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The System

A Policy With Teeth in It

A Weekly Check on Health Care Costs and Coverage

Tuesday, September 28, 2004; Page HE02

If you're long in the tooth or soon to become so, AARP has plans for you. Dental plans.

The nonprofit has begun marketing an insurance program in partnership with Delta Dental, whose other products cover more than 20 million people nationwide. Open to all AARP members -- anyone over 50 who pays the group's dues of $12.50 a year -- and to their dependents, the plan is aimed at people who can't buy dental coverage through an employer or other group sponsor.

A single person living in, say, Alexandria would pay $534 a year for Plan A coverage or $397 for Plan B. Premiums vary by Zip code; a single in Gaithersburg, for example, would be charged $474 or $352.

What does that buy? The higher-priced Plan A fully covers a variety of diagnostic and preventive services, such as twice-yearly cleanings and annual X-rays. After a $50 annual deductible, the plan also pays 80 percent of the bills for other cleanings and denture repairs and 50 percent for oral surgery, root canals, crowns and other care. Plan B covers only 80 percent of diagnostic/preventive care and 50 percent of the other services. The deductible is $100.

AARP says that while about 60 percent of people over age 50 have dental insurance, most lose it when they retire. (Medicare does not cover visits to the dentist.)

"There's a huge need" for policies like AARP's, said Arnold Lear, a health insurance counselor for seniors in Montgomery County. "There are some people that have huge bills."

Best-case scenario for someone considering the plan is to find that the dentist he's already using has joined the AARP/Delta network. What are the odds of that? Good in some places, not so good in others.

Jeff Album, a Delta spokesman, said 35 percent of all dentists in the District, 28 percent of those in Virginia and 58 percent of those in Maryland have agreed to reduce their fees for AARP/Dental members. People using other dentists would have some of their bill covered, though they would be likely to pay more out-of-pocket.

Aside from the AARP policy, options include programs offering discounted fees at participating dentists.

Some counselors refer clients to the dental section of the insure.com Web site. The plans listed there include one from Dominion Dental of Alexandria that is priced at $7.50 a month for a single person, $10 for a family.

Delta also offers an HMO insurance plan with an annual premium of $102 for a single person and $250 for a family. Unlike the AARP program, this plan requires you to choose from a limited number of dentists.

Lear doesn't see that restricted choice as a large obstacle: With managed care programs having trained people to switch doctors whether they want to or not, "a lot of people don't care anymore" who's poking around inside their mouths.

-- Tom Graham

The System welcomes comments from patients, providers, insurers and others about the delivery of health care. While we cannot advocate on behalf of individuals, we are looking for examples of problems and solutions that may direct our reporting. Contact us by U.S. Mail at the address that appears below or by e-mail at thesystem@washpost.com. Do not send original documents.


© 2004 The Washington Post Company


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