I would like to be able to make real comparisons of actual benefits and be able to inquire in advance as to what the benefits will be for a service or procedure. The product summaries show ranges of benefits (e.g. up to $200 for optical) but when it comes to making a claim you may find that the amount paid for an individual item number is less that you are led to believe from the summary (e.g. $70 frames, $70 single vision lenses - so can’t claim the whole $200 if you have a single vision prescription). Even if you already have a policy, you can’t find out what the benefit will be until you make a claim (or at least, that’s been my experience when I have asked at an optical store - they couldn’t make an inquiry without entering an actual sale) because as a consumer you don’t know what all the item numbers are and what you will likely use. e.g. a root canal treatment might consist of 10 items or more by the time you have had xrays, temporary fillings, a crown and multiple visits. It’s no wonder people find they have significant out of pocket expenses the way the information is provided at the moment.
I would like insurers be forced to print clear and concise product disclosure booklets. That clearly outlines what a member is entitled to. eg I have been for years trying to get our insurer to disclose what they classify as minor or major dental. In times past we used to get a list that detailed item numbers and rebates. Instead now you have to contact the insurer with the item number to get the rebate $. That means an extra visit to the dentist.
As a rule, do not for profit funds offer better value than industry funds please?
Hi @Liz1976 and welcome to the Community
I have moved your post to this existing topic that was covers your query.
I would think that Industry funds may have better deals as they are mutualised (owned by the members) rather than profit makers for shareholders. I may be corrected on this, and I’m sure you will get some detailed answers from others in this site.
Thank you for your question.
