Dental insurance: It’s not what you think!

It seems at least once a day a patient comes into my office and says “I can’t get my teeth fixed because I don’t have dental insurance”. This indicates that the patients do not understand “Dental Insurance”. I cannot blame the patients for not understanding because the insurance companies makes sure there is confusion about this benefit.

We try to explain to our patients about dental insurance but its impossible to tell everyone what this so called insurance covers. My purpose with this newsletter is to give you information that the insurance companies will not tell you.

I started practicing Dentistry in the mid seventies. Dental insurance was just coming onto the scene. At that time the benefits were $1000-$1500 per year. Now fast forward 35 years. The benefits are still 1000-1500 per year. Do you think the premiums that were paid to the insurance company increased over the last 35 years? Of course they did. Do you think $1000 buys the same amount of dentistry that it bought in 1975. In 1975 a crown fee was $222. Now its about $1200.

The purpose of insurance is to protect you from catastrophic loss. You buy home insurance in case your house burns down. You buy medical insurance in case you have to be hospitalized. Do you need insurance to pay a $1500 dental bill? Its not insurance it is a benefit. This so called insurance is of more benefit to the insurance company than the actual patients. It distorts the patients perceptions of how to treat their problems. It complicates the treatment plan because we now have a third party advising the patients on what is covered. A common situation is we decide a patient needs to be reevaluated for periodontal disease in 3 months but the insurance company will only pay if they are seen in 6 months. Sometimes the patient will forgo the appointment because the insurance company refused to pay. Another example is we recommend a crown and the insurance determines they will only pay for an amalgam. The patient gets confused and thinks the dentist is recommending unnecessary work. The insurance company never even saw the patient and they are dictating treatment. The insurance companies are not interested in your dental health. They are only interested in paying out as little money as possible. Our goal is to protect your teeth and keep you out of dental trouble.

Dental coverage is a benefit and it helps if you do not have to pay the premiums. Usually your employer pays the premium and whatever they pay helps with the fee. If you have to pay the premium you must evaluate how much it is going to cost you vs what they are going to pay. Quite often its not worth the cost.

This information is the responsibility to of the insurance company to tell you. It is not the job of the dentist to teach patients about their individual policies. But the insurance companies do not explain this because it is not in their economic interest. It is misrepresented to the employers and to the patients. Its not insurance and its is of a minimal benefit. If you don’t pay for the coverage be happy with the help that it affords but please don’t think that dental insurance is going to take care all your dental costs.

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