A Mailbag of Insurance Questions...

A Mailbag of Insurance Questions...


            Every now and then, an article that I post leads to an inbox full of questions. Last week’s tome, regarding the expiration of insurance benefits, filled my Gmail with insurance based questions.  From that, I can only assume that I did a poor job in way of insurance explanation.  Or, my essay elicited some interest or reflection on the exciting subject of dental insurance.  As all dentists tend to be perfectionists, I’ll try to clarify some of the questions that I may have raised.


            Why does my insurance max out so easily?  -O. O. Benefitz.  Most dental insurance plans contain a yearly maximum pay out of benefits, usually between a thousand and two thousand dollars.  I’ve been told that this is the same amount allowed by dental insurance plans back in the 1960’s.  A little research reveals that a dental exam, x-ray and filling back then cost less than seven dollars.  A 1965 Ford Mustang, top-of-the-line, cost less than $2,500.  In other words, inflation has affected the cost of dentistry and there seem to have been little adjustment to the benefit maximums.


            You say your office is “insurance friendly.”  What does that mean?  -I.M. Confused.  Dental offices span the spectrum of large, group practices accepting and being providers for EVERY type of insurance plan to smaller fee-for-service practices who do not deal with ANY insurance plans.  There are many right ways that dental offices handle patient benefits.  “Insurance Friendly” means that an office staff will file all  insurance claim forms for their patients and wait out the insurance company for reimbursement, which can take up to ninety days.  Patients in this type of setting, are allowed to pay only their estimated co-pay or estimated patient portion at the time procedures are performed.


            Why doesn’t Medicare pay for dental care when it is so important to your health?  -R. E. Tired.  That is an excellent question.  I’ve been told that, back in the day, dental was considered as a potential benefit for Medicare, but was quickly cut due to what it would have cost our government and ultimately, us, the taxpayers.  I was not around then and cannot vouch for the truth or lack of truth in that statement.


            How will the new healthcare laws affect my dental care or benefits?  -M. Romney and B. Obama.  From what I can tell, even those who have actually read the bill are not sure if and how dentistry will be affected.  There is a proposed expansion of Medicaid that could provide dental benefits for those under the age of twenty-one, but this may be determined differently by different states.  The bill does include a tax that may be collected on many medical and dental supplies and lab made devices.  As of recently, to what this tax refers to has yet to be clarified.  To make a long story short, nobody really knows how this may change the practice of dentistry.  I am certainly no expert.  Only time will tell.


            Hopefully, this has clarified a few things.  If not, please feel free to send an email and we’ll be happy to reply.


            Yes, the names have been changed.  And no, I’m not that important to get emails from presidential candidates.  Although, I did once receive an email from an African prince who wanted to send me all his oil money.  Maybe we could fund healthcare that way... 


            Until next week, keep smiling.


-Please send comments to Drs. Parrish at www.ParrishDental.com.