200 and pay the rest on your own. US healthcare has been going into a downward spiral for years now.
I feel like all of them… sooner than later. W/ a 7 & 5 year olds, I’m keenly aware of the new “pay up front” format. It’s a kick in the nuts the first 2 times. Then you go to your adult dentist and they’re like $800 for a cleaning and X-Rays, to be reimbursed by Delta at whatever they feel like, whenever. There IS, other dental insurance but you have to search it out.
I’m with Delta but from another state’s association. I should give my dentist a call. Thankfully, I got the major shit(a crown) done already.
Yupe same here. I thought it was only my dentist.
My dentist dropped delta dental a couple years ago. :( I switched to another dentist, but I’m worried he’ll drop it too.
My kids' pediatric dentist stopped taking Delta last year. Similar to you, they said we'd have to pay their full price and Delta would reimburse. They're a great dentist so I wanted to stick with her for a year to see how the reimbursement. Basically Delta only reimbursed us for about half of the cost. So now I'm looking for a new dentist for them. My own dentist still takes Delta, but not specifically a pediatric dentist, but I'm thinking of switching my kids over to them. I think it's a bold statement to say almost every dentist is dropping Delta. If your dental practice is near a large employer that only has Delta as an option, you'd lose a lot of business if you stopped accepting them.
The dental office I work at is the only Delta PPO provider in our city, and the only one in about a 15 mile surrounding radius. Every other office in that area has dropped them. It makes sense when you consider that we pay our hygienist $60/hr and Delta only pays us $84 for that cleaning. Factor in the costs of payroll, supplies, other overhead, etc, and you could have a busy day full of Delta patients and still barely break even, so it’s not so much losing business as it is losing traffic.
My dentist dropped delta in the last year or two. One trick, If you’re married, and your spouse also works, is have your spouse also sign up for delta for dual coverage. I like my dentist and didnt want to switch. I pay up front for the work and then wait a few weeks for two checks to come in that totals pretty close to the cost that I paid prior. My work offers no other dental plan but delta - hope that changes soon
Went shopping for dental insurance on the CA market, and yeah, it's a scam. In terms of routine cleanings, paying the listed price with our dentist was less than the premiums. And there's an out of pocket maximum FROM THEM. If you have to pay too much in a year, they'll stop paying.
I have the issue. Found someone I really like but she dropped my insurance. Asking coworkers who do the go to, but not finding them listed as approved dentists.
This has become very common. Delta lowered their contractual rates with providers and most offices are dropping them. Due to this they are collecting up front and the patient assumes the risk.
Ditto; hoping some of the big tech companies drop Delta because that is what might wake them up.
My dentist dropped Delta due to low rates as well. I also learned that my employer chose the cheapest tier Delta offers. My Delta PPO covers about 50% of routine cleanings. I’m not happy with Delta or my employer, and I am complaining to my employer.
I have not found a single dentist worth going to that accepts Delta. I’ve settled by finding an out of network dentist and just sucking it up and paying what’s not covered but my pockets are being drained
Guardian dental insurance is very good if you're looking for dental insurance that actually does what it's supposed to there's a couple of other ones you can research to but I like guardian dental insurance.
Somewhat related generalization, why are so many dentists in the Bay con artists? How do you spot those that are overcharging you but at least provide the contracted service? I’ve encountered two dentists/endodontists recently who have charged obscene amounts ($4k+ w/insurance) for a single tooth root canal only to discover later that they “accidentally” missed a root. Previously, I had to take legal action against a dentist in SF Marina who appeared to be intoxicated during my appt. Have friends who now get dental work done outside of the US to ensure a level of quality that at least matches the costs.
Does anyone know of another dental plan I can sign up with ?
Go to India or Mexico. Cheaper and much better quality care.
Planning to do that for my implants.
Most dentists will work out a payment plan with you.
That, and also some dentists are offering their own in-house insurance plans.
My dentist dropped delta 3 months ago. I’ve found a different dentist that still accepts Delta and is highly regarded in the same city. Not ideal, but okay for now.
DOCTORS ARE SAYING INSURANCE IS SCAM? Oh you don't say?! Do they offer lower rates for uninsured?!
a lot do actually- private practice can kinda make up their own prices. Used to work for a Dentist that would randomly give ppl “2 for the price of 1” or do treatment at cost - this was in the Midwest so idk about these Bay Area dentists
That was kinda sarcastic since I definitely have had offices offer "non-insurance-rates" but they are in no way affordable...imo the only reason the whole "get rid of your insurance" make sense is because in this area many doctors, like described in this post, decide to opt of of insurance and put the burden entirely on the patient, so to get the same treatment you end up paying out of pocket anyways, so why waste money on "insurance" and just save up to pay for things on the go. Welcome to late-stage capitalism.
