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Tuesday, June 23, 2015

The Dental Insurance Merry-Go-Round: Let Me Off!!!



Most of us have wonderful memories of being a child and riding the merry-go-round.  It represent good times in our lives; youth, happiness, etc.  But sometimes the merry-go-round isn't where we want to be.  Sometimes it just won't stop to let us off.

This is how we feel about dental insurance which we are renaming for the purposes of this blog to"dental benefit".  Dental benefits do not operate like medical insurance. That tends to "hang" patients up more often than not.

Being a "PPO" office (preferred provider office), which simply means we contract with a number of dental benefit companies, we literally deal with hundreds of insurance plans.  Though we do our best to navigate these rough waters for patients, we simply cannot know the ins, outs and fine print of every plan.

Most times patients are paying out of pocket for their dental benefit premium.  Some are blessed to have it covered by their employer.  The majority of people don't have it at all and so chose not to go to the dentist to get regular dental care.

Here's what we know:
  • Dental benefits rarely ever provide enough benefit for a patients needs.
  • Many patient's will only do what their dental benefit allows.
  • Those patient's oral care can tend to sub par as a result.
It's a very unfortunate situation.  There is such a great risk to waiting to have needed dental work done.  Infection, pain and tooth loss are the greatest of risks (though many people die each year from oral infections). 

For example (not shown with co-insurance):

Scenario one:  Small 1 surface cavity, immediate treatment - $170 for filling
Scenario two:  Small 1 surface cavity, wait for treatment, tooth pain - option 1: root canal ($1000), buildup ($250) Crown ($1000); option 2: extraction ($272), in the smile zone: bridge ($3000).

What could have been solved at $170 only becomes more expensive.  It will never hurt less or cost less than it does today!

This is the dilemma we face daily as providers.  If you rely on dental benefits to keep you healthy, you will be greatly disappointed and could experience bigger issues in the future.  So what's the answer?  A dental office that genuinely cares about it's patients and works hand in hand with them to accomplish their needed treatment through payment options.  Not only do we provide payment options we developed our own in-house membership plan for uninsured patients that saves them a great deal of money, while helping them stay on track with their oral health.

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