Choosing Dental Coverage
I started with some simple questions about the various plan choices:
- What does it cost?
- What is the maximum benefit?
- What are the deductibles and co-pays?
- Can I use my own dentist?
- What about the coverage I already have through the Federal Employees Health Benefits Program?
- Four eligible family members (our oldest son will drop off next year when he turns 22).
- We want to keep going to the dentist we've used for 25 years, and he doesn't participate in any dental plan.
- Dental checkups and cleanings twice per year.
- X-rays once per year.
- The kids need occasional fillings, but they're past orthodontics needs.
- My husband and I are getting into the age group where crowns and root canals are more common.
Our FEHBP plan will be our primary payer for dental services, and then the dental coverage will pay. Most FEHBP plans do not provide much in the way of dental coverage.
I had to start by eliminating plans that wouldn't cover our dentist and those that weren't available in our area. I liked the high $3,000 annual maximum benefit of MetLife High Option. That would come in handy for those crowns and root canals. I also liked GEHA High Option's low 20 percent co-pay on intermediate services (which include the following: restorative procedures such as fillings, prefabricated stainless-steel crowns, periodontal scaling, tooth extractions and denture adjustments).
To see exactly what services we might need to use, I reviewed our dental bills for this year. I was surprised to see that our total expenses added up to $3,403. All of our services were minor and intermediate. Two family members had several fillings. Our son had his four wisdom teeth removed. We all had X-rays, two cleanings and two dental exams.
Our current FEHBP plan paid $360 for the services. The rest was paid out of our flexible health care savings account. After analyzing each expense, I figure that the most one of the new dental plans might have paid was around $2,000. In reality, the plans probably would pay less than my estimate, since going out of network will limit the reimbursement to the usual "customary and reasonable" charges.
The annual cost for the MetLife Dental plan is $1,226.68. Employees (but not retirees) have the advantage of not paying taxes on the income used to cover these premiums, so net cost is more like $850. Since it's still early in the open season, I will continue to compare the MetLife high option with the GEHA and Aetna high-option plans. Then I'll make my decision by Dec. 11.
Now it's your turn.
- Step one: What are your needs?
- Step two: What are your questions?
- Step three: Get the answers.
- Step four: Choose a plan and sign up at Benefeds.com, or call: 1-877-888-FEDS. Do not try to enroll using an FEHBP enrollment form, or through your agency's electronic system. It won't work.
- Step five: Adjust your Flexible Spending Account since you will have lower out-of-pocket dental expenses next year.