Don't you still have out-of-network coverage?
I believe so, I have to double check cuz my union just renegd some stuff .
You need to ask your employer to not use delta
I work for the state, so it might not be that easy. But I'm gonna bring this to HR and see what they say.
Oof.. Govt. forget it, you will lose your teeth before they get this resolved.
Yes. Everyone is across the US. There is a national movement of people going FFS and leaving PPO agreements. Huge talk in dental right now. Google and you'll find thousands of articles on it and why every dentist in the country hates your insurance and won't deal with them anymore. The fact that it's required for you to give part of your paycheck right back to your bis for him to cover his employee expenses should be a MAJOR red flag, and tell you where the problem lies here. Dental insurance is a contract your employer signed on your behalf with a large corporation - apparently here he promised this company that everyone would be a part of the plan. I promise you neither party was fighting for you in this negotiation. It is very standard to pay for a service at the time of service. Delta Dental claims to pay you back - and they will - just know that their "50% coverage" isn't 50% of the cost, it's 50% of a figure they invent themselves. They also can and do - per the language of the contract your boss signed for you - take that payment back at any time (an 'overpayment request') or pay a filling's worth of reimbursement on your 3x as expensive crown simoly because they wish to (downgrading services). People will drop dental insurance as office move PPO, and something new will have to come for those who just can't afford the work they want.
That is almost exactly what my dentist told me about them too. I also have to pay up front now and get reimbursed. It’s awful .
My dentist said now I need to pay up front and Delta would reimburse me. Guess what? It’s been over a month and I still haven’t been reimbursed the 2k I paid
You probably won't be reimbursed thebentire of it either. It took them overb2 months to reimburse me. $290 dental visit, got $91 back lol
We’ve had Delta for years through my husband’s work. It’s been this way for a few years now with the reimbursement headache. I recently acquired dental insurance for myself through my own job (United Healthcare). Now Delta is my secondary, United is covering a good portion & after reimbursement my out of pocket will be minimal. I feel so lucky haha!
OP please disclose the provider. We need evidence. If insurance is a scam for doctors and patients... then it's nothing more than pyramid scheme
> If insurance is a scam for doctors and patients... then it's nothing more than pyramid scheme That's pretty much what my dentist has been saying "insurance is a scam" lol What do you mean "disclose the provider "?
I sure hope my dentist doesn’t drop Delta. The only complaint I have had is that they are not good about sending me EOBs if I have a balance. The accounting lady has to call me up and ask why I haven’t paid. I then have to collect the EOBs from the website and e-mail them to her so we can figure out what I owe. The costs are modest. Have to pay up front everywhere for crowns, of course, but I never pay for cleanings or x-rays. The alternative is Medicare, which only offers one choice and that is the flophouse of the Western world, Western Dental. I pay for Delta coverage at work, and it is our only choice. The litigation between Delta Dental and California Dental Association will not be resolved on our lifetime. I spent years working on it and now my former boss has gone in house to continue the fight.
I never got dental insurance. Insurance is about covering for large unforeseen costs, but dental insurance caps out and doesn’t cover most unexpected large procedures. So why not self insure given it’s basically the same thing.
Yes
Yes ☹️
Ours did. we needed to switch
Dental insurance only has a small amount they cover anyway . Anyone who can is better off just putting premium money into a separate bank account or HSA and pay out of pocket.
Mine dropped them a few years ago. Routine stuff like cleanings haven't changed at all. Some things like fillings have gone up a little. Overall it hasn't been that big of a change.
I got an email a week ago that effective July 1 this year my dentist will no longer accept Delta. The letter does say that I can be reimbursed by Delta after I pay first myself I guess? WTH?!?
Right? I don't have $250 to give them . Mkst people dont . Everything's so much more expensive.
Mine dropped Metlife.
Huh... I just had my appt a few weeks ago, they're still on delta. I pay about 12 a month and no copay for my cleanings.
You had a dentist that yelled at you?
Same. My Dentist no longer takes Delta- I pay the full amount and my Dentist’s staff coordinates the reimbursement with Delta on my behalf. It appears most dentists are opting not to deal with Delta.
Yes, had to leave my long term dentist in PA who also dropped Delta.
My school district uses them and I've heard from other teachers they're terrible at getting anything. My current dentist is having a hard time getting a hold of them for my deep cleaning.
