So if my out of pocket is less if I go to a dentist on a list, why wouldn’t I just go to a dentist on a list to save money.

Whew that was a long headline!  Do you make all of your buying decisions based on cost?  Do you buy the cheapest car?  The cheapest television?  Go to the least expensive place to eat every time you go out? 

A dentist on an insurance list has agreed to cut their fees in order to get on the list.  They typically get on the list because they need new patients.  Ask yourself, why do they need new patients?  We get 85% of our new patients based on referrals from existing patients.  Current patients send their friends and family to us because they trust us and appreciate what we do for them.  This is a big compliment to us!

When a dentist is on a list what expenses are they cutting to keep their bottom line the same?

A dentist sets their fees in order to meet their business expenses, office building, employee costs, lab costs, dental supply costs, electric, continuing education, better equipment etc.  If a dentist has to cut their fees to be on a list how do they make up those costs? 

Think about it.  A dentist is not going to participate on a list in order to take home less so they need to cut costs somewhere…. but where are they cutting costs and are you ok with going to dentist that cuts costs in these areas?

Instead they are cutting costs in other areas that can effect your experience as a patient and even the quality of the work done in your mouth.  

• Because they need to see more patients, the doctor can not take the time off to take continuing education classes that help them get better at what they do or learn a new technique which makes things more comfortable for you the patient. 
• They may use inferior dental materials that are cheaper and don’t last as long.
• They may use a lower quality dental lab because the cost is lower. 
• They may not pay their employees very well so they don’t attract and keep the best employees.  It’s comforting to see the same hygienist at each cleaning or talk to the same dental assistant that asks about your kids and knows you like nitrous oxide or have a latex allergy and to be greeted when you walk in the front door by someone you know.  
• Many times it effects your wallet because they overbook their schedule because they have to see more patients which means you are stuck waiting in the waiting room.  Time is money ya know.
• Or perhaps you are rushed through your appointment because patients are backed up in the waiting room.

So, the money question.  Does choosing a dentist on a list save me money or my insurance company money?

Consider this:  In 2007 we were a participating provider with a big name insurance company that happens to use a cartoon character in a lot of their advertising. 

• We had patients that participated in this plan and came to see us “out-of-network” prior to 2007. 
• Prior to 2007 some of these patients that came to see us “out-of-network” their out-of-pocket on their cleaning was 50¢. 
• The insurance company paid our fee for a cleaning except for 50¢
• When these same patients came in for their cleaning in 2007 our fee for a cleaning hadn’t changed.
• Because we were a provider on the list and had contracted to take reduced fees, the insurance company only paid 66% of our fee for a cleaning which saved the insurance company over $22.
• So the insurance company saved $22, the patient saved 50¢!
• No wonder the insurance company wants you to go to a provider on their list.  It’s better for them but is it better for you?  Only you can decide that.

By the way, We got off the list in late 2007 because we were unwilling to shortcut the way we treat and care for our patients.

I guess that depends on your definition of insurance but when you compare dental insurance to the other insurances that you carry on your home, car, life, and medical it seems like more of a dental maintenance plan rather than insurance.

Dental Insurance … it’s not really insurance at all

Insurance is defined as a third party taking the risk of a catastrophic loss.  The annual limit of most dental plans is a maximum reimbursement of $1200. 

Now, you may not have $1200 in your wallet and it is a lot of money, but there is nothing catastrophic about $1200.  It lacks the catastrophe that insurance was designed to protect us against.  If you lost your home to a fire, totaled your car, or had a major medical surgery that required a long hospital stay, that would be catastrophic.

If your other insurances worked this way, there would be rebellion!

Say for example that you totaled your new car the insurance man offered $1,200 total settlement.   You would call the state insurance agency, your lawyer, the Better Business Bureau, 6 on Your Side and complain.  We have expectations of coverage for losses that would be significantly unmet.  However, this is exactly how most dental “insurance” works.

So, lets call dental coverage what it really is… a maintenance plan

If your car insurance only covered oil changes twice per year, annual tire rotation and wiper blades, and a tune-up every three years, it would be useful to have, but you wouldn’t consider it insurance. 

A dental benefits plan helps us keep our mouths in good health but if something major should happen that requires a crown, root canal, dental implant, etc, our dental “insurance” isn’t going to cover the entire cost.  And if we have hit our annual maximum, it will be all out of pocket.

The $1200 annual maximum hasn’t kept up with inflation

When dental insurance was first introduced in the late 60s the annual maximum was about $1000.  If you use a 3% inflation rate, dental insurance today should cover over $5000 per year. 

Is a dental benefits plan useful to have?

Absolutely!  If you keep in mind that it is designed for the maintenance of your teeth not to cover everything. 

Most dental benefit plans cover the majority of the fees for cleanings, x rays, and doctor exam.  These procedures are essential to maintaining your teeth.  When problems do arise, your dental benefits will go a lot farther if you catch the decay when it is small and easy to fix with a small filling. 

Decay left untreated doesn’t disappear.  It just gets bigger and costs more to fix and you will have more out of pocket costs to cover.