If you are a dental patient with dental insurance, change is coming and you may not like it!
When I was beginning in dental practice there was no dental insurance. Imagine that! No insurance. Everyone had dentistry anyway: crowns, bridges, root canals, fillings, checkups - the whole thing.
Then dental insurance came along and that made things a lot easier for people. They had help with the cost of care and their employer or union paid for the insurance plan.
But. As the years past, employers and unions began to feel the weight of the dental insurance (and health insurance generally) on their bottom lines and they began to cut back.
In 1970 the maximum benefits you could use in one year was about $1000, and that bought quite a lot of dentistry at 1970 fees. Almost 40 years later in 2009 the maximum benefits you could use in a year is still $1000 to $1500 for most plans. That buys much less dentistry at today's fees.
And now most people have to pay part of the cost of their dental insurance through payroll deductions and co-pays. So the value of your insurance is getting smaller and smaller.
And to make it worse, many businesses - especially small businesses - are discontinuing health insurance completely because the cost is killing their business.
To add to the burden, most people who lose their job or change jobs lose their insurance. Ow!
Feel bad enough? Wait - there's more. We have noticed something that some employers and their dental insurance carriers are beginning to do. They are reducing the benefits for specific services.
Here's an actual example and it happens every day. A patient whose fee of $133 and was benefited in full last year and who had the same service last month now is getting only $126.39 for that same service. The benefit has been lowered and it's only the beginning.
Another thing that is happening is that waiting periods for replacement of dentistry are getting longer. For example, most insurances plans will pay a benefit for a new crown if the old one breaks after 5 years in the mouth. But now we are beginning to see 10 year wait periods.
It's the same for things like x-rays. A good standard of care in dentistry is for a patient in good dental health to have diagnostic x-rays every three years. This is good preventive practice, like mammograms or colonoscopy in medicine. But now we are seeing insurance plans that will not pay the benefit until 5 years have passed. Waiting that long is dangerous and leads to undiscovered problems that are much worse when they are found.
But employers do not care much about that when they are struggling to keep the business going in the face of rising health insurance premiums.
Why is this important to you? Because if you wait until next year to have recommended dental treatment, you may be paying more out of pocket for it, due to this new trend. The insurance company saves money at your expense, because some people will not use their full annual maximum and those people help offset the insurance company's annual outlay of benefits.
The employer saves money at your expense because they can purchase a lower-cost policy for each of their employees. There is only one loser with this trend: You.
So what can you do?
Your dental health is important. If you lose it you will suffer. Things will get difficult. But you can do a few things:
1. Have regular evaluations. Do not skimp on the schedule. We establish an interval with our patients based on their individual situation. Those evaluations and professional cleanings have a powerful effect on our patients' dental health. Not only do they make sure things are not overlooked but they are, let's face it, motivating. That matters.
2. Personal oral hygiene is critical. Our patients know how we always talk with them about the bacterial biofilm called plaque and how we work with them to be sure they have great tools and techniques for reducing it. It works. It's in your hands and you have the power.
3. Don't put things off. If you need dental treatment, move to get it done before you find that you are now receiving less help from your insurance carrier. Or even that you have no insurance at all. If we have suggested or recommended care for you, try to stop talking yourself out if it. Three of the most powerful words in getting what you want are these: Just do it!
4. Share your economic situation with the office. Like most dental offices, we have payment plans and we can help. Sometimes things can be staged. There is usually a way. But it all starts with you saying “YES!”
5. Stay positive. Earl Nightingale wrote a famous book about what he called “The Strangest Secret”. It is this: You become what you think about. If your thinking is negative, negative will come into your life. Zig Ziglar, famous motivational speaker, calls that “stinkin' thinkin'. Colin Powell, distinguished General and former Secretary of State, says, “Do not let fear be your only counsellor.” And I like the well known acronym for FEAR. Here it is: False Evidence Appearing Real.
6. Be smart. Understand the situation and act to protect yourself. Dental insurance is uncertain, even though we have become used to it. The world is changing and we can't stop it. But we can still win by being a Smart Patient.
If you have questions or want to talk with us about anything just call or send e-mail. We are a dental office that cares and we can help.
