Insurance…you know you need it, but the benefits can be confusing and written in pure legalese. When most of us sign up for health insurance through our employer, we glance at what’s covered but still end up taking the most economical option available. However, in most cases, dental insurance is NOT included as part of coverage. Instead, it’s defined as an “excepted benefit” that you much proactively sign up for and pay for with a separate premium.
If this seems strange, maybe you’ll feel better learning the origin of this policy. Because it is deliberate, and there is a why.
Until the 1800s, dentistry was in the domain of barbershops (insert surprise here). The same barber who trimmed your beard also removed teeth and drained assesses. It took a long time for thinking to evolve from that norm since most dental issues do not result in hospitalization (the olden standard for what was deemed “medical”).
Thankfully, the practice of dentistry has evolved, and we are no longer expected to fix both your teeth and cut your hair! However, while the practice has modernized, its inclusion in traditional health insurance benefits has not.
Who has coverage?
It’s estimated that about 30% of the population lack dental insurance altogether. The dentally uninsured rate has increased to about 4 times the medically uninsured rate—and that’s even with dental coverage expansions.
For older Americans, many assume Medicare will pick up the tab like it does for other health coverage. Unfortunately, most government programs like Medicare and Medicaid do not traditionally cover dental insurance as an automatic benefit. For our patients aging out of private market or employer coverage, it’s important to thoroughly examine your Medicare benefits and consider purchasing a supplemental plan or finding a Medicare Advantage plan that does cover dental services.
For those who lack insurance coverage, it can be confusing and scary going to the dentist and not knowing how much a procedure will cost you. Since our medical system relies on third-party payers (insurance companies) to negotiate and pay for services, patients are generally left in the dark on how much something costs. This is not beneficial for the patient or the dentist.
Adding to the confusion, health insurance and dental insurance policies and coverage are structured very differently. While you might need to pay a copayment when you visit your doctor, if you aren’t careful about your dental coverage then that bill—even with insurance—can be significantly higher. Think of dental insurance more like car insurance. You don’t pay a copayment when you get an oil changed on most policies, but instead you’re covered if you get into an accident. This is true in many popular dental insurance policies, too. While you may have to pay slightly more out of pocket for minor services, you will be protected against truly catastrophic costs for other procedures. This structure allows premiums to remain low compared to health insurance, so it does have its pros.
How we talk about insurance
Due to the confusion in costs, here at Josey Lane we want to be able to provide you with as much information up front as possible. On our website you can find the cost of a cleaning for both new and returning patients. In addition, we partner with serval financing agencies if the care you need isn’t in your budget this minute, but that toothache says the time is “NOW.” The best part of reading through our payment and insurance information on the website: we also offer cash discounts!
Finally, if you are in need of dental care and simply are not in a place financially to pay for it, we are happy to help you locate free dental clinics. Charities like the Urban Community Center of North Texas helps individuals pay their medical bills, too. If you are experiencing tooth pain, it’s crucial to address it early before the problem becomes more severe and results in even larger bills later. Give our office a call today to discuss all your options! We’re here to help.
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