How to get supplemental dental insurance in California

May 28, 2024 4:03 PM

My new job's dental insurance is terrible for the first two years. Is it possible for me to purchase my own supplemental insurance?

I've had Delta Dental my whole life, am forced to give it up due to the new job. The first two years of employment, you're not allowed to use any PPO, and everyone says all the provided options are terrible and barely pay for a cleaning. I'm told "in network" dentists of all kinds are terrible with the work plan. I am a big ol' dental problem child (just got two last minute fillings today) and there's no way I can keep out of dental problems that long--probably at least a few fillings a year and who the hell knows what else might go wrong--plus I have a really good dental team I don't want to give up. They won't network with anyone but accept Delta Dental PPO if you pay out of pocket and then get a partial reimbursement. Everyone seems to hate Delta Dental, but it seems to be the only option to see whatever dentist you want. And I can't get it back for two years.

I'm trying to figure out if I can purchase some Delta Dental PPO plan on my own or not and if that's worth it. The dental people today were all, "honestly, it may not be worth it to even try, you probably just want to get a worse dentist for two years or pay for everything here out of your pocket with no insurance," yikes. I'm not sure if I can get supplemental dental through Covered CA or not or have to go through something like this, which looks to be about the same cost. I'm not sure how much I'll be making net, but probably too much to qualify for any discounts of anything anyway, so I'm not really shooting for that. I've been trying to figure out this crap all day and my head is splitting. Anyone have any advice?

posted by jenfullmoon to Health & Fitness (11 answers total)

Anyone have any advice?

Go to the dentist you like and ask if they'll do the work you need done for the cash price equivalent to what a Delta Dental PPO patient would pay with reimbursement taken into account. I give you very high odds they will immediately take that offer. You may even be able to push the negotiated price to somewhat below what a Delta Dental PPO patient would pay.

Dental insurance isn't really insurance. It's pre-paid dental coverage, with negotiated discounts with dentists. You can negotiate the same discounts yourself, without the cost of the insurance. It's fairly straightforward too; dentists would much rather you pay them directly with cash then them having to go through the whole reimbursement process, medical billing, and hassle of dealing with the insurance company.
posted by saeculorum at 4:46 PM on May 28 [7 favorites]

That will only work for the total bill if the dentist accepts Delta Dental as full payment, a "participating provider" who does not bill patients for the balance.

I also have Delta Dental, and my non-"participating" dentist bills me for the entire cost but submits to Delta (they require x-rays, which I obviously could not submit) and a check (much smaller) is mailed to me by Delta.
posted by citygirl at 4:59 PM on May 28 [1 favorite]

You may not realize this if your dental plan is subsidized by your employer but the basic rule of all insurance is that it is priced so that the insurance company makes money after it covers all of the expected claims. Dental plans, in particular, include an annual maximum which limits how much it will have to pay. I haven't priced it out but I would assume that a private pay plan would exclude pre-existing problems which means that it won't pay on the stuff that you already know is an issue plus the total amount you can expect to get reimbursed (if you are an average patient) will be less than the total amount of premiums paid. Insurance is set up so that you only come out ahead if you have big, unexpected bills (more than average) and, in the case of dental insurance, you won't come out that far ahead because they limit the max payout.
posted by metahawk at 5:31 PM on May 28 [3 favorites]

Dental insurance at my last job would have cost more than my family incurred in claims every year. I negotiated with our dental practice for a discount if we paid cash. You should ask about this.

Also, question why you can't use any dental PPO for two years. That seems very off base.
posted by notjustthefish at 6:40 PM on May 28

I would try saceulorum's advice. The main benefit you get with dental insurance is that they negotiate harder than you can, normally. (In Boston, Delta negotiated prices so low that most of the popular dentists dropped them.)
posted by mrgoldenbrown at 7:14 PM on May 28

Out of the box idea: I've heard of Californians in your situation getting their dental care from reputable dentists just over the border, in Tijuana. I don't know what part of CA you're in, but in my experience (Bay Area), flights to San Diego are pretty cheap, flying in early in the morning and heading back in the late evening. What about flying to San Diego, renting a car, driving to the border, leaving the car and walking over the border, doing your dental stuff for significantly less than it would at home, and then coming back? Or skip the rental and get an Uber from the airport to the border footbridge? Haven't done it myself, but I know it's a frequently done thing. It's true it doesn't tick the box of preserving your established dental team, but maybe if you find yourself needing to do something expensive?
posted by pleasant_confusion at 8:10 PM on May 28 [1 favorite]

Look into continuing your dental insurance coverage from your previous employer through COBRA or Cal-COBRA. When I left a previous job, I signed up for health insurance through Covered California and continued to pay to keep my existing dental plan through either COBRA or Cal-COBRA (I don't recall which at this point) because that route provided me with best option of desired coverage + price.

tl;dr: it's not obvious that in the US, you may have the option to get health insurance and dental insurance from two separate sources. In my case, I got health insurance through the state exchange and dental insurance through (Cal-)COBRA.
posted by Goblin Barbarian at 2:53 PM on May 29

Response by poster: I had my dental office look at the Delta Dental pay-for-it-yourself options (through Covered CA, though it looks like other places had the same plans) and she said all of them were no good. The "No Wait" option is literally a LIE as in the fine print, you have to wait 12 months for them to pay for anything. Unfortunately, "pay for everything all by yourself" was the only option because otherwise you are paying $50/month for nothing. So that answered that one.

Of late I've had to pay for everything myself and get a partial reimbursement later through DD, which is what I had to do at the dentist before the insurance ran out. I guess it's about the same now, minus the reimbursement.

Also, question why you can't use any dental PPO for two years. That seems very off base.

So far, nobody has an answer for this one :P
posted by jenfullmoon at 9:51 PM on May 29

Please check your MeMail.
posted by Iris Gambol at 2:59 AM on May 30

^hey, jenfullmoon. The message I sent has information about that 2-year restriction, and how it doesn't apply to certain new hires. The only "critical" element of the message relates to time: see if you qualify for exemption a.s.a.p.; if so, your employer can reinstate your Delta insurance.
posted by Iris Gambol at 2:20 PM on June 5

Response by poster: Argh, I need to get back to this, will try to remember when I'm at leisure, thank you!
posted by jenfullmoon at 2:37 PM on June 5