torquill: Art-deco cougar face (wave)
[personal profile] torquill
You'd think that, given a huge pool of healthy early-20-somethings who don't need anything but maintenance, the dental insurance co. would make more money by not covering cleanings and only covering large procedures which are fairly rare. Since it's part of the health insurance bundle we all get as students, the dental portion's small premium is part of the deal for everybody. They'd get to collect monthly premiums and seldom, if ever, pay out on these people. (You could explain it by calling it catastrophic dental insurance, handy for when you sail over your handlebars and eat asphalt.) But nooooo... instead, my cleanings are covered, a cost that is about the same as the total of the premiums, and I have to pay for things like thousand-dollar crowns out of pocket, because that's not the sort of thing my 20-something pool fellows would need. No percentage -- completely out of pocket.

They end up paying back most of everyone's premiums, instead of gambling that this healthy set of college students won't need as much heavy dental work as the pool pays for. Does that make sense?

So not only is it not actual insurance (like house or car insurance), it may not be the best business model either. It's an even more striking example than most health "insurance". Why is this system in place?

Date: 2009-07-25 07:55 (UTC)
From: [identity profile] fiona-monkee.livejournal.com
the reason they do it that way is that if you get the basic things on a regular basis then you shouldn't "need" the big stuff... at least that was my understanding.

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