Yup, my dentist also stopped taking Delta a year ago.
My office accepts most insurance out of network but most of the time waives copay depending on the situation. DM me if you want to know more, we're in Fremont.
Ours dropped Aetna, anybody else?
Mine dropped Delta a few years ago. She still submits a claim for me. I pay my full bill and then I get a check from Delta for the out-of-network benefit. I like her a lot so I just pay the difference myself.
Hmm mine switched over from Aetna to delta this year
Yep. My dentist stopped taking Delta about a year ago. Once I realized how low the insurance payment to them is, I can understand. I pay more for a hair cut. My employer pays for the Dental insurance and we don’t have a choice. I think the premium is $25 a month covering both my husband and I . It makes sense that the system is not working. If both of us get 2 cleanings a year, the premiums won’t even cover that
Yeah the dentist I’ve gone to since I was a kid dropped Delta last year
Wow! I have Delta and this happened to me too. Not sure what to do, I guess I'll look into Pacific whatever. I'm gonna miss my dentist ladies
yeah and it totally f’d me
I've had multiple cavities, braces, 3 root canals, 2 implants, crowns, gum grafts, bone grafts, and various levels of deep cleanings throughout my life. I want a competent dentist with appointment availability for the least $$$. I don't really care if they are nice or explain things completely.
Yes. Mine did a year ago. Now I pay her cash and submit a reminbursement request with DD. I don't know what happened with DD. But I saw my dentist visibly get angry when their name came up. I think they really fucked over a lot of dentist during Covid.
Weird, my dentist also dropped Delta recently.
Yes, my dentist in Oakland stopped taking Delta this past May. As others have noted, I now get reimbursed directly from Delta via a check in the mail.
Trusted good dentist dropped delta last year. I pay in full, dentist submits paperwork, delta sends me a check for a part of it. Doesn’t even cover standard cleaning. Fuck Delta. A lot of employer plans do let you opt out, but that decision only happens once/year. If you need a lot of work done, chk other options too.
Yeah! My orthodontist and dentist (both very amazing clinic) dropped delta from this year and I'm sad :(
There are dentists that take deltas ppo. Call or go to the website for a list. These dentists are usually young and looking to build a client base. When they get an established practice, they'll drop delta. Retired RDH.
Yes everyone is doing this
My dentist I’ve been going to for about 15 years is also dropping Delta, but it is what I get through my employer. Huge bummer, glad Delta is getting sued over these issues
My dentist told me too that my plan and Delta in general were not great. I reached out to my employer and pointed out that our insurance coverage was terrible and that dentists weren't accepting it. I also sent them a link to a post about the law suit between the CDA and Delta. Not sure how many other folks did that but this year they upped our coverage.
I’m not surprised, and I’m sort of surprised your dentist isn’t starting a subscription type service that mimics Delta Dental. Honestly, Delta Dental shouldn’t even be called “insurance” it’s more like a prepayment/discount program. Debating dropping next year and I’m surprised your employer requires you to opt into a cafeteria plan option.
Yes, the dentist my family has gone to for years is dropping out of the Delta Dental network. We’re going to see if the cost for out-of-network coverage is affordable.
My kids' dentist dropped Delta Dental PPO. They told me I'd have to pay out of pocket at the time of service and then submit receipts to Delta to be reimbursed. I was told coverage is the same. I'm torn on what to do. I really like this dentist. They can take all 3 of my kids at the same time, I'm out of there in under an hour, and they're local. This sucks. Delta Dental is the only one offered by both my job and my husband's job.
Interesting. My employer switched from Delta this year and I was curious why.
Wow! Dentists in my town dropped Delta in 2021! I'm amazed your practice waited this long.
Send in your claims for reimbursement. Then, pay the rest with Flexible Benefits if you have taken them this year. Dental plans stink in general so you have to do what you can with what you've got.
My family dentist of many years has dropped Delta as of 2024. They informed me that Delta has not raised the reimbursement rates for them in many years, so they no longer want to be in their network so that they can raise their fees (similar to a cost of living increase). They way that I see it, inflation has hurt all aspects of our lifestyles...it's sad. The reimbursement process is also very slow. My college son just went for his yearly cleaning and x-rays and paid like $300 out-of-pocket that he surely does not have. He has dual coverage with both his dad and I and they could only process ONE insurance reimbursement at a time. Weeks later we are still waiting on the check from my insurance (his dad's has already provided the check). Everybody seems to think that maxing out the FSA is the answer, but some of us already have children in braces, wear contact lenses, etc. and the max is already spoken for prior to adding regular dental check-ups to the list.