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Only three things in life are certain: death, taxes, and the fact that you’ll probably have to visit the dentist at some point in your life. This is why so many people eventually ask themselves, “Should I buy dental insurance?”
Many people are under the impression that dental insurance is designed to help you gain access to the best possible dental services. But in our experience, that’s not always the case.
At Smile Fort Worth, our mission is to use our education and experience to help people achieve their best level of oral health. Unfortunately, there are a lot of flaws in the dental insurance system that place barriers to optimal care.
In part two of this series, we’re taking a closer look at the fine print of insurance policies and how they impact your oral health.
Waiting Periods and Dental Health Don't Mix
Dental plans are notorious for waiting periods. These waiting periods apply to non-preventative care and can last between a few months and a full calendar year from the time you first sign up for coverage.
But keep in mind, your oral health isn’t going to wait for your benefits to kick in. If you need non-preventative care, like a root canal or filling, these waiting periods can have detrimental consequences.
Studies show that oral health plays a direct role in your overall health. If a dental problem goes untreated, bacteria can spread into the gumline and enter your bloodstream leading to gum disease as well as a host of other problems, such as infection, heart disease, diabetes, pregnancy complications, and more.
Every year there are stories of patients who have been hospitalized because they feel they have to put off dental treatment until their insurance kicks in.
We don’t believe patients should opt into a system that encourages them to wait for necessary treatment. You’re paying for insurance the entire time, shouldn’t you be able to access the care you need when you need it?
Companies Keep Finding Ways to Reduce Preventative Care Coverage
We hear this all of the time: : “Why didn’t insurance cover the cost of my check-up? I thought they were supposed to!”
An even better question is: “Why didn’t anyone tell me that my benefits changed, even though my monthly premium hasn’t?” As we mentioned in our first blog, dental insurance companies used to cover 100% of preventative care costs. Now, they’re increasingly finding ways to provide less and less for the same cost, leaving you blindsided when you get the bill.
Some of the fine print tricks they use are:
- Limiting fluoride treatments to once per year (The AAPD recommends applying fluoride twice per year)
- Limiting x-rays to once a year (to monitor tooth decay, some patients may need x-rays twice per year)
- Removing sealants from their definition of preventative care treatment (sealants are one of the most effective ways to prevent cavities)
If you won the DNA lottery and were gifted with healthy teeth, these coverage reductions might not affect you. However, some patients need more than one x-ray or two cleanings per year because they have a genetic makeup that requires more visits to the dentists.
Experts agree that routine cleanings and exams can minimize the risk of developing serious problems, like tooth decay and gum disease. And although insurance companies love to promote themselves as preventive care champions, they’re not really holding up their end of the bargain.
Pre-Existing Conditions Are Rarely Covered
Insurance is all about peace of mind. You sign up for health care knowing you’ll be taken care of in the event you get sick or injured. So, you sign up for dental insurance thinking you’ll get that same peace of mind—but the devil is in the details.
Dental insurance plans claim that they cover a portion of major restorative work, such as dentures, bridges, and implants, to replace missing teeth. That’s wonderful news until you read the “missing tooth” clause.
Most dental insurance companies will not pay your claims if you were missing a tooth prior to enrolling with them. But, that’s just one “pre-existing” condition they won’t cover. If you had the misfortune of chipping or cracking a tooth before signing up, your coverage to fix those issues will stop there. You’ll have to pay for those services out-of-pocket no matter how long you wait.
Unfortunately, many of our patients have come in thinking that their insurance would help them finally restore their confidence and achieve a healthy smile, only to be disappointed when they read the fine print.
At Smile Fort Worth, We Treat You. Not Your Insurance
Many people assume that dental insurance is necessary to receive the best possible care. But, what if you could always visit the absolute best Fort Worth dentists, without dealing with the burdens of insurance?
You can, and you should.
The best dentist is the best because they’re concerned with their patient’s wants and needs—not because they cost the most or because they’re an in-network provider.
At the end of the day, you should go somewhere where you feel important, valued, and cared for. If Smile Fort Worth is that place for you, become a patient today!
Don’t forget to join us in a couple of weeks for part 3 of our series. In it, we look at the ways dental insurance has transformed the culture of dental care for both patients and practitioners.
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