It’s that time of year again… Turn on the TV, and it isn’t hard to find some talking head discussing open enrollment, the latest doomsayer getting worked up over market instability, or an advertisement for Medicare or some other insurance provider trying to get your attention – and your money. But when it comes down to actually crunching the numbers and seeing what fits in your budget for the next year, sometimes it’s tempting to ask… do I really need those “added benefits” of dental and vision?
Our answer here at Wellness Centered Dentistry may surprise you: NO.
And that answer has nothing to do with viewing dental and vision as “luxuries” – a claim some insurance companies are eager to make. We view your dental care as essential, but your dental insurance, on the other hand, as optional.
Unlike medical expenditures, there’s a limit to how much your dental care can cost, even under extreme circumstances. This isn’t a cancer diagnosis, a kidney transplant requiring dialysis, or some other inpatient procedure that can very quickly cost upwards of hundreds of thousands of dollars. And even if it did, dental benefits are usually limited to less than $2000 annually. We here in dentistry often have the luxury of being able to cater to your budget and plan out treatment in a way that accounts for both your medical and financial needs. Which brings up an interesting question… why don’t we?
Well, we here at Wellness Centered Dentistry do. But many dentists don’t. And that is, in part, because they are accountable to the insurance companies, meaning that the insurance companies tell them how much their time and their services are worth, and they have to figure out how to make a living within those restrictions. But your dental insurance providers didn’t undergo 9+ years of education in dentistry, so: what makes them more qualified to determine your care than your dentist?
We’re having a hard time answering that one, too.
Let’s use the popular provider, Delta Dental, as an example here. Delta Dental is a huge dental insurance provider, available in all 50 U.S. states, the District of Columbia, and Puerto Rico. Delta Dental provides coverage to approximately 68 million people inside the U.S., and is heavily used in the Pacific Northwest, where their company began. If you’ve ever worked a government job here in Washington, you’re probably intimately familiar with Delta Dental. As an insurance provider, Delta Dental comes up with their own fee schedule for every treatment code that they choose to cover, and then they pay a portion of that fee (typically 50% to 100%), depending on the type of procedure.
According to Delta, a standard crown should be billed at roughly $800… but you can’t get a high-quality crown anywhere for that price. So, the dentist who charges $800 for a crown squeezes his prep appointment into 30 minutes, uses the cheapest labs available, and “glues” it in as quickly as possible. Your bite may be off, which causes jaw pain and excessive wear, and that crown likely doesn’t fit your tooth perfectly, meaning the nerve inside your tooth isn’t sealed off from external elements. Depending on your individual pain tolerance, you may not notice this much, but there’s a huge potential for sensitivity and almost a guarantee for plaque buildup under your poorly fitted crown – and you can’t brush that away, no matter how hard you try. So, when your crown fails a few years down the road, you’ve got rampant decay inside that tooth – meaning, you’ve lose tooth surface to aggressive decay that you can’t get back. Well, luckily for you, your insurance covers a replacement crown every 5 years, and your dentist knows that – so that crown is built to last about 5 years. And then your dentist can collect that $800 again to re-treat that tooth until there’s no longer enough tooth left to “fix,” and you need an implant. Lucky you! Or maybe, lucky dentist… You just end up with more time spent in the dental chair, more nasty shots, and eventually a mouth full of gums. All because, well… you get what you paid for.
Now, aside from care that more than likely will lead to tooth loss, what has that “affordable” insurance plan cost you? Let’s say we’re looking at the Delta Dental Enhanced Plan, with monthly payments of approximately $50. That’s $600 a year. $600 a year that entitles you to $1000 in benefits, and has you paying half of the cost of that crown – plus your $50 annual deductible. Unless you’re using up almost all of that $1000 in benefits a year, you’re really not saving any money – and if you’re using those benefits up, you’re likely spending around another $1000 out-of-pocket on co-pays each year. If you can afford to be spending roughly $1500+ annually on dental care, why not just pay to do that crown correctly in the first place, and have it last you twenty years instead of five? (For a look at our in-house insurance option vs. a basic Delta Plan, check out Part 2!)
We care more about taking care of you than fitting within the insurance company’s parameters. We care about getting you healthy. And we want to partner with you to help make that a reality. That’s part of why, regardless of whether you’ve been a faithful patient for twenty years, or are just starting on the road to taking ownership of your dental health, we never charge you to sit down and talk with us. Consultations, second opinion visits, and treatment presentation or clarification never cost you a penny – something that an in-network doctor will struggle to be able to fit into their schedule or budget!
There are a time and a place for dental clinics that we in the industry often described as a “mill,” but if you are seeking personalized care with an emphasis on health, Wellness Centered Dentistry may be a good fit for you. We take the time to deliver our very best, every time – and because Dr. Hsu takes pride in his work, he gives you his guarantee. For regular patients who demonstrate healthy plaque-free levels, if a crown of ours fails within five years, we fix it at no cost to you. Oftentimes, if we need to redo work outside of our coverage period, Dr. Hsu will simply charge you the lab fee or collect insurance payments only. That’s what patient-focused care looks like. And if you’re good about setting your budget and holding yourself to it, we offer ways to help you maximize the money you set aside for dental care – whether it’s through our layaway plan, which earns you a 10% credit on all monies paid to us in advance of treatment, or our Affordable Smile Plan, where you pay for your cleanings for the year upfront and gets a discount off of any needed treatment – we’re here to help.
For more information on our financial options, check out our website or give us a call: (425) 882-1354
http://www.wellnesscentereddentistry.com/finances
SOURCES:
https://en.wikipedia.org/wiki/Delta_Dental
https://www.deltadentalwa.com/our-plans/individual-and-family-plans
