Dental Insurance not covering cleanings 100%? You bet!

For ages, it has been commonly accepted by patients that their dental insurance covers 2 cleanings, 2 exams, and 2 sets of x-rays every year.  However, I have to warn you about something, and you should seriously look into talking with your Human Resources Department about this to see if it may be happening at your company — this is not always true any longer!

It really shouldn’t be surprising, but with employers looking to cut costs, and insurance companies looking to find ways to keep from paying out as much, but in just the last several months, we have run across this situation with SEVERAL companies, and it seems to be occurring more frequently.  So just what is happening with your dental insurance coverage?

1) Just last week, we found 1 insurance company that now only pays 75% of the exam and cleaning, and that’s even if you see a dentist who is in-network. It seems crazy, but true.  Even if you go to a dentist who is in-network for this plan, they don’t cover 100% of the exam and cleaning.  Surprisingly, they DO still cover 100% of x-rays, but I expect to see that change soon, too.

2) In the last 3 weeks have found 2 insurance companies that now make you pay your deductible (usually $25-50/year for an individual) on your exam, x-rays, and cleaning! This means that – EVEN IF your plan covers 100% of the cleaning, exam, and x-rays, they still make you pay your deductible on that.  This is fairly new; it used to be that deductibles would only apply to things like fillings, crowns, non-surgical gum therapy for gum disease, root canals, etc.  Before this, if all you needed was the exams, x-rays, and cleanings every year, you never paid anything out-of-pocket.  Not any more!

So a little warning…….CHECK YOUR BENEFITS and BE AWARE.  It’s not bad enough that the amount of insurance coverage you get hasn’t changed since 1970 (did you know that?  Yes, in 1970 dental insurance typically covered $1,000-1,500 per year — the same as they do today.  Shameful, isn’t it?), but now they’re cutting it back even more.  Don’t be surprised to hear that you have to pay for your cleaning, exam, and x-rays.

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