Since our society has become accustomed to being “insured”, when an employer suddenly drops a patient’s dental benefit, I am often asked,”What is the best dental insurance plan I can buy?  Well, I am not an insurance expert, so I asked my staff about that and was shocked when I discovered that there really is none.  From what I discovered, you are better off saving the money spent in the premium and putting it in a money market for your recare appointments or the occasional  treatment you may need.  Why, you ask?  Listen to the latest exclusions that some  individual policies enforce:

*There is no coverage for panoramic x-rays at all.  BUT, there is coverage for a full mouth set of periapical films every 2 years.  (A full mouth series requires  more radiation than a panoramic film since it is a series of 18 films but this series will not give you information about any abnormalities under the tissue. Some policies set the payment solely on age of the patient, NOT risk assessment. Under age 17 they will cover cavity detection x-rays every 12 month–that includes children who are extremely cavity prone. Most children require x-rays every 6 months to keep them pain free.  Decay in a baby tooth can go ballistic in 6 months time.   Over age 18 insurance will cover x-rays every 24 months. Again, if the patient has an area of decay in between the teeth that started and we waited 24 months to detect it, we wouldn’t need x-rays to see it. It would probably be overtly present in the mouth requiring more than a small filling!

*There are plans out there that only cover $50 for preventive appointments no matter what treatment they needed on that appointment.

*Deductibles are taken on ALL appointments even preventive ones.   In the past those services were exempt.

* Some policies will cover fillings at the benefit fee for ONE surface regardless of how many surfaces the decay extends.  Other plans  will only cover 2 fillings PER YEAR. So if you had 6 areas of decay, they will cover 2 of them, and you, the deligent patient will not allow decay to remain in your mouth, so you pay out of pocket for the  remaining areas of decay. SO, next year, when you pay your premium all your cavities have been filled and the insurance doesn’t have to pay a penny.  Clever, uh?

*We found a plan that only covered simple extractions.  All those impacted molars?  Nope. They are not covered.

*Another plan would not cover a foundation under a crown unless we performed a root canal first (which, of course, we refused to do).

*One of the above mentioned plans had absolutely no maximum.  Well, why not?  You CAN boast of THAT advantage if you offer a the plan with more exclusions than benefits.

As my patient, please realize that I care about your dental health. Read the small print of a proposed plan; that is where you will find all the disappointing exclusions.

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