Thanks to everyone that participated in our survey.  As of 8/4/2010 the survey is now closed.  Look for your Chipotle cards in the next week or so…. we were a little overwhelmed by the response….

Many people in Columbus have to update or sign up for their insurance plans in the Fall.   We are doing this survey to collect some information to write a future blog article on Dental Insurance.  We need some real world information so we are requesting your help.

Your answers will be anonymous and the results will be posted sometime in September.  The information may help you make a future decision on your dental insurance. 

As a thank you we will send everyone that participates a Chipotle gift card.  You do not need to be one of our patients to participate.  Click to take the survey!

I our last blog post we began an explanation of what dental insurance is, and isn’t. 

We continue the theme today.

My dental insurance will pay only for a less expensive treatment.  Should I get that instead?  Insurers commonly pay for the “least expensive” alternative treatment.  Many times this is not the smartest or best choice.  Together you and your dentist will decide on a dental treatment plan that is right for you.  Think of other buying expereinces.  Do you typically go for the bare bones basic or do you go for something more middle of the road.  In the end, it’s how you value your mouth and what you want to spend to keep it in shape.

If I don’t have coverage for the dental treatment, it must not be needed.  Nope, I don’t think so.  The limitations of your dental policy are totally arbitrary.  They have no relation to the treatment that you need or may want.  It is our responsibility to advise you what treatments are available and what is best for you.  Your insurance contract is designed by lawyers and financial experts to control costs.

Why aren’t preventive treatments or better, longer lasting alternatives convered?  Employers change insurance carriers on average every 2 years so your insurer is not concerned with what happens later.  The incentive for insurance corporations to save now, not years later.

Why can you only estimate my dental coverage?  We deal with 1000’s of dental plans and 100’s of types of treatment each year.  Most insurance carriers refuse to release the details of their plans to the dental office.  They change policies and reimbursements constantly and without notice.

Read more: What does my dental insurance cover Part 1

Columbus Dentist answers you dental insurance questions:

Dental insurance isn’t really insurance (a payment to cover the cost of a catastrophic loss) at all.  It is actually a money benefit, typically provided by an employer; to help employees pay for routine dental care.  The employer usually buys a plan from an insurance company based on the amount of the money benefit and how much the premium costs per month. And the premium for dental coverage is a fraction of the cost of the premium for medical coverage and with all things in life, you get what you pay for.  And as you know,  there are many Columbus based businesses that invest in decent dental benefit plans for their employees and others that tend to skimp there.

The majority of dental benefit plans are only designed to cover a portion of the total cost of a person’s necessary dental needs.  For example, a dentist may recommend a crown for a tooth that has extensive decay, however, the dental plan may only cover the cost of a filling.  This does not mean that the patient does not need a crown, only that the benefit is limited to a filling.

While a twice yearly insurance payment toward the cost of teeth cleaning is common, that type of payment arrangement actually has no relationship to what any patient might really need. It’s just how their dental benefits plan was setup.

Many patients need cleanings more frequently.  People who have heavy plaque, lots of calculus buildup, or gum disease are prime candidates.  Also, people who are generally healthy but have certain types of systemic conditions, such as diabetes, or those taking specific medications, may require more frequent cleanings.

The good news is that with the help of your dental benefits, the amount you have to pay is reduced!  If you are looking for a new Columbus dentist, give Beth a call at 614-486-7378 and she can answer all your questions.  Or request an appointment online.

Preferred Provider is a term used by the Insurance Industry to make it sound like these doctors/dentist are “better” than others.  Makes it seem that perhaps your Insurance company has graded the dentist in some way to prefer them over all the other dentists in the area.

In reality, a “Preferred Provider” to a dental insurance company is a dentist that has agreed to take reduced fees in order to be on a list.  And remember that no dentist goes on a list to make less money.  It means they need more patients and they will reduce their fees to get them.

So, how do they make up for the reduced fees?  One way is double booking appointments so they can see more patients in the same day and make up for what they are reducing in thier fees.  What does double booking appointments mean to you?  A long wait in the reception area, in the dental chair, and being rushed through your appoinment just to start with.

Dental Insurance is different than Medical Insurance - In many ways, too many to put in the blog post.  But here are the highlights

• 9 out of 10 medical doctors are on an Insurance preferred provider list
• 2 out of 10 dentists are on an Insurance preferred provider list
• Medical Insurance Lifetime maximum coverage per patient can be 1 million dollars
• Dental Insurance Annual maximum coverage per patient ranges from $800 – $1500 per year.  That would be a lot of years before it reached a million.
• Medical Insurance monthly premium fee is hundreds of dollars
• Dental Insurance monthly premium fee is $10 for a family of 4

So when you decide to chose a dentist because your insurance provider has them on a list, think about this:   Did you spend more time chosing where you are going for lunch?

It’s open enrollment time of year……

It’s that time of year again when patients begin asking which plan they should choose during their employers open enrollment period.  So we thought we would define the different flavors of dental benefit plans out there.

There are probably 50 to 100 different dental benefits providers in the Columbus Ohio area.  And within those plans there are even more different flavors of the plans that were negotiated between your employer and the Insurance company.   A Metlife plan at company A isn’t the same plan as the Metlife Plan at company B.

Dental Plans typically fall into these catagories.  If you are having difficulties figuring out your plan choices, fax us(486-2608) a copy of the pages from your benefits handbook.  

PPO Plans

• You are free to choose any dentist 
• If you choose a dentist from a list, the patient is given financial incentives.  How great are the financial incentives?  That’s hard to determine without a defined fee schedule from your plan.  In our office we’ve seen the difference in cost for a cleaning be nothing.  On average the difference is between $5 and $15 per cleaning. 
• Think about this: Does choosing a dentist on the list save me money, or my insurance company money?
• The PPO Plan pays all or part of the dentist’s fee to the extent that it does not exceed the UCR fee for that service.  How insurance companies calculate the UCR fee

DPO or DMOs

• Under these plans you must choose a dentist from a list to receive any benefit.
• If you do not choose a dentist on the list the entire cost of the dental visit will be your responsibility

My plan says I will be covered up to 80% or up to 100% so I’ve got a great plan, right?

Many plans tell their participants that they will be covered “up to 80% or up to 100%” but do not clearly specify the plan UCR fee schedule, allowance, annual maximum or limitations.  The UCR fee schedule is what they will pay 80% of, not the fee your dentist charges.  (See post on how insurance companies calculate the UCR fee) 

By the way, your dental office has no idea what the UCR fee schedule is for your particular plan with your insurance company.   We don’t know for certain what your insurance company will pay until we receive the claim back.  Based on our experience, it is realistic to expect dental insurance to cover about 50% for major restorative services like crowns, large fillings, and root canals. 

The good news is that most dental benefit plans pay the majority of the fee for your dental maintenance such as cleanings and xrays.  And coming in for professional dental cleanings on a regular basis can help us keep small problems from becoming major restorative stuff.

So which should you cho0se if you are a Grandview Dental Care Patient? 

You need to decide what dental plan to choose based on your needs.  If you choose a plan where you are allowed to choose any dentist(typically a PPO) you will receive dental benefits to help you pay for the cost of the dental work you have done.

Cigna, Metlife, Anthem, UHC, etc, as long as you can choose any dentist, you will have a certain level of coverage from the insurance company and a certain level of out-of-pocket depending on your plans fee schedule.  Remember, you get what you pay for.  If you pay $10 per month for dental coverage for your entire family, you are going to have some out-of-pocket expense for your dental care.