Do you think your dental insurance is good enough?

Quality dental care may not be reimbursed by your dental benefits 100%

Quality dental care may not be reimbursed by your dental benefits 100%

As we are approaching the end of another year, it’s a great time to review dental insurance benefits.  Forty years ago, dental insurance benefits averaged $1,000 per year, which was the equivalent then of around $8,000 today. Here is the kicker; the average yearly insurance plan in 2013 is still close to $1,000. The purpose of this article is to explain the facts and fiction of what everyone calls “dental insurance.”

Fiction: You have a major medical problem, which includes surgery and hospitalization. You expect your insurance to take care of the major expenses after the deductible, and it does so. You would think dental insurance works the same way, but it doesn’t. Just calling it insurance is complete and total fiction.

Fact: People who think they have dental insurance really only have limited and restricted benefits that are controlled by an insurance company. A dental benefit is more like a coupon. It is only worth what the insurance company says its worth. It has nothing to do with what the dentist charges.

Fiction: To believe these two statements are true “My dental insurance will pay for it,”  or “My dental insurance will pay 80 percent” is, in fact, fiction.

Fact:  $1,000 was a lot of money in 1972. That year, you could by a brand new Buick for $3,000.  Typical dental crown fees were $250 and the insurance company paid well. Basically, a patient could reimbursed for two or three crowns a year on old broken down, filled teeth and in a few years, their mouth was fixed. Plus, the patient could get two cleanings a year and not even max out their insurance. It was a great deal for patients.

If benefits kept up with inflation and raised the benefit ceiling each and every year with today’s benefit close to $8,000, people would still have a good deal. As it is, today’s crown price for one tooth could basically wipe out a year’s benefit. Not only that, the insurance company (yep, the one with the tall skyscrapers in major cities) often goes out of its way to deny your benefits.

Fact: Today’s dentistry is nothing like it was 40 years ago. If patients had problems, the choices were to pull a tooth, fill a tooth or crown a tooth. Today’s dentistry serves the patients with some of the most advanced, pain-free techniques in medicine. These procedures are not even covered by the dental benefit contract, or the procedures cost more than the paltry yearly benefit.

Today’s insurance companies want you to choose a dentist based on cost and assume that all doctors are equally talented, knowledgeable, caring, ethical, available and personable – and that just isn’t true. In order for them to stay in business, they have to see more people, do more procedures and cut costs in some manner…which is why we see an increase in the number of large, faceless group dental practices. It is very difficult financially for an individual dentist to open a practice alone and earn a living.

Fiction: The dentist and dental team should understand a person’s dental benefit, what it will cover, pay, etc.

Fact: The contract is between the employer, employee and insurance company. The dentist has no role to play whatsoever; they are simply caught in the middle. In fact, most insurance companies will no longer communicate with the dental team as they used to.

Most important: Never let an impersonal insurance company dictate your dental care. They couldn’t care less about your health, comfort, peace of mind or appearance. Be happy you have that coupon for some “dollars off”, and understand that quality preventative and restorative care can be considered “priceless.”

Dr. Andrea Stevens is a cosmetic and family dentist in practice in Kanata, Ontario. If you have dental questions, you can call her at 613-271-7091 or visit her at kanatacosmeticdentist.com Please also feel free to leave comments or questions below, and Dr. Stevens will be happy to answer!