Don't Let Dental Insurers Dictate Your Care

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By Tod A. Bigelow D.D.S.

A dental plan helps cover part of the cost of dental care - it does not cover the full cost of the specific treatment you require. Dental insurance is designed as supplement to your co-payment and will pay a percentage of the dentist's bill, not the entire bill.

Some plans will only provide the level of benefit allowed for the least expensive way to treat a dental need, regardless of the most effective treatment required. Utilize your insurance as a benefit to help cover the costs involved.

The plan was never intended as written by the insurance company to cover 100 percent of everyone's dental needs. Don't allow your dental plan to dictate the care you receive. Some dental plans exclude necessary dental treatment such as sealants, orthodontics, and crowns and bridges. Not doing recommended dentistry because insurance won't cover it can only harm you and let conditions worsen in your mouth.

If you expect your insurance to cover it all and choose to not do completely and totally what your dentist recommends, you will be putting your dental health in jeopardy. Only your dentist can provide you with a treatment plan with your health in mind. It is not the insurance company's job to do so.

Insurance company's primary concern is to make a dividend or profit for its stockholders. Therefore, the more dollars they keep, the more successful they are. Insurance companies can keep their dollars intact in many ways. To name a few:

• Offering coverage at several payment levels.
• Paying less than the dentist fees.
• Paying a lesser percentage on procedures.
• Denying procedures or not allowing (on preauthorization's.
• Not covering certain procedures.
• Recommending lesser alternatives (less expensive) than what the dentist recommended. These usually are alternatives that don't promote ideal optimum health, but only maintains a mouth in its current, sometimes unhealthy condition. Thusly, these alternatives do not heal or stabilize, but can allow further breakdown to occur, which can create more dental problems later on in life.
  

This is ideal for the insurance company as they pay out less now, keep their money invested and later on if you die or drop off their insurance they don't have to pay for your future dental breakdown.

These are the facts and the way it works. Insurance is a business. Now, having said all of that, I'd like it known that I'm not "dissing" insurance in general. As a matter of fact, I like insurance and support its usage in all ways. I just want people to know how it works so they don't compromise their care by following the insurance company's dental recommendations verses their dentist's recommendations (whose job it is to take care of your health.)

So just a little more advice, find yourself a dentist who practices complete comprehensive dentistry and gives you a complete evaluation of your oral health with recommendations for current and future care to keep your mouth healthy during your lifetime, and use your insurance as a supplement to help you do so.

Tod A. Bigelow D.D.S. is a dentist practicing at Smiles by Bigelow and Tolbert located at 4301 Lincoln Road. Reach him at 582-1623 or visit www.smilesbybigelow.com