The Chicago Sun-Times reported today that more Americans are choosing to cut back on visiting the dentist due to the current economic downturn……….with potentially far more expensive consequences than most think.
Click HERE to read the full story in the Chicago Sun-Times.
We understand the tempation to skip a regular check-up at your dentist’s office when times are tough and budgets tight. We also hope you understand that staying on track with regular check-ups could literally save you hundreds or thousands of dollars in dental treatment later. Think about it this way:
- Skip an appt. now or decide to wait to get the filling done for $1-200……..and when the cavity gets much bigger, you might need a build-up filling and crown for $900-1300.
- Skip getting the build-up filling and crown now for $9-1,300 and you may end up needing a root canal, too, which could add another $800-1100.
- Wait too long entirely and your tooth may not even be fixable and have to be extracted, and getting teeth replaced can be FAR more expensive than saving them. Just 1 dental implant and crown in Charlotte can cost $3500-5000; what if you need more than 1?
- Wait too long and multiple teeth that before only needed fillings, now need crowns and root canals?
- Wait too long and the early-stage gum disease that can be easily controlled now might progress to the point that they can’t be saved and you end up in dentures.
I know that I’m dramatizing the potential risks a bit here, but the thing is…..those risks are real and happen every day. It makes us really sad when patients put off the inexpensive treatment now and then have to pay a lot more, maybe even suffer a lot of pain, because they waited.
At Smiles by Payet Dentistry, we offer several options to help you afford your dentistry now, and of course we are glad to help prioritize your treatment to get the most urgent items taken care of first. Some options:
- CareCredit Interest-Free Financing for 3-, 6-, or 12-Months.
- Smiles by Payet Dentistry In-House Discount Plan
- And we have a couple others – Download our Payment Options worksheet for details or call 704-364-7069 for details.
The most important take-home message is simply this: don’t wait, because it will only get worse.
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.
I can’t claim credit for this analogy, but it’s a pretty good one, so I thought I’d follow up my last post on dental insurance, what it covers and what it doesn’t, with this example of how crazy it can be.
Imagine you are the manager of a Target Store. And in that Target, you have 600 items you sell. Everyone who comes into your Target on any given day has a different price they are supposed to pay for these 600 items. For many of these items, neither you nor the customer know the exact price, and the company with whom you have contracted these reduced fees for the customer won’t divulge the information, so you have to guess. Not that this isn’t already tough enough, but each of these customers has an Uncle who is going to pick up a portion of the elusive price, and it is your job as the manager to know exactly what portion the uncle is paying — assuming he will not deny it saying that they didn’t really need it!! Furthermore, you are supposed to know exactly where that uncle lives, and bill the uncle for the share he is going to pay. On top of this, the customer expects you to get it exactly right, every time, or they get upset.
And THAT, folks, is what it’s like dealing with dental insurance from the dental office side. 😉
Dental insurance is an interesting issue today, and it’s often a complicated one that confuses many patients. Heck, sometimes it even confuses us! Therefore, I’d like to offer a little clarification on what dental insurance is and isn’t, what it covers and what it doesn’t cover, when it’s worth having and when it’s not, and what you can do to make your life and ours a lot easier, smoother, and more trouble-free when it comes to your dental benefits.
- First and foremost: DENTAL INSURANCE IS NOT LIKE MEDICAL INSURANCE!!!! I really can’t stress this enough. With medical insurance, you pay your copay, and your insurance pretty much covers everything after that unless you go out of network or it’s something unusual. With dental insurance, you typically only get a certain amount of benefits per year, usually $1,000 – $1500. If you’re really lucky and have a great employer, it might be as high as $2,000/year.
- What does “UCR” mean, and is it really what it says? “UCR” stands for “Usual, Customary, and Reasonable” fees. Here’s the problem that most people don’t understand……every single insurance company determines what THEY think UCR should be, it varies by the ZIP code of your doctor/dentist, and not only will insurance companies NOT tell us or you what their UCR fees are, but they also don’t even reveal how they calculate them. Obviously, this makes it much more difficult for us to accurately estimate what your co-pay will be, and unfortunately, it often means you end up with a remaining bill after insurance pays less than we originally expect. The GOOD NEWS is that we have recently updated our practice management software to the newest version, and it has some marvelous features that will help us estimate much more accurately as we input more data. Please be patient with us, though — it is time-consuming to do and will take a little while to have completely set up.
