Questions On Dental Insurance
In general, all dental insurance companies dictates how the doctors are able to provide the best dental care the patients deserve.
"Insurance" means buying 'assurance' so that one will be covered in case of life-impacting major events, such as the earthquake, flood, storms, or automobile collision. Therefore, buying 'dental insurance' is a misnomer when applied in the healthcare. The correct term is buying 'dental benefit' from an insurance company. Following is a list of facts regarding the dental benefits that the insurance companies sell to the public:
1. No dental insurance pays 100% of the treatment a buyer needs. They are only a form of assistance to get the dental care that you need. There will be deductibles and co-payments that insurance say you have to pay out before they start paying out for your dental needs.
2. On average, insurance allow a benefit amount of $1,000.00 per year. This is the same benefit of allowance given by the dental insurance companies back in the 1950s. With today's inflation rate, the insurance benefits allowance should be at least $6,000.00 per year to actually benefit the buyer.
3. In addition, insurance plans vaguely states they would cover 100% or 80% or 50%, etc. They will not mention the deductible has to be met first. They would not disclose that this is based on the limited allowable fee schedule they created, not the actual cost of good dental care.
4. Insurance companies come up with what they call ‘usual and customary’ fees by surveying the fees from a geographic area, including the government-funded dental clinics, and using 50-70% of that fee. Because the survey includes the fees from the government-funded clinics (and managed care clinics), the true usual and customary fees of private dental offices appear higher.
5. Insurance plans usually do not pay out for the most routine dental needs. If you have an infected tooth, and you try to salvage that tooth, insurance will tell you it is major expense. If you have missing teeth and want to get a prosthetic to help you eat, insurance considered that a major expense. By ‘major expense’ they mean that you are required to get their approval first whether they will pay for it or not. They will decide if the treatment is necessary for you as you and your doctor say. In some cases, it means forcing you to stay in pain while they take 2-4 weeks to look over your X-Rays and decide to ‘approve’ the treatment or not. The sad fact: Due to this, many, many patients had lost their teeth unnecessarily over the past decades.
6. Insurance will ‘not allow’ the latest technology and material to be used in restoring your dental health: white fillings for your back teeth, porcelain crowns on your back teeth, implants for your missing tooth, implant-retained dentures for those who had no bone left, etc.
7. In past two years, insurance companies started selling “discount plans” where they do not pay for any of your dental treat at all. They charge you a fee so that you can have the list of dentists who were in their network. You still have to pay for everything out of your pocket, including exam, and cleaning.
8. If you have two dental insurance, it does not mean you have no out-of-pocket expense. On the contrary, you still have out-of-pocket expense 99.99% of the time after the secondary insurance pays out. There are times when the secondary insurance will pay nothing out on your treatment but reduces your annual benefit with the secondary insurance by the amount the primary insurance paid out.
Dr. Young's main mission is to deliver the most comprehensive and high quality dental treatment to all her patients. Over the past several months, it became apparent that continuing to participate with PPO dental insurance does not allow Dr. Young to provide the same quality and standard that her patients deserve and had come to expect. Dr. Young will continue to file your claims for you electronically free of charge so you can receive your reimbursement quickly. However, the responsibility for the cost the treatment with Dr. Young will rest solely on her patients. Dr. Young will continue to establish her fees fairly.
Dr. Young does not "match" the fees of other dental offices to have anyone become her patient, nor will she compete with other dental offices, because it is an unethical practice for a doctor. Such practice underminds the sacred trust between a doctor and her patients.
Dr. Young offers dental-oriented interest-free loan through The Lending Club, Visa, Master, Discover, American Express, and Flex-saving cards are also accepted.