Dental Plans
Types of Dental Plans
Your Mouth is Like a Car;
Your Dental Care is Like a Fence
About Dr. Lynne Heckert I Links
Dental Plans
Lynne Heckert, DDS, JD
Dental Insurance is advertised to employers and the public in glowing terms. If it really were something for nothing, the same services for less money that would be a nice dream.
Here is the smart way to think about dental insurance plans:
1. Find out what care you want and need for your dental health. Find a dentist you can trust. This is always RULE NUMBER ONE!
2. Use dental insurance to help pay for what you have decided you want and need. Take the Insurance Payment to Which You are Entitled but Don't Plan Your Care Around an Insurance Policy.
Here is the silly way to view dental insurance:
1. If I don't have insurance I won't see a dentist (This will lose you teeth and cost you more in the end);
2. I'll pick my dentist on the basis of whether or not that dentist 'takes' my insurance (Comparing dentists is not like comparing the price of a loaf of bread; Dentists vary widely and the cheapest way is not always cheaper in the end. Se below).
A dentist owes all patients treatment that is up recognized standards. Legally, the same standard of care is owed to a patient who pays full fee and one for which the dentist is reimbursed less that his/her regular fee. Unfortunately, dentists do not always understand this concept. If they have to cut corners, do work faster, take less x-rays, do a less thorough cleaning on plan patients in order to make ends meet, they should not stay members. Also, the plan patients should be treated with the same courtesy, recalled as frequently as regular patients and should not be giving only unpopular appointment times.
A mouth is similar in many ways to a car. There are tune ups and small repairs regularly. Sometimes something bigger breaks and you have a larger repair bill. People budget for auto expenses but do not budget for dentistry. When your teeth are gone they are gone. Also, a lot of money could be saved by common sense like plaque removal, flossing and avoiding candy / breath mint habits.
When switching to a 'plan' dentist ask yourself a few questions:
Is there a dentist with comparable skill and experience in the plan?
Will the plan dentist always be a participating dentist. Dentists frequently join plan when they are not busy and later leave when business picks up.
Will the senior dentist be the one to do the actual work or is work done by assistants or new dentists? Dentists may hire new dentists to take plan patients.
Will I getting a full unrushed cleaning and adequate x-rays? Is the same amount of time being allotted to my appointment? Are plan patients being appointed at less busy times of the day, or being treated differently that full paying patients?
Is the dentist quick to recommend advanced work (for which you I pay an expensive co-pay)?
Are unnecessary 'add-on' out-of-your-pocket treatments recommended to compensate the dentist for lower payment? (An example is the light-mediated cancer exam*)
If I don't get the best care now will it cost me more later to fix the problem?
Am I being given all my alternatives or are the dentist's recommendations slanted toward procedures that pay more.
Is the dentist using the plan to attract patients, then giving you an expensive plan for advanced work that you may not need? (An example of an add on is the cancer screening "light" for which you pay out-of-pocket, and which you may be "guilted into" approving for your kids. A cancer screening has always been part of a good dental exam and should be included in the fee.*)
Remember: It costs a lot of money to run a dental office (Equipment, supplies, salaries, rent or mortgage, computers, etc.) The typical dental office has an overhead of 80%. If you or your plan is paying less, you will get less. Do not rely on dental insurance. Do not put work off because you don't have insurance. A mouth is like a car. Expect to budget for regular exams, x-rays and cleanings (oil changes, inspections) and expect that from time to time bigger jobs will be needed like crowns, root canals, (body work, brakes, etc.).
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* A cancer exam is important and it should be included in the cost of the regular exam. If an additional out-of-your-pocket fee is suggested for a special light-mediated cancer exam you may way to check the Mayo Clinic site: "There's little evidence that using a special light to examine the mouth has any advantage over a standard oral exam." or the Oral Cancer Foundation: "In summary, evidence that supports the use of reflective tissue fluorescence systems to aid in the detection of oral pre-malignant lesions is currently quite sparse.")
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Please remember that dental information written by me on these sites is not all-inclusive and it may or may not apply to your situation and you need to call your own dentist. A dentist needs to see the tooth, take and x-ray, etc. to diagnose and treat. I cannot respond to email inquiries or phone calls. Thanks for visiting!