That is the opinion of a growing number (more than 70 percent) of dental professionals who express concern that dental insurance plans may limit more than just the amount of annual benefit afforded plan participants – it may actually limit a patient’s openness and/or opportunity to get the quality dental care they both need and deserve.
That’s because dental insurance is significantly different from most other kinds of insurance. Home, fire, auto and even health insurance are all designed to protect the insured from big ticket, catastrophic occurrences. You pay out a premium and deductible up front, then all (or most) major expenses are covered. Sadly, the opposite is true with most dental insurance plans, which generally cover the most basic of care, but greatly limit or deny more costly restorative or specialty care.
Think of it this way. The average cost of a car in 1960 was $2,600. If that car was totaled in an accident, your insurance (after deductible) would have paid the full replacement cost of your car. The average cost of a mid-size car today has increased to about $25,000, yet auto insurance would still pay the full replacement value of your vehicle. Now consider your dental insurance. The same $1,000 dental plan, which in 1960 would have covered all your basic care, plus a couple of cavities and a crown or two, today in 2012 won’t even cover the cost of your basic care and a single porcelain crown. Then add to this disparity the rising cost of dental insurance premiums, which have increased more than 10 fold, and the typical patient is being squeezed out of both dollars and care.
Yet even with these greatly diminished returns, patients fall prey to the misguided impression that they are “covered” and “protected.” They mistakenly believe that their insurance will cover any and all necessary care, and that the capped fees insurance companies impose will help to shield them from greedy dental professionals who want to “sell” them all kinds of unnecessary treatment.
The reality is, however, that these plans rarely cover any and all necessary treatment. What’s more, they serve to undermine the patient-dentist relationship by breeding mistrust of the dentist’s counsel and a fear of exorbitant or unnecessary fees. “I only want you to do the treatment my insurance will cover” has become the anthem of the insured. “The second crown will have to wait until next year when my annual benefit renews.”
The problem, however, with waiting until “next year” is that the decay or fracture in the tooth that necessitated the crown this year may require not just a crown, but also a root canal next year. Not only will the deferred treatment be MUCH more costly, but also the delay may give rise to the pain, infection, or other complications that may greatly jeopardize the patient’s overall health.
It is true that the dental insurance movement has been successful in motivation some to visit a dentist who would otherwise have been resistant to seek dental care, but getting them into a dental office is only the first step in helping them attain optimal dental health. “Insurance brings people to the office,” said one concerned dentist, “but the difference between expectations and reality makes them (i.e. the dentist and patient) instant foes.” “Insurance companies are an unnatural intrusion into the purest relationship between two unrelated humans: caregiver and receiver,” said another.
To be sure you are getting the quality of care you require, never let an impersonal insurance company, whose primary goal is to make a profit on your premiums, dictate your personal dental care. Do the necessary research to find a dedicated, trusted and highly qualified dental provider who will partner with you to protect your health, comfort, appearance and peace of mind.
The Spodak Dental Group is proud to be a participating provider for most PPO dental insurances. We are delighted to help you maximize your dental benefits, regardless of which insurance company you use, so please be sure to bring the necessary information with you on your first visit. For your convenience, we will gladly process your insurance claim electronically so you should not have any additional paperwork to complete on our own. If your PPO dental insurance plan is not listed, please contact us as we can still electronically file your claim with your insurance company to maximize your benefits.