Dental Insurance…A Love Story

As we draw toward the end of 2011, our practice makes it a priority to make sure patients realize what dental benefits they have remaining for the year. We’re always trying to explain dental insurance with patients throughout the year. The insurance companies try to make it as hard to understand as possible so patients are less likely to get the full benefit from their plans, in my honest opinion. And we fight with insurance companies to get every dollar the patient should get from their plans. Resubmitting x-rays and claim forms, writing narratives to justify reasons for sound, recommended treatment, and writing appeals for when insurance companies don’t pay what they said they would. Let’s face it, the insurance companies don’t make money by paying for claims so they do everything in their power to not pay. I could go on bashing the insurance companies, but after we jump through these hoops, they do subsidize some of the treatment costs and allow some patients to be healthier. But I still don’t like them…
The funny thing is that we (ie dentists) invented dental “insurance”. First, let me digress a little…it’s not really insurance. The definition of insurance is “to protect against catostrophic loss in which a third party payor guarantees coverage”. So if you wreck your car, the insurance company gives you a check for the totaled car. If your house burns down, your home insurance provides a check to build you a new home. Many of you know that most employers sign up most employees for dental “insurance” plans that give a maximum of $1000-$1500 per year. And if your in need of rehabilitative treatment (something beyond a couple fillings and a couple cleanings), your costs can be in the high four figures to 10’s of thousands. So the term insurance is not correct. Around here, we call them dental benefits because they subsidize the cost of most treatment.
So back to the story of dental “insurance”. We invented it back the late 1960’s and it was designed to provide coverage for the dental catostrophic event (accidents, trauma, extensive breakdown of the teeth, etc.). The coverage in the 1960’s was a yearly maximum of $1000-$1500, just as it is today. However, if we adjusted for inflation, today each patient would receive about $8700 each year in dental insurance. Notice I didn’t put that in quotes, because that could actually cover a castostrophic dental event.
Moral of the story is that an employee spends a certain amount out of their paycheck each pay period to have dental benefits. You might as well use them. We’re coming up on the end of the year so use ’em or lose ’em. Oh, by the way, that’s another way insurance companies make a bunch of money – people not using the benefits that they paid for throughout the year. I love dental “insurance”!