DENTAL BENEFITS 101

Effective July 1, 2020, our practice will be considered a Non-Contracted Provider with all dental insurance companies. The good news is that this does not have any bearing on our relationship with you! Many of our families use their Out-Of-Network Benefits with their dental insurance, many choose to use their HSA/Flex Spending for dental benefits, and many pay out of pocket. Regardless of whether your family has any form of benefits, we thought this information might be helpful in educating you on the landscape.

What does this mean for my family?

Recently, we sent additional information to our families that were affected by our July 1, 2020 network status change. Below, please find a PDF copy of each of the communications sent.

Click here for a copy of the letter
Click here for the Q&A

What are 'dental benefits'?

Perhaps the place to start with this answer is to help accurately describe WHAT dental insurance actually is. Unlike medical (or life or home or auto…), dental insurance is truly nothing more than a ‘discount plan’ to help offset the cost of dental treatment. It essentially has a maximum payment amount (ranging from $500 - $2,000 depending on how the plan was set up). As you receive treatment, the insurance company may pay out a portion of the cost to help reduce your responsibility, up to the annual maximum amount. We always encourage families to reflect on whether dental insurance is the best approach for their families’ needs – we know there are other options available (e.g., Flex Spending Accounts, Health Savings Accounts, Membership Plans, etc.) and would be happy to discuss those with you.

Do I always have to see a dentist that is 'In-Network'?

Happy to report that most insurance plans offer two categories of benefits - In-Network and Out-Of-Network. That means that you can be seen by a dentist that has either decided to contract with the insurance carrier - or has decided not to contract and is termed 'Out-Of-Network'. Again, most plans have benefits available for both categories! It's important to remember that the choice of where you wish to bring your children for care ALWAYS resides with you! We work with many, many, many families that exercise their Out-Of-Network benefits at our practice - and many who have In-Network benefits. If you have any questions regarding your plan, please don't hesitate to contact us and we can help you explore your benefits.

Is dental insurance always the best approach?

Not always! Many families are unaware that they may have the option to forgo dental insurance entirely and instead leverage a Flex Spending Account or a Health Savings Account. In addition, there are Membership Plans that are available to you (one of which we will be rolling out in our office so stay tuned!). If you wish to discuss what options may make sense for your family, please don’t hesitate to contact our office! Know that most dental disease is preventable. If your family follows the principles of disease prevention, your children may not need much more than preventative services (i.e., exams, cleanings, fluoride, x-rays, sealants, and diagnostics). If your family is able to embrace these prevention principles, it may not make sense to spend the money on dental insurance – we are happy to help explore other options for your family so please give us a call!

How can I learn more?

The American Dental Association (ADA) offers a series of very short articles on their website that we think you might find helpful as you weigh your options. Here are a few links:

What's the difference between 'dental insurance' and 'dental benefits'?

https://www.mouthhealthy.org/en/dental-care-concerns/insurance-vs-benefits

Do I need a dental plan?

https://www.mouthhealthy.org/en/dental-care-concerns/do-i-need-a-dental-plan

Why Aren't Dental Benefits Typically Included with Health Insurance?

https://www.wgbh.org/news/local-news/2019/11/20/why-arent-dental-benefits-typically-included-with-health-insurance?fbclid=IwAR0iUI50DCYMORWag9RJwDBV7PtJdIjQr2HzDu3YlgVzBy3g4PZbu2xQVzg

We wanted to share one last piece of information regarding Delta Dental. Over the last several months, Delta Dental has had numerous lawsuits filed against it from organizations and individual doctors expressing concern over their business practices. Most recently, the American Dental Association (ADA) has filed a class-action lawsuit against Delta Dental.

Click the link below to learn more:

https://www.ada.org/en/press-room/news-releases/2019-archives/november/american-dental-association-files-suit-against-delta-dental?fbclid=IwAR3y9Xo2wHbtMF8YHzJupULef2LvFlPZLBEjgEg7tez8N00mySyhklRQBeE

As always, if you have questions or think we can be of help, please don't hesitate to give us a call!