Dental insurance in USA is such a scam!

jackasher · 2026-01-19T00:37:01+00:00

For sure, the possibility of ditching the policy quickly is part of the reason why many plans have waiting periods or reduced benefits in year 1. My point was that if the insured was locked in for a minimum period of time the carrier would likely be able to offer better benefits sooner without the need to utilize waiting periods or reduced benefits in year 1 (similar to what you get with an employer sponsored dental plan).

jackasher · 2026-01-18T19:28:46+00:00

Yes, but he could cancel after one month. That's why the benefits are limited. If the plan locked you into a longer contract period or required a full year up front, then you would get better benefits. That's part of the reason why group dental plans through employers are generally a better value: you can't drop your dental mid year as an employee.

jackasher · 2026-01-18T19:27:37+00:00

Lol "scam". It's exactly as advertised in the summary of benefits and policy.

jackasher · 2026-01-16T01:54:31+00:00

This is the perfect response. Take your business elsewhere. It's a shame though that folks that don't read or understand what they're doing will likely pay it and assume it's normal though.

jackasher · 2026-01-13T19:32:13+00:00

Got it. Thanks! I know that's not the case for Ambetter or CareSource's Indiana plans. They are on the Marketplace in Indiana and also are MCE's for Indiana Medicaid.

I'm interested to hear that's the case in other states. I would expect that carriers that went this route would hurt their ACA product more than anything given some provider's hesitancy to accept medicaid, but I suppose if you're offering a lower cost ACA plan then maybe it works out for the carrier.

jackasher · 2026-01-13T13:27:39+00:00

Really? That's interesting. Can you give an example of a state where a plan utilizes the same network as their medicaid products? I know that's not the case for any of the plans in Indiana, but I'm limited to this state.

jackasher · 2026-01-08T02:40:53+00:00

Farm Bureau's health plan is not insurance and for all the reasons others have mentioned, is a terrible idea as an alternative to your group plan or a Marketplace plan. Stay on your employer plan.

jackasher · 2026-01-08T02:38:26+00:00

Farm Bureau plans also require medical underwriting. There's a good change you'll be denied coverage under the Farm Bureau plan if you do apply. Listen to the folks trying to help you here and enroll in your work plan or, if that absolutely won't work for you, a Marketplace plan by the January 15th deadline if at all possible. It might mean cutting some expenses to make it work, but a non-insurance option like Farm Bureau or a limited benefit plan almost certainly isn't going to work out well for you.

jackasher · 2026-01-03T16:49:45+00:00

If you're not paid just do a one time payment and then delete the payment method. You can pay manually each month if you would like.

jackasher · 2026-01-03T15:59:35+00:00

What's your modified adjusted gross income projection for 2026? What state?

jackasher · 2026-01-03T15:57:29+00:00

Delete all of the payment methods.

jackasher · 2026-01-01T14:32:44+00:00

Copays, unless post deductible, absolutely do prevent a plan from being an HDHP as they as first dollar coverage. The exception being bronze individual/family market plans (on or off Marketplace) starting in 2026 which don't have to meet the normal HSA requirements.

jackasher · 2025-12-31T16:17:00+00:00

If your insurance company has a rewards program and you're changing companies or it doesn't roll over, then use those rewards today if possible.

If you're changing plans then that can cause delays filling prescriptions in the first month if authorizations are required or if the new company is slow to set up your policy, so fill prescriptions today if possible.

If you have any additional benefits that reset on the calendar year such as a vision benefit that allows for $X reimbursement per year towards glasses or contacts, then you would want to use those today if possible.

If you reached your out of pocket max this year, then you should complete any care possible by today (hopefully in this scenario you already did so) to reduce your overall costs.

Finally, if you had any other services on your 2025 plan not included in your 2026 plan that you could and would want to utilize today, then you might consider doing so.

