Dental Insurance Is Broken, Say Two Out of Three Dentists

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Dental Marketing Ethics

In this poll, we asked dentists: Is dental insurance just as broken as medical insurance?

Two out of three dentists think so. In our most recent survey, 70% of dentists felt the current system is not meeting the dental care needs of many Americans. The other 30% think health insurance and dental benefits are very different and it's not fair to compare
the two.

Read the dentists’ comments on dental insurance for more insight.




General dentists versus specialists



 



 



General dentists had very much the same feelings on this subject as specialists.




Urban, suburban and rural dentists



 



 


Geographic location was not particularly correlated with results.






Male dentists compared to female dentists


 


Additionally, gender was not a factor in determining a dentist's feelings about dental insurance.



For more insight into what our respondents are thinking, check out their comments!

"Almost everything we do in dentistry is elective. We don't have to let the insurance companies dictate our fees. In our office we don't even accept payments from any insurance company. Physicians have no choice. They either play ball with the insurance companies or they will have no patients. We are so much better than the medical profession." (Oregon general dentist)

"As bad as it is, it is not nearly as bad as the medical profession." (California periodontist)

"At $1,000 per year in benefits (sometimes hardly paying for one tooth), how can you even call it insurance? Co-payment might be a better word. Yet patients still think it's an end-all, be-all. Will they EVER get it??" (Illinois general dentist)

"Benefits haven't changed much in 35 years. Costs sure have." (California general dentist)

"Both answers above are correct. Dental insurance has never met the needs of most Americans, nor should it! I'd love to drive my car uninsured, have a wreck and then buy insurance that would repair or replace it. All insurance (medical, dental, fire, theft, etc.) should be to cover unexpected events. People are losing any sense of self-responsibility." (Arkansas general dentist)

"Dental insurance is a luxury and a privilege, and you get what you pay for." (California general dentist)

"Dental insurance benefits and maximums have not changed in many years; however, the cost of treatment has increased drastically." (California general dentist)

"Dental insurance companies are professional leeches making their CEOs rich by cheating dentists (and physicians) out of a moderately
decent living. There is NO insurance company in the world dedicated to fairly treating those expecting compensation from them; there is always some denial or underpayment of every claim, or claims are returned 'for more information' when all the requested information was clearly stated on the claim. When are companies going to get smart and co-insure their own employees? (Especially larger companies like Verizon and Raytheon–do I intentionally point out the coincidence that these are both contracted with MetLife-yes, I do!) These corporate giants would do so much better that they could actually pay the dentists something close to their normal fees, thus stopping the escalating 'quoted fee' spiral. Any time one party cheats another, the cheated party eventually catches on and compensates for the fact that he knows in advance he is going to be cheated if he does business again with that party! P.S. How can an insurance company arbitrarily decide that a growing child with a dental eruption problem only merits a Pan-x every 2 or even 5 years? Isn't this the dentist's decision to make?" (Massachusetts orthodontist)

"Dental insurance hasn't increased its benefits since 1975." (Florida general dentist)

"Dental insurance is not really insurance but an aid to help defray the cost of dental care. Dental care is mostly elective and people need to be able to make the choice whether they want to keep their teeth healthy or purchase unnecessary consumer products. The only ones who win in the insurance health care industry are the top level executives of insurance companies." (New Jersey general dentist)

"Dental insurance is wonderful. People who would never attend the dentist now have good care. The fact that some dentists charge more than the plans pay is their problem. There are still many good dentists who accept dental insurance as paid-in-full benefits. I make my living from dental insurance. My patients could not afford the dental work I give them without insurance to pay the bills." (New York general dentist)

"Dental insurance pays for extractions in an Oral Surgery office. The other procedures like biopsies, surgery, and infections are covered under medical. Since less than 0.05 % of the medical dollar covers oral surgery, there lies the problem with low percentages and insurance coverage tied to medical reimbursement." (Texas oral surgeon)

"Dental insurance serves only as a partial rebate for services received. Look at the erosion of the value of a $1500 policy over the past 20 years; it used to provide benefits for a 3-unit fixed bridge, but only covers one crown with buildup now. Patients need to accept responsibility for their oral health decisions. I don't see anything wrong with this." (Washington general dentist)

"Dental plans are typically nothing more than marketing strategies for insurance companies. If the patient paid regularly to the dentist what he pays to the insurance company, he would get good care and the dentist would not have to leave most of his fee with the insurance company." (Maryland dental office worker)

"Dentist need to do comprehensive treatment plans. That is, look at the patient as a whole so they and the patient can plan for the future. This includes 3rd party payments (credit) as well as treatment over a few years with a goal in mind – just like other facets of life." (South Carolina periodontist)

