Dental Insurance is NOT Insurance

I only want what my dental insurance pays for.” I have heard this so many times. When I hear this statement, I want to scream! I want to shout out, “Congratulations, you get a cleaning and an exam but we will ignore all the decay in your mouth because the insurance won’t pay for it all.” Dental insurance is NOT insurance, it is a discount benefit. Dental insurance is like having a coupon, it doesn’t pay for everything!

Unfortunately, in today’s society, many people equate dental insurance to medical insurance. We expect to pay monthly premiums and have 100% coverage on all procedures. With medical insurance, the small ticket items (office visits) are covered but every time a patient must pay a co-pay. The $100 office visit is covered by the insurance, but the patient pays a $35 co-pay. Although the expensive ticket items, a stay in the hospital, which cost tens of thousands of dollars, we must only pay a small deductible. We pay a very small percentage of the overall charge. Medical insurance covers the high ticket items but nickel and dimes us for the small procedures.

Dental insurance is the exact opposite. It was developed to encourage people to go to the dentist and have preventative care. Dental insurance will pay 100% for the small ticket items (6 month cleanings and exams) and not require a deductible for these items. But, the larger ticket items say a root canal or crown that save a tooth, Dental insurance will only cover 50% of the service and most patients have a maximum of $1000 per year of coverage. Dental insurance is a benefit for the routine preventative care, but it is really only a discount service for most dental procedures.

Dental insurance was first introduced in the late 1960’s to early 1970’s. A group of dentist in California developed a cooperative in 1966 that now is known as Delta Dental. In 1972, Delta Dental offered a dental insurance plan with a maximum benefit of $1000 per year. Forty plus years later, most dental plans still offer a maximum benefit of $1000 per year but the monthly premiums have increased. If these dental plans would keep up with the rate of inflation since the early 1970’s, today’s yearly maximum dental benefit would be about $9000 per year. Dental insurance companies are making more and more money, but not sharing that money with their consumers.

People need to remove the mindset that dental insurance is the only form of payment for dental care. Dental insurance is a coupon. It is a benefit supplied by an employer to entice you to stay with the employer. Dental care still needs to be paid for by the patient. We have car insurance for accidents, but we still have to pay for repairs, oil changes, new tires, and gasoline to keep the car running and working. Why are people willing to pay thousands of dollars a year to keep their vehicles working, but not willing to pay anything above dental insurance to care for their teeth? Teeth last a lifetime, a good vehicle last 10 years.