Insurance is tricky business. If you've ever had to file a claim through an insurance provider, be it automotive, medical, dental, renters or otherwise, then you're probably aware of just how time-consuming this process can be - and the run-around insurance companies live to put you through. If it seems like they're looking for any excuse to not pay you, despite the fact that you've faithfully been making your monthly payments to them for years, then guess what? You're right! They will do anything to avoid having to cover you.
I've heard stories third-hand from people who have worked for insurance companies about how they would shred piles of claims daily. Making you re-submit your claims over and over is just one method for them to weed out the less persistent - albeit, totally justified claims - from getting through, and getting paid.
Ultimately, your insurance company is just that - a company. As such, your insurance provider is subject to all the expenses associated with running a business - payroll, rent and utilities, and standard overhead expenses, to name a few. Somehow, they have to make a profit off of you, their customer. For companies as large as most insurance providers, they likely have to answer to a board of executives and shareholders as well - all of whom are interested in seeing the company profit more, grow more, gain more, yield more for the owners of the company. So, why not cut out the very expensive middleman - in this case, a multi-billion dollar company - and go directly to the source for the care you need?
It seems like common sense, but we've been sold the idea that insurance coverage is a necessary precursor to receiving care. The dental industry, however, has always been the proverbial black sheep in the medical family. Many healthcare plans do not cover basic dental needs, and instead, treat it as optional. Apparently, whoever designed those plans has never needed a root canal...!
Not to pick on Delta Dental too badly, but since they're the largest dental plan system in the United States, let's take a look at a quick side-by-side comparison of the Delta Dental Basic Plan vs. our in-house Affordable Smile Plan. I looked at what the cost for dental insurance would be for a single adult with coverage starting Dec. 1st, 2017. Delta Dental offers a Basic plan, ideal for people who are relatively healthy, with minimal dental needs. For those who are on a budget, who practice good oral hygiene habits, and are free of any major dental concerns, this would be an appropriate fit. This Plan is designed to target individuals whose typical yearly dental needs will consist of cleanings, checkup x-rays, and fluoride treatment. Any major restorative or cosmetic procedures are not covered.
Let's start with a quick look at the up-front costs. Note that the Delta Dental Plan's monthly cost does not account for the $15 co-pays that accompany every visit. For two hygiene visits a year, that's an additional $30, or $2.50 a month not included in their premium fees over the course of a year. Here's how it all stacks up:
The cost is essentially the same, especially when adjusting for the co-pays on the Delta Dental Basic Plan. The benefits, however, are another story. It's important to note that Delta Dental will pay off of their own fee schedule instead of ours, and their fees typically run low... we'll take a look at how that affects things momentarily. But first, here's the breakdown of what's covered under the Delta Dental Basic Plan off of their fee schedule compared to the Affordable Smile Plan discount off of our fee schedule:
Looking at the chart above, things look pretty close! But now, let's say we account for the disparity between Delta Dental's fee schedule and ours. Keep in mind that insurance companies rarely adjust their fee schedule for inflation or the cost if living in a geographical area, and there is no discernment between a dentist straight out of school and one who has been practicing for 20+ years. Looking at our office's latest payment from Delta Dental, I was able to adjust for the percentage of our fees they generally pay for these procedures. The numbers change drastically! Here's the proportion of our fees actually paid by Delta Dental, compared to the Affordable Smile Plan:
These numbers are devastating for the Delta Dental Basic Plan. The difference here makes the answer obvious. If you have affordable insurance provided to you at no additional cost through an employer, certainly take advantage of those benefits! But if you're generally healthy and considering signing up for a personal dental insurance plan that has you paying $30+ for your monthly premium, we can usually undercut the cost of your insurance and save you potentially hundreds each year.
To learn more about the Affordable Smile Plan, visit the finances section on our website: https://www.wellnesscentereddentistry.com/finances.
16150 NE 85th St #115
Redmond, WA, 98052
Wellness Centered Dentistry: Raymond Hsu, DDS, MAGD, LLSR
16150 NE 85th St #115
Tel: (425) 882-1354
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