Robert A Foster, Jr
DMD/PC
Family and Cosmetic Dentistry
770-971-5119
1230 Johnson Ferry Place
Suite C-10
Marietta, GA 30068
Dental Plans are Different From Medical Insurance
Dental Plans are geared toward providing a maximum fixed quantity of benefits each year. No matter how much dental care you require, the insurance company will ONLY pay the fixed benefit that your plan has allotted you. A dental plan doesn't really expose the carrier to any significant risk because every plan has an annual allotment of benefits. And, that is the total amount they will pay and no more. These limits will typically be between $1000 and $2000 per year. This is not really insurance because it doesn't protect you from a catastrophic loss. Instead it would be more accurate to call this a dental benefit plan. Rather than protecting you, the company is protecting itself from catastrophic loss in the event you have major treatment.
Insurance companies have to make a profit, so they charge the premium for the dental services in the hopes that you will not use them. If the plan promises a maximum of $1000.00, and if you do not use all of the benefits for the year, the benefits are lost. Over the years it has been a goal for the insurance company to deny coverage for a variety of services. A lot of plans have waiting periods for basic or major services that prevent you from ever using all of the benefits. There are waiting periods such as a “missing tooth” clauses that prevent implant or bridge coverage if your tooth was lost prior to the initiation of the insurance plan. Some even deny benefits for white fillings and expect the patient to get silver fillings instead of the state of the art bonded ones. When the patient gets the uncovered treatment anyway, that is more of your benefit money that the insurance company is able to retain and thus increasing their bottom line of profit. Insist on a copy of the contract and be sure to read the smallest print of it, because that usually outlines limitations or possible denials of coverage.
Unlike your homeowner or automobile insurance, whereby the money you spend on the premium gives you peace of mind that you will be able to survive a catastrophic loss. If you pay for your dental insurance and it is not an adjunct to your medical benefit, you need to weigh the premium you pay against the actual benefit you may be receiving based on your history of dental needs.
Call us, we would be happy to help you with that decision.