r/CAStateWorkers • u/TheLSDofHumanity • 15h ago

Benefits Pre-Paid (DHMO) vs PPO Dental Plan

I know there have been a few posts about the dental plans. I didn't see anyone really talking about the Pre-paid plans, and was curious why you would not choose this plan.

When looking at the documents (24 tabs later), it seems that at least I can see exactly what is covered and how much. Metlife has no maximum, but you would have to pick a dentist in that accepts this plan and maybe that is why this one is not chosen. Just trying to navigate this, I have some bug dental work coming up and my kid just got braces.. It is a lot financially.

2 Upvotes

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u/wandermeow 15h ago

I had the prepaid plan the last 2 years as that was all they offer for the first two years for my BU. I had a really hard time finding a decent dentist. All the ones that took it (which was not many) had horrible reviews and I ended up paying out of pocket to continue seeing my dentist from before. If you are thinking about doing the prepaid I would look and see if you can find anyone in your area that takes it and if they are a good dentist.

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u/TheLSDofHumanity 14h ago

Thank you, that is what I thought.

5

u/skyblueinsf 14h ago

From what I heard, unlike health insurance, dental plan is more like a discount program which only a tiny discount given. Not much financial help on big dental work😣😣.

1

u/Accurate-Candle5601 14h ago

You will likely have a hard time finding a decent dentist who accepts the prepaid plan. If you qualify for it, get the PPO hands down. Also, if you can, sign up for afflack to get some money back after your dental work is completed

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u/TylerDurden-4126 13h ago

But the PPO plans all have max annual limit of only $2,000... that's nothing if you need actual work done

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u/Accurate-Candle5601 12h ago

that’s also why i suggested afflack. Unfortunately secondary insurance is necessary no matter which plan you choose 🥲

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u/TheLSDofHumanity 14h ago

Thank you. I was figuring that was the case.

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u/DismalSuspect5524 12h ago

When I first was employed and was forced onto the prepaid plan, it was a nightmare. My kid needed a root canal, and the dentist literally held him hostage in the chair mid-way procedure until I paid an amount that I knew I wasn't supposed to pay. I was on the phone with the plan who had to explain to the office staff that they are on a "capitation plan" in which they receive the same amount of money each month based on the number of patients enrolled with them ... even if a patient has no work completed. Of course, the dentist loses out when it is major work that is needed. This dentist apparently didn't understand how that works, and the plan cancelled their contract after forcing them to complete the work on my kid ... but it was a crappy job, cosmetic-wise.

Also, once you decide on a plan and can estimate your out of pocket expenses (knowing that there is an annual maximum), you can sign up for the Flex-Elect program, which will reduce your monthly take-home pay, but it will also reduce your tax burden. If you estimate well, it can be a big benefit.

0

u/Anxious-Doughnut-224 14h ago

Do we get paid to not take the dental plan?