Dental Insurance Today

Man charged for cancelled insurance

KGO-TV - San Francisco,CA,USA — Wed, 27 May 2009 15:59:01 +0000

Health insurance is expensive enough but what if you pay and still aren't covered at all? 7 on your Side's Michael Finney says it can and has happened. Many people dread going to the dentist. But, for one Bay Area man, a recent visit was especially painful and it was not because of the dental drilling. It was his dental insurance. Glenn Bell had two good dental plans. One through his wife's job and another through a Delta Dental plan he bought a year and a half ago through his own job. "I figured, well with Delta Dental and paying that much money, I probably have great dental insurance," he said. Out of habit, Bell was using his wife's insurance. But at his last dentist appointment he found out his Delta dental plan would cover more of the cost, so he used it. That is when he found out the truth. "I had no benefits and was unaware that I had no benefits," he recalled. It turned out that Delta had cancelled his dental insurance way back in April 2008, yet Delta had been taking his money, $156 per month, the whole time, in premiums that came directly out of his paycheck. A Delta official told him, "I can confirm that your benefits were terminated." "Why didn't you pick up the phone and call me and let me know or write me a letter or say something?" Bell asked. "Well, you know, there's a lot of people in your group and we really don't have time to contact each and every individual," was the reply he got. Bell had one more question. "What have you been doing with the $156 that I've been paying you for the last 15 months?" he wanted to know. "Well, you're going to have to contact someone else," was the response. Bell demanded a full refund of all that money, about $1400 in all. He wrote letters and left messages but got no response. So, he told Delta he was headed over to its San Francisco headquarters to straighten things out. "You no longer have Delta Dental benefits, so we don't have to discuss it with you," they told him. "So, you have a nice day and stay away from our building." That felt about as nice as a root canal and Bell did not know where to turn. "I've watched Michael Finney and I've seen what he can do. I just said, "Let me call 7 On Your Side." So he did and 7 On Your Side contacted Delta and got answers quickly. Delta said Bell was dropped from the plan due to an error by an outside plan administrator. Delta said it should not have taken so long to research his problem. And, the company said it was "working with those individuals who contributed to making this an unsatisfactory experience for Mr. Bell." "About 96 hours later I got a check in the mail for $1,404 and a letter of apology," said Bell. Delta said mistakes like this are "a rare occurrence" in a company with 18 million customers. It said, "We know how frustrating it can be dealing with an insurance company ...

Dental Insurance Coverage for Dentures

The Editor — Mon, 25 May 2009 21:08:02 +0000

There are plenty of dental insurance plans that will cover dentures, but you need to plan ahead. Many but not all dental insurance plans have waiting periods from 6-18 months.

As an example: Replacing teeth with dentures is classified as major dental services. The average benefit is 50% co-insurance for your dentures. Dentures are covered by some dental discounts dental plans. Remember discount dental plans are not insurance dental plan.

What happens when you get dentures?
Full or partial dentures replace your teeth when you have lost your natural teeth, from periodontal disease, tooth decay or injury. They will help your appearance and your health including support for facial muscles sag which makes a person look older. Dentures normally take one month and 4-5 appointments which include the initial exam, wax bite impressions, and final denture adjustments.

How to take care of dentures?
Remove and brush your dentures with a tooth brush and denture cleanser designed for dentures. When the dentures are not used, soak the dentures in a denture cleaner solution or in water.

Should dentures be worn at bedtime?
Dentures should not be worn while sleeping to allow the gum tissue to rest and normal stimulation and cleaning by the tongue and saliva.

Are there alternatives to dentures?
Strategically placed supports or implants can be used to support permanently cemented bridges, eliminating the need for some dentures.

I hope this information on dental insurance …

Digesting the alphabet soup of dental insurance

The Editor — Mon, 25 May 2009 21:03:01 +0000

Understanding the alphabet soup of dental insurance plans can be a difficult endeavor for most people. Two common insurance acronyms include PPO and HMO. Managed care plans are often either PPO or HMO, standing for preferred provider organization and health maintenance organization.
With PPO insurance plans, the companies negotiate fee schedules with dentists in exchange for the dentist being put on a list of “preferred” providers. Employers give the list to their employees to match them up with dentists who participate with the dental plan. Dental insurance can help people pay for dental treatment, but it has its limitations. Most insurance plans have a deductible of $50 to $100, pay only a specified percentage for each type of treatment, and have a yearly maximum amount of funds available for dental care.

