Topics in Dentistry
Most people think that dental insurance is similar to health insurance, but there are significant differences. This article discusses the advantages and limitations of typical dental insurance plans.
We at Straits Area Dental are proud to be a Delta Dental PPO. While we do accept other insurances that are billed as “out of network”.
We also accept Michigan Healthy Kids / MIChild because we support the effort of the State of Michigan to assist children with dental health.
At many dental offices, you have to pay in full at the time of treatment, and then insurance payments are sent to reimburse you. At Dr. LaTocha’s office, we file your claims daily via electronic claim submission and reimbursement comes directly to us unless otherwise specified in your particular policy. You pay only your co-payment at the time of treatment.
We Accept Most Insurance Policies
Our dedication to your oral health has come first and we continue to be one of the few dental office accepting most insurance policies, including PPOs. Because our office is computerized, we are able to use the fee schedules provided by the insurance companies. This makes our calculation of your co-payment very accurate and reduces the chance of paying either too much or too little at the time of treatment. There are rare times when what we estimate and what the insurance carrier pays differ; however, we pride ourselves on attempting to be as accurate as possible when dealing with your insurance carrier.
Many people believe that because they have Medicaid they can only receive dental care through the health clinic. For many, Medicaid, in the State of Michigan, covers dental visits through the insurance company Delta Dental, including Michigan Healthy Kids and pregnant women under 19. At Straits Area Dental, we participate with Delta Dental, allowing Medicaid patients to receive care at our private practice.
History of Dental Insurance
In the early 1970s, there were very few dental insurance carriers. It wasn’t until the auto companies negotiated dental insurance coverage that we saw a boom in the dental insurance industry. The first policies that were written for the auto companies, the biggest employers in our state of Michigan, were wonderful. They included a $1000 insurance maximum. Can you imagine having $1000 in 1970 to assist you with your dental needs? One thousand dollars in 1970 would buy a lot — that was almost half the cost of a car and gas was only 29 cents a gallon! Most people using their dental benefits in the 70s couldn’t even use their entire maximum.
Dental Insurance Today
Sadly the insurance industry has not kept up with inflation, and most policies today still have that 1970s $1000 maximum. When adjusted for inflation, $1000 in 1970 is worth nearly $5600 today. Conversely, $1000 today was worth roughly $184 in 1970.
What’s more, only half the population even has dental insurance. (Even those patients who qualify for state-funded plans are not applying for this benefit.) If you don’t have dental insurance through your employer, it’s difficult to get insurance (except through Aflac) and rarely worth it anyhow.
Learning About Your Policy
It can sometimes be difficult to figure out what your policy pays for and how much. There are hundreds of insurance companies, and each company has hundreds of different policies from which your employer may choose, each with different payment levels.
We pride ourselves on being able to assist you in researching your dental insurance policy and assist you with understanding your insurance. We will call the insurance carrier for you and verify your coverage and benefits. We then load this information into our computer system so that we have easy access to the benefits and co-payments at all times. If your insurance carrier will send us a fax of your benefits, we will give you a copy to take home for your files so that you will have your benefits at your fingertips.
For your convenience, we will file your insurance claim for you and payment will come directly to our office — you will pay only your co-payment at the time of treatment. With the information provided by the insurance carrier, we will calculate your co-payment as accurately as possible. Occasionally there are small differences and we will always either credit your account or send you a statement if there is a remaining balance.
Obtaining an Individual Policy
People often ask us how and where they can purchase dental insurance on their own. If you don’t have dental insurance through your employer, then purchasing an individual plan would be your only option if you wanted to have dental insurance.
When shopping for a policy, you should carefully consider the cost of premiums against the benefits that you receive. Some of the carriers who write policies for individuals include:
Many employers offer flexible spending accounts (FSAs), where pretax dollars are set aside for medical and dental expenses. This is an excellent option for reducing your dental expenses. The amount of money you save is based on the tax bracket you are in. In addition, some banks and credit unions allow their clients to open health credit card, much like the old fashioned Christmas Savings Clubs.