How Not to Use Dental Insurance

Posted Sep 30, 2014

Many of my patients have dental insurance and use it wisely. They come in every 6 months for a cleaning and exam. If any cavities are found, they schedule the appointment to get them treated right away. brand mentions This is the most efficient and cost effective way to use your dental insurance benefits. Why? Preventative measures (cleanings, x rays and check ups) are covered well by most plans (many at 100%). Plans typically pay more for smaller fillings than what they would for more involved treatment. So it is a win-win. Your treatment is less expensive because things were caught early and it’s cheaper still because insurance typically pays more toward it.

Now, let’s talk about how not to use dental insurance.   I have patients that have not had a cleaning and exam in years even though they have dental insurance. They come in when something hurts or breaks. Normally, that’s dad (mom and the kids came in a long time ago).   I’m okay with that but let me show you how your dental benefits aren’t really designed in your favor here.  Unlike medical insurance, which starts to pick up more or all the bill when something disasterous happens, dental insurance works the opposite way.   As soon as you really need it, it’s gone. More expensive treatment that is needed to fix severely broken down teeth, for example a crown, is typically covered at 50%. So not only is the treatment more expensive, insurance will pay less towards it. A lose-lose. Also, dental plans will typically pay a maximum benefit of 1000-1500 dollars. That’s about enough coverage to treat two teeth that need extensive treatment.   By the way, that maximum hasn’t changed in decades. Back in the day, that maximum actually could have paid for lot of extensive treatment. Does a gallon of milk cost the same today as it did in 1985? You get the picture.

Also, where there’s smoke, there’s usually fire. If you haven’t had a check-up in a while, it’s usually not one tooth that needs treatment, it’s more like 10 to 15. And if you need a root canal and a couple crowns, your benefits are used up before you get to the other teeth. And what happens when cavities are left untreated? They grow. They grow from 100 dollar fillings to 1500 dollar root canals and crowns. So if you hold off on treatment and hope to get the rest of the work done next year when your benefits get renewed, the odds are heavily stacked against you for saving money in the long run.

Ok, you just got dental insurance, what do you do? Schedule a cleaning and exam today.   On that day, your dental treatment plan will be the cheapest it will ever be. Let’s say you have a lot of work to get done and your benefits may run out halfway through the year. Get it done anyway.   At our practice we have financing options to help if needed.   Because ultimately, treatment done early is treatment done for less cost.

And when it’s all done, come in regularly and start making those benefits work in your favor.