Most PPO plans cover preventive care, cleanings, check-ups, protective dental sealants, x-rays, and fluoride treatment at 80-100%. Basic care, including root canal therapy, extractions, and fillings are usually covered at 80%. Major care such as crowns (caps), permanent bridgework, and full and partial dentures as well as periodontal (gum) care are often covered at 50%.

Many insurance companies have a yearly maximum of a $1000. Dental insurance is not cumulative, so if you don’t use it, you lose it. It is interesting, and disappointing, to note that when dental insurance companies became common in the early 1970’s, the yearly maximum in many was the same $1000 it is today, even though the cost of delivering dental care has nearly tripled since then.

HMO’s have received a barrage of negative publicity in recent years, primarily in the medical community, for dubious “gag” clauses in the contracts, bureaucratic snafus, and the limitation of appropriate care of patients by their physician. While some HMO insurance plans may be adequate for practitioners in the medical community, they are more difficult to justify in the dental community. The main reason is that practice overhead is generally higher in the average dental practice than the average medical practice, and the financial compensation from most HMO’s is very low. 65 to 70 cents of every dollar received at the average dental office is consumed by office overhead, including staff salaries, supplies, laboratory fees, rent, etc.

The reduced fees allowed by dental HMO’s has participating dentists doing many dental treatments at a financial loss. A recent study by the American Dental Association found that the average dental HMO does not even adequately reimburse inexpensive preventive dental care. Consequently, a dental practice with a majority of patients having HMO insurance is often forced to see patients quickly- too quickly in my opinion, to develop the necessary rapport essential to the dentist- patient relationship. A dentist I know told me that when an HMO patient comes into his office for a cleaning, he does not give that patient the “free” toothbrush that he routinely gives to his other patients.

As you might have guessed, I am not a big fan of HMO’s. We do not participate with any HMO’s but are involved with some PPO’s. Dental insurance …

LFG adds providers, optional benefits to dental coverages

The Editor — Sun, 24 May 2009 20:34:31 +0000

The Insurance Solutions division of Philadelphia, Pa.-based Lincoln Financial Group announced the expansion of its panel of dental providers. ...

Healthy eating improve dental health of children

DentalPlans.com - Dania,FL,USA — Sun, 24 May 2009 19:59:40 +0000

Many parents aren't aware of various routine everyday behaviors they have that contribute to tooth decay and other forms of poor dental health for their children, according to an article in the Sebeka Menehaga Review Messenger. The paper listed some of the mistakes parents make, according to a survey by the American Academy of Pediatric Dentistry. Some of the most common mistakes stem from a lack of understanding that the presence of sugar in the mouth for bacteria to feed on is one of the key factors in causing tooth decay. Even the healthiest of snacks can result in sugar for the bacteria, as starches and other food particles are readily converted to sugar and usually stay in the mouth far longer than candy. The article recommends water, preferably fluoridated water and not bottled water, as the only thing to drink between meals and before bed. All other drinks contain sugar which can stay in the mouth for hours. The ADA recommends children see a dentist for a regular checkup by the age of 1. Avoiding excessive costly visits by preventing cavities is wise in this economy, especially with so many children going without dental insurance ...

Employer health insurance no longer option for many

The Editor — Sat, 23 May 2009 14:20:41 +0000

Recession, depression, cutbacks and layoffs are words all too commonly heard these days in news reports and conversations. Since the beginning of the financial crisis, millions of Americans have lost their jobs and many economists are predicting that more job cuts are on the horizon. With the loss of their jobs, Americans are not only losing their source of income, but for the 63 percent of Americans under the age of 65 who have health and dental insurance through their employer, they are losing that as well. In February, the unemployment rate hit 8.1 percent according to the Bureau of Labor Statistics (BLS). This translates into roughly 12.5 million people who have lost their jobs. The Urban Institute, a nonpartisan economic and social policy research organization, estimates that for each 1% rise in unemployment, 2.4 million Americans lose employer-based health care. For many of the newly unemployed, their first step to maintaining health insurance is to sign up for coverage via the Consolidated Omnibus Budget Reconciliation Act (COBRA). That's exactly what Sally Hughes of California did. Sally Hughes signed up for COBRA after she lost her job in July 2008 and is thankful she was able to maintain health insurance. "Last month I fell and broke my two front teeth. With the dental insurance through COBRA I saved thousands of dollars on the treatment," said Hughes. "Plus, with COBRA I am still on track with my routine doctor visits and preventative care." COBRA gives recently unemployed workers and their families ...

Dental schools offer affordable care

The Editor — Fri, 22 May 2009 13:13:42 +0000

If you are unemployed, chances are you don't have dental insurance. But there is a way to get state-of-the-art dental care at a huge discount.