"Benefits haven't increased since 1971… They would be now be worth $8000 a year with inflation." (Indiana general dentist)

"If dental insurance benefits were about $1000/year in the 1960's, why are many of them still about $1000/year today? Insurance premiums have soared, so someone is making a killing!" (California general dentist)

"Insurance is a misnomer. Dental benefits are not insurance." (New York general dentist)

"It has become a total rip-off for the consumer. No increase in plan maximums, increase premiums with no increases in fee plan or allowables, no specialists. Where is the ADA in acting as a consumer advocate as they say they are? Nothing but a bunch of hypocrites. Ever since the AETNA lawsuit, AETNA now controls the very panel dealing with insurance in the ADA." (Nebraska general dentist)

"It is a rip-off." (California dental implantologist)

"It is clear that the insurance companies are in business to make money and NOT to provide what is in the best interest of our patients – their customers." (Connecticut periodontist)

"It is not insurance, only a financial contract to help reimburse dental expense." (Pennsylvania general dentist)

"It's not as broken, but the insurance companies would love for us to work for nothing, and keep trying to sell poor HMOs & PPOs. Most patients don't even consider dental insurance as a benefit because it pays almost nothing." (Florida general dentist)

"It's not insurance, it's prepaid dental care. Use it or lose it, and it's simply intended to help defray costs of routine care. Best thing that could happen is for it to go away. People with it feel cheated and put off care, people without it feel deprived and put off care. Who expects to have insurance for oil changes brake replacement or transmission failure?" (Pennsylvania periodontist)

"Not a black and white issue; both statements are correct. I do think, like medical insurance did to medicine, dental insurance has inflated the cost of dentistry, which then prices itself above a level than many of those who don't have dental insurance can afford. Dentistry, unlike medicine, is quite often discretionary unless there is pain or life threatening illness, making it different than medical insurance." (Maryland general dentist)

"Part of the problem is that patients think it is like medical insurance, and the people who sell and administer the programs do little if anything to explain. This then leaves the burden on our offices to do the "Dirty Work" and try and make them feel good about it. African-Americans are twice as likely to forego dental care without insurance as their Caucasian counterparts." (Maryland general dentist)

"The annual amount has not kept up with inflation, and therefore many patients cannot afford to properly maintain their oral health." (Texas general dentist)

"The maximum yearly limits are unrealistic." (New York general dentist)

"The maximums haven't been raised at anywhere near the rate that fees have. It is not uncommon to go over a patient's yearly maximum on treatment for only ONE tooth!" (Michigan general dentist)

"The public feels that medical insurance is broken. What would they be saying if there were yearly caps on how much medical coverage they could have?" (North Carolina oral surgeon)

"There are problems, but in the end, I believe we are in a better place than medicine. The main problem with dental insurance today is the assumption by the insurance companies that dentists cannot be trusted. Therefore, a crazy number of hurdles need to be jumped in cases needing extensive treatment." (Michigan general dentist)

"This is not a true either/or question. Both alternatives are true! It is clear that the current system is not meeting the dental care needs of many Americans. But let's not forget that dental insurance was NEVER designed to take care of people's dental needs — it was designed only to HELP defray the costs, whatever they may be. Since dental insurance is NOT designed to take care of any person's complete dental needs, it's also true that it's not fair to compare health insurance to dental benefits. Employers buy dental insurance so that the employees will have a little financial help with their dental expenses. If employers also provided a free loaf of bread and a baked chicken to each employee, would that be supposed to meet all the 'food needs' of the employee? Of course not. It would just be an added help from the employer." (California general dentist)

"We – dental offices and patients – all need to understand that the insurance companies are businesses and need to make money. However, to be fair for the patient who is paying for the insurance benefits, insurance companies should inform their clients exactly what they are paying for: clearly stating what the company usually covers and what does not, in much easier-to-understand language." (Oregon general dentist)

"While both statements are true, patients do not know the difference between insurance and benefits. This is what leads to confusion for the patients. Many patients believe that what their insurance company allows is what they need." (California general dentist)

"While I agree that these two insurances are very different, unfortunately, the patients do not realize this and expect dental insurance to cover everything. Also, I cannot believe what little dental actually does reimburse for services!" (Pennsylvania dental hygienist)

"With miserly reimbursements and annual limits unchanged in twenty years, it is a joke, not insurance. They make FEMA look saintly!!" (New York general dentist)

"Yearly benefits have hardly changed in 20 years, while premiums have significantly risen. Insurance companies still promote themselves as advocates for the patient. The reality is the they are investment firms that collect working capital through premiums and then seem to practically resent having to pay out on a claim. It is ridiculous that well-documented treatments such as implants are offhandedly rejected and frequently referred to as 'experimental.'" (Illinois general dentist)

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