Dental Insurance: The Good, the Bad and the Ugly

Should I get dental insurance?  Is it worth it for me to have dental insurance?

My quick answer is it depends.

My longer answer is three scenarios:

If you have dental insurance->Keep it

If you don’t have dental insurance, and currently need only cleanings->Get dental insurance

If you don’t have dental insurance , but DO need dental work->Not worth getting it because of “waiting periods”

*If you don’t know if you have work that needs to be done, pay out of pocket for x-rays and an exam to determine if you have any dental needs that should be addressed.

Wait, now I am more confused than ever.  Well, we are talking about insurance, so you start at being confused and go from there.

Waiting period– is the length of time after you purchase your plan that you must wait before you can use your full coverage, which is usually twelve months.  By that time it would have been cheaper to have the work done and the cavity that was a small filling, after waiting a year has become a much more expensive crown.

The Good:

Overall, dental insurance is a good thing. People with dental insurance are more likely to have important preventative care done, like x-rays and cleanings. They are also more likely to have maintenance work done, like fillings and crowns. Both preventative and maintenance care is essential to having healthy teeth and gums and this greatly contributes to overall general health.

The Bad:

There are a lot of assumptions about how we acquire your dental insurance benefits. Is there a central dental insurance database where we can automatically download your benefits? Is there a membership service we belong to where we have a separate computer specifically integrated to give us your benefit breakdown and spit out your treatment plan? Do we just guess and purposely lie to steal your money after you have already had the work done so we can pad our extremely inflated bank accounts? No, no, and not always. This is the benefit breakdown form we fill out for every patient.

insurancebreakdown

This form needs to be updated yearly or if your insurance has changed. How do we fill out this form? We have to call the insurance company and wait to speak with a representative who we then have to ask around 50 individual specific questions to get as accurate a breakdown as we can. We do this so that we can give you a reasonably correct treatment estimate.  Each insurance carrier has dozens of different plans patients can choose from, so virtually no plan is alike even for people who work at the same company. For this reason we never want to make assumptions about what plans may cover. Assumptions make for inaccurate estimates and understandably unhappy patients.

The Ugly:

While there is definitely a need for insurance there are a few quick tidbits that I cannot help but point out when discussing this topic and from these facts I will let you decide who is getting the better of the patient/insurance company relationship.  It is obviously very expensive to buy the naming rights to NFL stadiums, the league annually brings in about $10 billion dollars and so the organizations can charge an absolute premium to have your name being advertised on their building.  8 home games a year minimum provides a lot of advertising time.  However, there is an NFL stadium that has the luxury of not only having 8 home games a season, but 16 home games a season.  This would be the stadium in which both the NY Giants and the NY Jets call home, in the largest city in the richest country in the world.

metlife-2

It was an insurance company that was willing to pay the approximately $20 million dollars a year, for 25 years, for the naming rights to MetLife stadium.  Secondly, what do you think is the most expensive website domain ever sold?  Not askthefifthdentist.com which cost all of $4.99, but it was insurance.com, coming in with a pricetag of $30.5 million.  That is a lot of premiums.

Lastly, it is frequently assumed the extremely nice and extremely expensive car parked near my office is my car.  When people ask I inform them do not be mistaken, it is not mine, it belongs to someone that works in the insurance agency in my office building………I however am the proud owner of that awesome minivan next to it.minivan-hating-pic-draft-1

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