Why doesn’t my insurance go as far as it used to?

Q. Dental care is so expensive!  Dental insurance used to go so much further.  Now, it barely seems to cover my cleanings and a few fillings each year!  Why does dentistry have to cost so much?

A. It is an increasingly complicated situation….below are only a few ways that insurance has affected the affordability of dental care:

Annual Maximums Don’t Keep Up

Years ago, $1,200 annual coverage afforded patients many options for their dental care.  45 years later, many plans still have $1,200 annual maximums. If dental insurance plan benefits had kept up with the increase of plan premiums, that maximum would be $7,000 today. During that same period, gasoline prices have gone from 29 cents to $4 a gallon! Where was the inflation adjustment for dental insurance?

Discounted Reimbursement

Many insurance plans, in an attempt to reduce the premiums that employers are paying, have negotiated plans that pay out less to the participating dentists. It is important to keep in mind that your insurance policy is an agreement between your employer and the insurance company. The goal of the employer is to pay lower premiums and the goal of the insurance company is to pay out as little as possible.  This has resulted in employers paying less for policies and patients receiving less in return.

Fewer Dentists Participating

In many single dentist practices, joining an insurance network means having to see twice as many patients to maintain the same profit margin. This puts pressure on dentists to make financial decisions about patient care that protect practice viability at the expense of access to care or quality of care. Either, dentists participate in the plans and feel pressure to focus on quantity over quality OR dentists drop out of the insurance plan networks in an attempt to maintain high quality care knowing that it will limit the number of patients that will seek care at their offices.

Understandably, many patients assume that their dental insurance serves the same purpose as their medical, home, and auto insurance.  In reality, “dental maintenance plan” may be a more accurate term for the type of coverage in the typical dental insurance plan. It is the equivalent of your auto insurance covering oil changes, air filters, and tires but nothing more.

At Titus Dentistry, we sympathize with our patients and look for creative solutions to help our patients manage the ever increasing patient portion of dental treatment costs.  Email us or give us a call to find out how we can help!

Do you have a dental question you’d like answered?  Click here or email us at ask@titusdentistry.com and watch this column for the answer!