Every individual has an oral environment and subgingival and supragingival biofilm that is as specific to them as their fingerprint. For that reason, each and every patient requires an oral care regimen and often a restorative treatment plan that is specific to their individual needs. Caring dental professionals understand this imperative and strive toward this ideal standard with their patients.

 

But, today’s traditional dental insurance isn’t even in the same ballpark as this idyllic standard of care. If anything, the existence of traditional dental insurance and the impression it communicates to patients hinders dental teams and patients from receiving quality care.

 

The source of this chasm between traditional dental insurance and patient specific care starts with how dental insurance is primarily sold. With 8 out of 10 patients with medical coverage having dental insurance supplied by their employer versus 3 out of 10 that purchase individual medical insurance also purchasing dental insurance, employers are the dominant and primary customer of any dental insurance provider*.

Employers primarily provide medical and dental coverage benefit packages as a means of attracting and retaining quality employees. With the continued rise in cost of employer provided medical coverage, most employers seek out the dental benefit packages that provide “coverage” at the lowest possible price. Therefore, dental insurance companies are in competition to provide employers with a minimum offering with the cheapest possible price.

 

In order to continually lower the price of their plans to stay competitive while working to maintain their profit margins, dental insurance providers often employ a number of tools to keep costs down. Such as reducing fee payments, limitations and waiting periods for what is covered, denying claims outright, placing bureaucratic roadblocks to minimize claim approvals, or requiring additional or unnecessary x-rays or other confirmations to get a claim approved.

 

Within this environment there is no room for the dental team to provide any semblance of individualized care when the insurance companies and employers are dictating coverage. Also giving patients the impression that their dental insurance company is advocating for their care by denying “unnecessary” preauthorization’s or claims.

 

What was once intended to be a true benefit to patients and dental teams has now become an expensive, time consuming, bureaucratic nightmare for patients and dental teams. With the number of patients with dental insurance experiencing a 10% drop since 2002 (from 60% to 54%)**, is it time for dentists and patients to give traditional dental insurance the boot?

 

*http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&ved=0CEkQFjAA&url=http%3A%2F%2Fwww.cdc.gov%2Fnchs%2Fdata%2Fdatabriefs%2Fdb40.pdf&ei=LtXbVKDnNsuwogT4moKQCg&usg=AFQjCNH5Rl2DNXJ-qi8NVn8GHe4PIYSICg&sig2=B_nLs2vigzBx_PNNsizHsw&bvm=bv.85761416,d.cGU

**Delta Dental Insurance Data 2014