4 ms·

Something else I don't quite understand is why plans have drastically higher rates between tiny private-company and ACA bought. Lost my job at a small company,

Something else I don't quite understand is why plans have drastically higher rates between tiny private-company and ACA bought. Lost my job at a small company, only three people with insurance, and wanted to purchase the same silver-level insurance through the ACA. I could've, for over 3x the total payment for the private plan. Even the lowest-level catastrophic was still $100 more than the total cost of the silver plan. Then there was the dental. Same plan, same dental insurer... but hey guess who gets a 6-month waiting period on that filing?

gowld 7y ago
Why is there a waiting period on a filling? Any dentist can do that.
- ganoushoreilly 7y ago
  Sadly there's a lockup period for most work besides standard cleanings within the first 90-180 days with a lot of providers. Mine had a 1 year hold on fillings and crown repair etc. Even then they only covered part of it at that. I also have the highest plan available from the Provider (employer paid in full) with a nominal annual deductible for the whole plan. Understanding what's covered and not, how much etc. is tough. Planning your dental care involves the Dentists looking at Timelines and fitting procedures around timelines more than priority simply because of the billing issues noted above.
- zaroth 7y ago
  Not waiting for the dentist, waiting for the coverage. With a new dental plan, if you didn’t have dental before, you can get cleanings but not other work covered for the first 6 months. Otherwise since most dental work is not an emergency, you would pay for one month of dental insurance in a year you had any work needed, and pay out of pocket for cleanings. If you had prior coverage and are just switching plans because of employment changes, then I believe the waiting period is waived. We used to have the same thing with “pre-existing conditions” in health care. You needed “prior credible coverage” to be able to get treatment for an existing condition in the first 6 months of a plan. Again, it’s to prevent people from only buying insurance after they get sick.
- deleted 7y ago
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gowld 7y ago

Why is there a waiting period on a filling? Any dentist can do that.

ganoushoreilly 7y ago
Sadly there's a lockup period for most work besides standard cleanings within the first 90-180 days with a lot of providers. Mine had a 1 year hold on fillings and crown repair etc. Even then they only covered part of it at that. I also have the highest plan available from the Provider (employer paid in full) with a nominal annual deductible for the whole plan. Understanding what's covered and not, how much etc. is tough. Planning your dental care involves the Dentists looking at Timelines and fitting procedures around timelines more than priority simply because of the billing issues noted above.
zaroth 7y ago
Not waiting for the dentist, waiting for the coverage. With a new dental plan, if you didn’t have dental before, you can get cleanings but not other work covered for the first 6 months. Otherwise since most dental work is not an emergency, you would pay for one month of dental insurance in a year you had any work needed, and pay out of pocket for cleanings. If you had prior coverage and are just switching plans because of employment changes, then I believe the waiting period is waived. We used to have the same thing with “pre-existing conditions” in health care. You needed “prior credible coverage” to be able to get treatment for an existing condition in the first 6 months of a plan. Again, it’s to prevent people from only buying insurance after they get sick.
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deleted 7y ago
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