- In-Network vs. Out-of-Network: There is a big misconception out there that – if you go to an out-of-network dentist (assuming you have a PPO and not a DMO) — you will end up paying a lot more out-of-pocket. Here’s the thing – that simply is not necessarily true! Now, sometimes it is, especially on really major kinds of treatments, such as bridges, implants, and the like. But for check-ups and cleanings, fillings, and sometimes even crowns, there may be no more than a $10-20 difference. Ask yourself this simple question: if you are really happy and comfortable with your dentist, isn’t it worth a few extra bucks to keep seeing someone you know and trust, rather than pick a dentist just because they’re “in-network,” even if you may not like them but you save a few bucks?
- “My cleanings are covered 100%, Doc!” Sadly, this is no longer true for everyone. With the current economy, many companies are changing the coverage they offer, and some of those plans don’t even cover 100% of your regular cleaning, EVEN IF you go to an In-network dentist. Sad, but true. It is very important that you keep yourself informed of what you plan covers and doesn’t.
- “But my insurance was SUPPOSED to pay $XXX amount, and you told me wrong!” This is where we are really looking forward to the improvements in our software that should help us calculate the proper amount, but there is an EXTREMELY important fact to remember, which is: we can never give you better than an ESTIMATE of what the insurance will pay. The insurance company itself will tell you the same thing if you call them. Doesn’t even matter if you call and give them the ADA procedure code, our fee…..they STILL will only give you an estimate, NOT a guarantee. I know this can be frustrating, and it is for us, too, because we know it’s never fun getting a bill in the mail after you thought you’d paid all you had to pay.
- The last item for today: please remember that, when it comes down to it, you are responsible for the entire bill. If your insurance doesn’t pay; if your company quit paying the dues and the coverage lapsed, or any of the other possible reasons insurance doesn’t pay or it pays less than expected, you are responsible for paying your bill. We bill the insurance as a courtesy to you.
Of course, this doesn’t even get into all the details of all the different insurance plans. Bear in mind that our software has almost 500 different insurance companies listed, and there are probably close to 1000 different policies. It is impossible for us to know every detail of every plan, although we sure do our best to find out. Your best bet, though, is to know your coverage, too. Ask you Human Resources department to help; they are often a great resource if your insurance company is trying to get out of paying, too.
Yes, dental insurance is complicated. Call us if you have any questions.
We’ve actually been a Preferred Provider for Delta Dental Premier for several years now, but we just received confirmation that CIGNA has now processed all the paperwork, and we are officially listed as a Preferred Provider for CIGNA as well. This is great news for the many patients who already receive care with us and who have CIGNA, but for other patients who are seeking a dentist on their list. This will provide some significant savings for anyone whose employer offers them dental insurance through CIGNA.
Of course, I don’t want to miss this opportunity to plug our Smiles by Payet In-House Discount Program, which is a program that we created for our patients with no dental insurance, or who perhaps have dental insurance but it’s a HMO or other plan that won’t allow them to see us, but they value the service and quality we provide and want to keep us as their dentist. Follow the link to our website for more details, or call and talk with Rosie Bonnett, our Front Desk/Patient Care Coordinator, and she can help you get signed up.
Especially in today’s economic client, we understand that the lack of dental insurance keeps many people away from the dentist. In order to help, we have done some research and created our own “Smiles by Payet In-House Dental Insurance Plan.” For more details, see our website www.SmilesbyPayet.com and at the top of the Home Page you’ll see the announcement, as well as a link to a more detailed explanation. It’s pretty simple , and you can even download the form to apply.
The Basics: An affordable Annual Enrollment Fee of only $295, which covers 2 regular cleanings, x-rays, and check-ups per year, and once you’re signed up, you will receive up to 20% (TWENTY PERCENT) off ANY and ALL treatment options offered at Smiles by Payet Dentistry. Even cosmetic procedures not normally covered by dental insurance, such as Veneers, Bleaching Trays, Deep Bleaching ™, and Short-Term Adult Ortho. This can mean a huge savings for you, but what’s most important is simply that you won’t get off-track with maintaining your dental health.
Besides checking it out on our website, please also call Rosie Bonnett, our Patient Care Coordinator, who can fill you in on the details and get you signed up.
The plan is not open to those who already have insurance at this time due to the complications it would create administratively.