Put Your Money Where Your Mouth Is!

The Editor — Thu, 21 May 2009 14:35:00 +0000

When most people think about health insurance, they think first about covering costs of treatment for serious medical conditions or accidents. That’s a natural thing to do. But there’s another type of insurance that’s equally important to your well being–dental insurance. Because dental disease is so common, being protected by dental insurance and using it wisely are essential safeguards for you and your family.

There’s A World Of Difference Between Medical And Dental Disease…
Unlike medical disease, which can be both unpredictable and catastrophic, most dental ailments are preventable. Preventive care, including regular checkups and cleanings, is the key to maintaining your oral health. With regular visits to the dentist, problems can be diagnosed early and treated without extensive testing or elaborate and expensive procedures. That keeps the costs of dental care much lower than those of medical care. In fact, total spending for dental care is decreasing. In 1970, it made up 6.3 percent of total health care expenditures. But in 1991, dental care’s share of health care spending was only 4.9 percent.

…And Between Medical And Dental Benefits
Medical insurance is designed primarily to cover the costs of diagnosing, treating and curing serious illnesses. This process may involve a primary care physician and multiple specialists, a variety of tests performed by doctors and laboratories, multiple procedures and masses of medications. Depending on the health, age and attitudes of people in the medical coverage group, costs can fluctuate widely.

Dental insurance works differently. Most dental coverage is designed to ensure that the patient receives regular preventive care. High quality dental care rarely requires the complex, multiple resources often required by medical care. A thorough examination by the dentist and a set of x-rays are all it usually takes to diagnose a problem. By and large, dental care is provided by a general practitioner, although some cases may require the services of a dental specialist. Because most dental disease is preventable, dental benefits plans are structured to encourage patients to get the regular, routine care so vital to preventing and diagnosing the onset of serious disease.

In fact, most dental benefits plans require patients to assume a greater portion of the costs for treatment of dental disease than for preventive procedures. By placing an emphasis on prevention, and by covering regular teeth cleaning and check-ups, Americans saved nearly $100 billion in dental care costs during the 1980s.

Dental Insurance Is Helping Keep America Healthy
The availability of dental insurance is the single greatest factor in helping you get the dental care you need. More than 48 percent of all Americans–113 million of us–are covered by privately financed dental insurance plans. This compares with just 12 million people …

Guardian bolsters dental HMO members’ access

IFAwebnews.com - Baltimore,MD,USA — Thu, 21 May 2009 00:00:10 +0000

The Guardian Life Insurance Company of America, a provider of employee and voluntary benefits for small and mid-sized companies, unveiled its Direct Referral program that will give dental HMO/pre-paid plan members access to any in-network specialist without pre-authorization. The company said the move will provide faster, easier access to important treatment. Through Guardian's Direct Referral Program, plan members can see any in-network specialist with a specialty referral from their primary care dentist, reducing wait times, a common issue for DHMO/pre-paid plans, according to the insurer The program also lessens the administrative work for providers, an incentive that promotes provider retention which helps to expand the network offering members a wider selection of dentists, the company said. "The goal of dental benefits is to help individuals maintain or improve their oral health which, studies show, is directly connected to overall health," said Chris Swanker, vice president of Guardian Group Dental, in a statement. "Dental insurance is an affordable and highly valued benefit. In today's economy, business owners are looking to manage their benefit costs while providing coverage that promotes oral health, which can have an impact on employees' overall ...

Individual Dental Insurance Online

The Editor — Tue, 19 May 2009 15:20:24 +0000

Humana (NYSE:HUM) is now offering individual dental insurance and vision insurance products online under the umbrella of its individual health business, HumanaOne(R). Web visitors can now check prices, compare plans and purchase HumanaOne individual dental and vision products at www.humanaonedental.com. With fewer employers offering group benefits, such as dental and vision, more people are turning to individual plans like HumanaOne. HumanaOne's individual dental insurance and vision insurance products, which are available regardless of a person's health condition, help fill that gap. Individual dental and vision coverage also is attractive to people who lack similar coverage through their employer or through Medicare. HumanaOne Dental plans are affordable with rates in some areas starting at $10.14 per month for dental insurance or $5.95 per month for a dental discount plan that is not insurance. The vision insurance plans start at $10 per month. Web visitors can choose from a number of different plan designs. "Sometimes people forget about dental and vision coverage when they're shopping for a health plan," said Steven DeRaleau, chief operating officer of HumanaOne. "That's a mistake because dental and vision health is closely linked to overall health. Additionally, plans can be more affordable than one might think." Individual dental insurance and vision insurance products work just like group dental and vision. Members ...