About Dental Insurance

By Dr. Steven Parnett

The introduction of dental insurance to the practice of dentistry has allowed the improvement of the dental health of millions to be accomplished over the last 30 years. Many on both sides of the insurance card have benefited and been frustrated at the same time. Much of the controversy has occurred when consumers and dentist alike expected this form of insurance to behave the same as medical insurance had in the past. As we all know even the medical insurers have had to change their programs due to problems with rising costs of the practice of medicine.

I would like to offer some suggestions to help with the understanding of your dental insurance as a consumer without getting into the details of any specific programs. As a job benefit, dental insurance can be compared to say, getting a company-owned vehicle for your own personal use. It is your employers’ choice as to which make, model, color, etc. that he is going to offer you. He makes it available and it may even be your choice whether you will use it or not. If you have a ‘Cadillac’ dental plan or a Yugo, determines whether the treatments that you need are covered expenses or not. The coverage is not determined by your needs or wants, but by the coverage that your employer has chosen for you.

Your choices come in the form of another analogy that depicts dental plans very well. Since no plan covers everything 100%, look at the coverage that you have in the form of the coupons that you might take to a grocery store. You may get some things absolutely free, others may come at a discount and still others you may have to pay for totally out of pocket. Do you plan your weekly meals totally around everything that you have a coupon for or do you throw a few extra things into the cart to satisfy your personal needs regardless of cost? You should look at your dental coverage the same way. There will be times when the dentist will recommend a treatment for you that is only partially covered or may not covered at all by your insurance. You will need to discuss with the dentist the timeliness of the treatment and what will happen if it is not completed at all. The decision is ultimately yours and, if you do not like the choices, you must resolve that by asking your employer to change your coverage or asking the dentist for an alternate and maybe less desirable treatment.

One of the best options is to ask your employer to consider offering a Direct Reimbursement program. This type of dental insurance is the most equitable for all involved. It allows the employer to know what amounts will be necessary to provide for each employee every year. The employee will decide where to spend the dollars in their dental budget every year and not depend on the insurer to tell them if they have coverage for orthodontics, cosmetic treatment or whatever. The dentist will be able to tell the patient exactly how far they will be able to go in a specific treatment plan before the patient will be using their own funds to cover treatment and not insurance. Another benefit of this program is there are no requirements for ‘participation’ by dentists. Until this type of program becomes the standard, many patients will find that they will be forced to go to a dentist of someone else’s choosing and not their own.

Dr. Steven Parrett earned his degree from the College of Dentistry at The Ohio State University in 1976. He has served his community since 1977 in a full time private practice in Chambersburg, PA. His memberships include the American Dental Association, Pennsylvania Dental Association, Cumberland Valley Dental Society, Academy of Laser Dentistry and the Academy of General Dentistry. He has participated on ADA advisory panels, as well as presenting at the AGD annual meeting and the International Dental Health Foundation. He can be contacted at drsteve@dentistry.com

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