Deleted
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Sept 19, 2024 16:30:30 GMT
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Post by Deleted on Jul 2, 2014 18:00:20 GMT
I am pea livid.
MetLife started offering dental insurance to disabled veterans the begining of this year. Being a disabled Vet I signed up my family and am paying the premium.
We even picked out an IN-NETWORK dentist for it to cover more.( 50% for in-network vs. 40% for out-of-network)
Well here in TEXAS even if you choose an IN-NETWORK dentist they only have to pay out-of-network regardless if you choose a in-netork provider.
SO the in-network coverage % is a crock of shit for Texans.. its ALL out of NETWORK % coverage regardless.
SO who should I be livid with:
1.) for Texas having that Law/Loop hole ?(BUT Metlife doesn't do that with the AD military)
2.) Metlife for taking advantage and screwing over the VETERANS?
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Post by justkallie on Jul 2, 2014 18:04:41 GMT
I am pea livid. MetLife started offering dental insurance to disabled veterans the begining of this year. Being a disabled Vet I signed up my family and am paying the premium. We even picked out an IN-NETWORK dentist for it to cover more.( 50% for in-network vs. 40% for out-of-network) Well here in TEXAS even if you choose an IN-NETWORK dentist they only have to pay out-of-network regardless if you choose a in-netork provider. SO the in-network coverage % is a crock of shit for Texans.. its ALL out of NETWORK % coverage regardless. SO who should I be livid with: 1.) for Texas having that Law/Loop hole ?(BUT Metlife doesn't do that with the AD military) 2.) Metlife for taking advantage and screwing over the VETERANS? Probably both - in that order. |
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Post by dawndoll on Jul 2, 2014 18:07:04 GMT
I need to research this. I have CHAMPVA through my 100% disabled Veteran husband. They have sent me information for both MetLife and Delta dental plans.
I have to buy a plan this week, as I have a cleaning set up for the 18th.
I have been putting it off but have been leaning toward Delta simply because that is who I had before I retired.
I wonder if your above situation holds true in Michigan as well.
Ugh, I hate these kinds of decisions. I am very very thankful though that I do have this coverage available.
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Post by eebud on Jul 2, 2014 18:39:42 GMT
That sucks but I am curious............by going to an In Network dentist, does the dentist at least have to honor the In Network rates? In other words, the In Network doctor may have a contracted rate for Procedure A of $100 and the Out of Network dentist might charge $120 for procedure A. At 40%, you would owe $60 if you went In Network and $72 if you go Out of Network. If this is the case, while it still sucks that you are not having to only pay $50, it is still a better rate by going to an In Network doctor.
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Deleted
Posts: 0
Sept 19, 2024 16:30:30 GMT
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Post by Deleted on Jul 2, 2014 19:01:12 GMT
eebud, they do use a contracted price.
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lindas
Pearl Clutcher
Posts: 4,267 
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Post by lindas on Jul 2, 2014 19:39:40 GMT
I need to check this out. I was going to go with MetLife only because I could not get any info on Delta.
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Post by tomocus on Jul 2, 2014 19:42:52 GMT
I don't understand. What is the Loop Hole in Texas?
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Post by eebud on Jul 2, 2014 20:31:05 GMT
eebud, they do use a contracted price. I am glad to hear that you are getting the lower contracted price. Years ago, I had MetLife but have had Delta for a while now. I am not a Veteran so I don't know if it makes a difference or not but Delta pays out just like I expect it to and I am in Texas. When I was with MetLife, I was not with an In Network dentist so it is harder to say because insurance used reasonable and customary charges to figure out what they were willing to pay. |
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Deleted
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Sept 19, 2024 16:30:30 GMT
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Post by Deleted on Jul 2, 2014 20:46:51 GMT
tomocus,
I have no idea what the loop hole is.That is what the lady in customer service stated at metlife when I called.
I got my SOB and noticed that everything was paid at the out-of-network rate.
My dentist office estimated the benefits at the in-network rate at the time of service but now I owe them 10% more.
SO now I have to call my dentist and let them know that Metlife is only going to pay at the out-of-network regardless that they are in-network with them.
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Deleted
Posts: 0
Sept 19, 2024 16:30:30 GMT
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Post by Deleted on Jul 2, 2014 20:52:40 GMT
Something sounds really odd. Is it possible that the dental group is in network but your actual dentist is not? If your dentists name shows up as in-network under your plan name (and Metlife could have multiple kinds of plans with different networks per plan type -- so make sure the two coincide), I would contest it. Ask for a supervisor and be willing to put your complaint in writing.
Ask Metlife for a list of participating dentists in your specific plan. I do know that sometimes they will be different depending on your plan.
So sorry you are dealing with this though.
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YooHoot
Pearl Clutcher
Posts: 3,429
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Post by YooHoot on Jul 2, 2014 21:41:08 GMT
The delta plan is available for retired veterans.
Sent from my iPhone using Tapatalk
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Post by dawndoll on Jul 3, 2014 19:00:11 GMT
I need to check this out. I was going to go with MetLife only because I could not get any info on Delta. Here is the Delta Dental site: www.deltadentalvadip.org/plans/ |
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Post by dawndoll on Jul 3, 2014 19:10:31 GMT
Wow. When I looked into this a few months ago, I SWEAR my dentist was listed on the Delta site. Now he's only available through MetLife.
So, it looks like my decision has just been made for me.
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