I was so excited to find out that there are Medicare plans offering dental and vision coverage. I called for more information and after talking with the Medicare representative almost an hour about our needs, we settled on two companies to compare, Horizon and Bravo. Medicare sent a more detailed report about the two companies.
Meanwhile, I contacted our doctors and found out that all of them take Horizon. Not all of them took Bravo, though, nor did a hospital we use and so that was a deal breaker. When the reports came, we focused on Horizon and read through it carefully. It sounded good.
Right now, TB and I each pay over $200 to our current secondary carrier, $96 to Medicare and $36 to our prescription plans. With Horizon, we'd pay $84 a month and then $96 to Medicare. We'd save quite a bit of money. A drawback was that specialists' co-pay would be $35 and TB sees a few specialists a month. Okay, so that would eat up our savings but, hey, we'd get vision and dental! I contacted Horizon and asked for their benefits book and some applications.
The books arrived yesterday and TB and I were taken aback and confused. The dental and vision plans are very limited. For instance, with vision you pay up to $35 for the exam and then they cover a max of $100 toward glasses every two years. That's fine for someone who doesn't have involved prescriptions like TB and I do. Our glasses are, minimum, about $300 each. Still...maybe we could save up. And then we looked at the dental plan. There's a $35 co-pay and then you pay for each additional service. A filling would be $56. A root canal (which is what TB needs) is $661. Crowns cost $1000 and up. There's no way we could pay for these things.
On top of that, there's a $150/day for 10 days co-pay on hospitalization. That was the deal breaker for me. With everything we have going on, I couldn't say we wouldn't be in the hospital for a surgery or something. There is absolutely no way we'd be able to pay that bill.
I am so bummed. TB and I have talked about it and talked about it and it doesn't really look like it would be in our best interest to switch. We could stick with our company and have no co-pays and full coverage. We would have to save for a year to afford getting glasses or our teeth fixed, though--if then. Other emergencies keep popping up.
This is yet another reason I totally support health insurance reform. Too many people either don't have it or have really limited benefits and then are screwed when something goes wrong. Oh well. Having dental and vision insurance was a nice dream while it lasted. :(