this is the gospel truth!  That's been the experience of me and everyone
at work who picked a DMO.  We all found we suddenly needed an expensive
"deep cleaning" called scaling.  I refused and they said if i refused to go
with
their recommendation that they wouldn't even do a regular cleaning.  I went
back to my old dentist and asked them about this.  They said the suggestion
i needed scaling was ridiculous.  I then went to a periodontist -- same
thing.
A friend was told he needed all sorts of work by the DMO dentist.  He went
to his old one and they told him everything was fine.  Lots more stories
like
this from work.  I now skip dental insurance.  DMOs are a scam, get the
dental
PPO or pay cash.  Some dentists out there nowadays are like crooked
mechanics... it's unreal.  An Indian friend of mine who needed some work
found
it cheaper to fly to India to have it done.

_____________________________

You must be referring to Guardian's regular dental insurance. Regular
Guardian dental insurance is not an HMO.

There is a substantial difference between real dental insurance (like
that of the standard Guardian policy) and "dental HMO" plans. This
thread had been referring to HMOs, which are totally unlike your
Guardian dental insurance.

- dentaldoc

"Andrew White" <nospamers@allowed.at.all.net> wrote in message

I didn't see Consumer Reports, so I don't know what they wrote.  My memory
of them is that they usually get a lot of stuff wrong.  However, I used to
be an Aetna case manager.  I don't know what you mean by a difference in
region.  There isn't any.  The difference in coverage is based on what your
*plan sponsor* purchases.  IOW, your employer could buy a Cadillac plan, or
a rusted Chevy plan.  It's all about what they're willing to pay for.  There
are as many variations in plan as there are employer groups.  Perhaps in the
MidAtlantic, the prevailing practice is for employers to buy certain
products and not others.  But they can have anything they want, as long as
they don't refuse something that's mandated by state or federal law.  You
will see some variations among states due to the wide variety of state
regulations.

I don't much like HMOs vs. PPOs, either.  As a consumer, when I've had a
choice, I've always gone with the PPO.  But again, it's not the insurance
company not bringing in the doctors.  It's about the doctors not being
willing to accept capitation, which is what happens with their HMO caseload.
Not that I blame them.  They can't survive on what capitation pays.  The
formulary *was* pretty limited.  I used to advocate for the members I helped
as a case manager, trying to get waivers and special approval for their
critical medications.

Interestingly, when consumers are offered indemnity plans as an alternative,
they almost never take it.  Thirty years ago, health insurance meant "major
medical" for most people.  If you went into the hospital, you got some help
with the costs.  You paid for your own doctor visits or routine diagnostics.
The shift in coverage was supposed to insure that everyone got their minor
or latent medical problems caught early, before they became major, and
expensive, problems.  Now everyone screams if they have to pay a dime out of
pocket.  And pharmaceutical companies have been allowed to raise their
prices through the roof while consumers have demanded every drug imaginable,
knowing that insurance was going to foot the bill.  When it's your own
money, it's suddenly a different story.

In fairness, I scream, too.  My employer just changed insurers, and we're
all up in arms about being hit with a 90/10 coinsurance plus office copay
for doctor visits.  I haven't taken my antihypertensives or antidepressants
for months, because I was denied for pre-existing conditions, although I
submitted a certificate of eligibility.  Lovely to pay for insurance I can't
use.

Guess you missed the SMD thingy.

--
W_B

wubbabubbazG@RBAGEyahoo.com
Take out the G'RBAGE

There are no good HMO's.-Jitney