A Word on Dental Insurance
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. To me this indicates that the patient does not understand what "Dental Insurance" is. 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 page is to give you information that the insurance companies will not tell you.
First, a brief look back. When I started practicing dentistry in the mid-seventies, dental insurance was just coming onto the scene. Since then, the benefits have not kept pace with the advancements and inflation. Though insurance premiums have increased, coverage is similar to what it was in the 1970’s. So for those who are depending on insurance companies to help them with the costs of their dental work, they are often in for a surprise. To understand why this ‘insurance’ does not function as intended, or as most people expect, take a moment to examine our perceptions of its purpose.
What is Insurance?
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 and the kind of treatment they must have for the insurance company to pay. 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 is dictating treatment without ever having seen the patient. 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 versus what they are going to pay. Question that. Quite often its not worth the cost.
How Every Patient Should Think About Insurance
This information is the responsibility 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. It is not insurance and it provides minimal benefit. If you do not pay for the coverage, be happy with the help that it affords. But please do not think that dental insurance is going to take care all your dental costs. —Dr. Arnold K. Chernoff
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