Dental Insurance: ‘Scam’ Or Not, Why You Probably Don’t Need It And How It Often Leads To Problems
By Jesse Nickles | October 12, 2014
Going to the dentist is a necessity. But dental insurance?Not so much.
Dental insurance is a relatively recent consumer phenomenon that exists primarily in North America. The industry sprang up almost completely overnight due to large American companies who decided to begin offering dental insurance as an extra benefit to their employees, in the hopes of looking more attractive. In fact, Delta Dental is almost single-handedly responsible for creating the dental insurance industry back in the 1960s, when they began partnering with labor unions, military and government organizations, and private corporations, in order to offer dental coverage plans.
In contrast with other developed countries – such as those in Europe – dental insurance in the U.S. is completely separate from health insurance, and is considered an “add-on” benefit that many American employers offer in conjunction with their health insurance, but usually under a different brand. For example, a company may have “group coverage” health insurance for their employees through the Blue Cross / Blue Shield network, and might offer additional dental coverage through an organization like Delta Dental. In many cases, employers offer dentals plans BUT DON’T COVER THEIR COST, meaning that its an out of pocket monthly fee passed on to their employees.
Despite there being no such thing as “vision insurance” or “chiropractic insurance” in existence, the self-created, industry-driven anomaly that is dental insurance continues to grow bigger (and seedier) with each passing year. And unless you’re an MMA fighter, cocaine addict, or have a rather large family, buying dental insurance is almost always a waste of time and money.
Monthly Payments Exceed Typical Costs
Many people have unreasonable expectations of insurance; they believe that by paying into an insurance plan, all of their visits to the doctor, dentist, or otherwise should be free of charge. Not so. The main purpose of insurance is to protect you in case of an emergency which may land you with massive bills – for example, breaking your leg.
Ergo: unless your lifestyle presents serious risks to your oral well-being, 99% of people only need a basic dental cleaning a few times a year, meaning that separate dental insurance is rarely a necessity. In fact, even if you HAD a “dental emergency” the truth is that its probably not even covered by your dental insurance (see more information below). Even the U.S. Senate is contributing to dental insurance alarmism, due to the fact that Medicaid holders do not get dental coverage. Bullsh*t. Even if more people DID get dental insurance, it wouldn’t save most of them any cash at the end of the year because the monthly bills usually exceed out-of-pocket costs…
On average, the maximum annual payouts from dental insurance plans are only $500-2,000 per year, a figure which hasn’t changed since the 1970s. Adjusted for inflation, dental insurance plans should be paying out between $4,000-8,000 a year by now, according to MarketWatch.com. Instead, payouts remain minimal, while typical monthly fees of $30-60 per person add up to $360-720 per year in real costs, yet somehow only tend to cover 2 free basic cleanings each year. Oh, and if you want any “special” dental work done, such as implants, crowns, or other work, dental insurance plans typically won’t even cover those items until a few years into your coverage – and even then, it only covers 50% of certain procedures, OR LESS, in many cases.
Open Invitation For Insurance Fraud
Now, I know what some of you are probably thinking: “Well, maybe dental insurance is a ripoff… but I get it free/cheap from my employer, so I might as well keep it.” But even when insurance is FREE, it invites massive consumer fraud that comes with any other type of insurance. Except, for some reason, dentists seem especially prone to it:
- Unnecessary, dangerous procedures to hike up insurance billings
- Fraudulent inflated billings (i.e. lying to your insurance company)
- Phantom treatment on patients who aren’t even in their office
- Forcing you to get “deep cleaning” a.k.a. scaling/root planing
- Random charges for things like antibiotics or equipment
As a clueless young college graduate in California, I myself was a victim of “deep cleaning” fraud. At the time, I had Kaiser Permanente (HMO) health insurance with a Delta Dental add-on coverage package. Scanning the Kaiser online database for an “in-network” dentist, I showed up to their office for a basic cleaning when the dentist convinced me that my gums were unhealthy and that I needed immediate scaling to be done. She assured me that it would be mostly covered by my insurance, and tried to schedule me for a total of 3-4 additional visits to her office. After the 2nd visit, I attempted to ask her what would be done at the 3rd visit. She became angry and shouted at me that she “was done talking to me” and would “see me at my next scheduled appointment.” Well, needless to say, I didn’t return to her office, and soon figured out she was attempting to overbill my insurance plan on root planing procedures that I didn’t even need!
Besides the obvious risks to your own personal health, these shockingly common practices can also have the side effects of exhausting your annual payout limits and increasing your dental premium payments, among several other outrageous situations.
It’s no surprise, therefore, that companies like AFLAC, Delta Dental, and Encore Dental are regularly called out on the internet for their dishonest sales pitches, in which they promise customers things like free dental cleanings, coverage of advanced procedures like crowns and implants, and other false advertising that is ultimately a complete scam.
Finding A Dentist Becomes More Difficult
T. M. Bridgeland, a writer at HubPages who used to work in customer service for dental insurance companies, explains why in the end, finding a dentist is MORE complicated AFTER you have insurance (something I also experienced):
There are lots of details, of course, such as In Network or Out Of Network dentists. In Net means the dentist is under contract not to charge over a certain fee for each service. In Net is usually cheaper. So get your routine work done In Net, and normally you will pay very little or nothing for it. You may also get reduced prices on major work.
Out Of Network dentists’ charges are not controlled by the insurance company or the network. The dentist can charge any price he pleases. Some Out Of Network dentists may actually charge less than the network price, and be cheaper for you than In Network. You have to do your homework before going to the dentist. Find out if he is In Net or Out Of Net, and ask him directly how much it will cost before you go. They don’t like to tell you, but you are the customer. Be polite, but insist. Would you get a haircut if the prices were not marked?
As in the case with many doctors, dentists who have built a business model around getting a stream of customers directly from an insurance network are highly unpredictable as far as quality and honesty goes. And why should they be? They don’t give a damn about customer satisfaction or even Yelp reviews, because they will keep getting more business from being one of the only “in network” dentists in their area.
That is, dental insurance is getting you a dentist who relies less on reputation, is probably charging more for their services than others, and is possibly committing some form of insurance fraud on a regular basis.
Ultimately, it makes more sense in most cases to simply put a few hundred dollars away in a “dentist” fund each year for basic cleanings. Then, find a local dentist with a good reputation and reasonable prices who doesn’t require $500 worth of “mandatory x-rays” before you can get your teeth cleaned.
- See also: Dental Discount Plans: Instead Of Buying Dental Insurance, Consider A Discount Membership Option
If you have a large family, or members of your family will be needing braces or significant orthodontic work, however, it may still be worthwhile to check out family dental insurance plans. (As with any medical insurance, watch out for pre-existing conditions, such as missing teeth, that are usually not covered.)
Or better yet, check out one of the many new “dental discount plans” that are popping up all over the place, which typically have a low yearly membership fee in exchange for greatly discounted dental procedures in your area.
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