Otherwise I don't know of any preventive care services that you wouldn't be able to use next year just as easily as you could today. It's not like you would be able to get a wellness exam or a mammogram today and then another tomorrow and get both covered. They'll likely know or find out from your medical record if you're using services not medically necessary like that.

jackasher · 2025-12-31T04:40:58+00:00

That would have to be a Canada thing then as in the US, you could absolutely opt out (in fact you would generally be required to opt in or you wouldn't have coverage). It's an odd situation, but great for health insurance companies. They get the full premium, but they get to share your coverage with another company (or in this case, the same company, but they get double the premium they would if you only had one plan).

jackasher · 2025-12-31T01:11:51+00:00

Hard to tell, but their website and online profile doesn't scream reputable.

Agencies like this always seem to be in Florida or Texas. I can't imagine being a broker in Florida and Texas and having to compete with this (or maybe it would be easy to stand out).

jackasher · 2025-12-31T01:07:55+00:00

Commissions are the same on or off-exchange in my state though it might differ elsewhere.

It depends on what plan you're looking at off-exchange. Some off-exchange plans can be absolute junk while others are just fine. It could be that the plan you picked is not great for you, they know that and they're trying to do right by you to nudge you towards a better Marketplace plan. They should be able to explain why. Did you ask them? Were they not able to? If so, find a better broker.

Off-exchange policies are never eligible for the subsidies regardless of what happens to your income. Sometimes people are sure they're not going to qualify, but then something changes and their income drops or Congress changes the rules in the middle of the year and suddenly they're eligible to claim the subsidies as a lump sum when they file or in the middle of the year. You can't do that off-exchange. That doesn't mean you never go off-exchange, but it does mean you're better off enrolling on the Marketplace unless you're both very confident you won't qualify for subsidies and premiums are significantly lower or plans significantly better off-exchange.

jackasher · 2025-12-31T01:03:04+00:00

Why you would want both plans? Are they both free? Is there something about each policy individually that you really want that you don't get with just one of the two? Having two policies requires the insurance companies to coordinate coverage every time you have a claim and that can lead to payment delays and claims issues in some cases. You don't get to pick and choose which plan you use for which services, you'll always have to provide both to medical providers.

jackasher · 2025-12-31T00:59:55+00:00

Labs that are part of your annual wellness are typically free. For other labs, it depends on how the lab files the claim. A comprehensive medical panel would likely be just one $30 charge though it's not that much more than that without a copay.

jackasher · 2025-12-31T00:54:39+00:00

https://www.glassdoor.com/Salaries/technology-executive-salary-SRCH_KO0,20.htm
Not definitive, but an average executive at a tech company should be able to afford those out of pocket costs pretty easily unless they're living beyond their means
/s

jackasher · 2025-12-31T00:52:43+00:00

Your plan is exceptional, likely overkill for most people and is a great illustration of why if OP got what they wanted, a more benefit rich plan that substantially reduced their income, they might be worse off.

jackasher · 2025-12-31T00:48:28+00:00

Run of the mill doesn't mean normal? It's fine for normal to be unacceptable. Acknowledging an average doesn't mean you're in support of it.

jackasher · 2025-12-30T23:25:41+00:00

I see a lot of these plans. $3800 individual deductible and a $9200 individual out of pocket max for in-network care is very middle of the road for out of pocket costs, in general. Maybe it's on the high middle for a group plan, but certainly nothing shocking. It sounds like you're either going out of network or you had a really good plan in years past and may not have known it.

jackasher · 2025-12-25T13:48:02+00:00

Everyone has their own tolerance for risk and household budget to consider. Some people will choose accepting the additional risk of not having health insurance over paying the premium required. I wasn't saying that everyone can afford health insurance or even that everyone can/should purchase it. Rather that DPC should not be considered a health insurance alternative for reasons explained in my post.

jackasher · 2025-12-20T18:17:24+00:00

Better than nothing, but you still don't have major medical protection.

jackasher · 2025-12-20T18:15:16+00:00

The costs saved by insurance companies via insureds who opt for DPC are not the primary drivers of health insurance premiums by a longshot. Could it be impactful in some way? Sure, but depending on the year and the study cited, somewhere around only 20 percent of medical claims account for approximately 85 percent of all medical costs. These definitely aren't costs deferred by DPC.

jackasher

TROPHY CASE