Why Is Dental Insurance a Bad Deal?

Why Is Dental Insurance a Bad Deal?

by | Sep 5, 2022 | General

Let us count the ways dental insurance is a bad deal.

Or rather, and with a topic this roastable, let’s go with a late night show countdown. Cue the drumroll, and we’ll start at four, counting down to the number one reason why dental insurance is an all-around a bad deal. While we’re at it, we’ll explain how, and why the increasingly popular, membership-based Direct Dental Care beats the old model in every way. 

Are you ready? 

Here are four of the ten reasons why dental insurance is almost always a bad deal. 

Number Four: It’s Not Even Insurance 

Not if you think about it. 

What is insurance anyway? 

It’s money you pay, usually at monthly or annual rate, for someone to take care of you when an accident hits.  A fender-bender, a flooded basement, having your identity stolen by teenage hackers in Belarus—something like that. When the unexpected hits, you might even pay a premium… but the reimbursement you receive is enough to cover your unexpected costs, get you back on your feet, and even pay for hospital bills that would otherwise be sky-high. In short, what you receive (or the peace of mind knowing what you will receive) when the unforeseen happens is worth everything you’ve been paying on a regular basis. 

Makes sense, right? 

But that’s not how insurance in the dental, or even the medical industry works today. 

Insurance for dental or medical care used to run on reimbursements. But overtime, third party control, arbitrary coverage limits, and confusing policies warped the trust between patients and practitioners. With their primary source of income being insurance companies rather than patients themselves, hospitals, doctors, and even dentists found incentives to pack schedules, charge additional fees, insist on treatments patients don’t even need, and get creative with their billing.

In short, it became less about covering someone when an illness occurred, and more about third parties and their shareholders regulating access to all care, preventative or otherwise. 

The end result of this slide from how actual insurance works? 

Dentists getting creative. 

Teeth not taken care of. 

Patients confused when they pay for costly procedures they don’t even need… from dentists they don’t even know. 

Surprise bills—not reimbursements—after the fact. 

If we go back to where this misleading model came from, that leads right into our next reason why dental insurance is a pretty bad deal. 

Number Three: Dental Insurance is Outdated

Dental Insurance dates back to 1955, but it really took off in the early seventies. While a lot’s changed in fifty years, with technology, tools, dental training, and innovations like 3D imaging transforming dentistry in incredible ways, the insurance model is still the same. 

In fact, most plans offer an annual maximum coverage limit of $1,000… (some go up to $2,000 and some hover in between). 

Do you know the exact maximum limit offered by one of the first Delta Dental insurance plans in 1970 was $1,000? By and large, the amount hasn’t changed. 

Take a bite out of that. 

Where the prices of gas, food, rent, and everything else have risen nearly thirty percent since 1970, the amount dental insurance companies will cover for annual dental work hasn’t changed at all. 

If all this were some teenage high-school movie, dental insurance might be that grizzled, dinosaur of a tenured science teacher… the one with no cellphone, the same outfit everyday, and old, yellowed projector slides instead of PowerPoint.  

But we digress. 

Number Two: It Makes for Poor Incentives

Dental insurance is a lucrative business… if you’re a dental insurance company. 

Unfortunately, and over time, the incentives of dental care paid for through third party insurance nudged dental practices in a poor direction. No longer paid by individual patients who knew and trusted them, dentists learned to deal with PPO contracts offered by insurance providers; contracts that often changed, confused patients, and required dentists to charge set prices for approved services like crowns or fillings. 

In a broad picture, muddied waters. 

While the model worked for insurance companies, it drove dentists to one side of the road—finding creative ways to not cover dental problems in the first place—or to the other—prescribing big, costly procedures that insurance contracts would pay for… but that many patients didn’t even need. 

The end result?

Dentists incentivized to make the most of insurance contracts, not out of relationships built on routine, preventative care that turns grateful patients into lifelong customers.

Patients who don’t know their dentists, confused and frustrated… strapped with plans and treatment they may not even need. 

Surprise fees and annual readjustments that make the jaw drop. 

Here it is… the Number One Reason Dental Insurance is a Bad Deal 

Are you ready? 

It’s not those bills that arrive in the mail. It’s not strict coverage limits, changing policies, and fine-print that would take its own Master’s Degree to understand. 

It’s not even that surprise root canal that made your Friday so very colorful. 

As plain as day, the number one reason why dental insurance is a bad deal is that it’s imaginary. 

That’s right. 

Knowing that dental insurance is outdated, knowing that it isn’t really ‘insurance,’ and that it traps dental providers with undesirable incentives, we arrive at a full picture of how the dental insurance model is one big bait and switch. 

It’s a system in which people pay insurance companies to pretend to care about their teeth. 

We realize that’s a bold claim… and we don’t make it lightly. 

But the fact that countless, dedicated dentists and many honest, helpful insurance providers do treat and care about their patients doesn’t offset the built-in dishonesty of the model itself. 

First, if dental insurance companies really cared about people’s teeth, they would incentivize dentists to focus on regular, preventative oral care—the kind that makes for satisfied, empowered patients, healthy teeth, few, if any, invasive procedures, and a cooperative, life-long relationship between dentist and patient.  

Unfortunately, this isn’t the case… and for most people, having a dental insurance plan doesn’t equate to getting the preventative oral care they really need. 

Second, dental insurance plays on the idea of insurance without really stepping up to it. In an article posted in Today’s RDH.com, Dental Hygienist Trish Walvern lays this out: 

“If it really paid for them, like insurance is designed to do, it would cover the unexpected problems, especially in emergency situations. Instead, dental insurance gives you just enough coverage to make you feel like it’s a value and scares you into thinking you can’t go to the dentist without it.”

Remember what we mentioned earlier? Most dental insurance plans have a fixed dollar amount of what they’ll cover per year, period. 

In most cases, if your teeth need repairs or dental work that exceeds that maximum, you foot the rest of the bill. 

Does that sound like insurance? To us, it sounds like a friendly discount… and one that might only shave $1,000 off a $5,000 dental bill in the case of a costly but necessary dental procedure. 

Case in point, there’s some sneaky deception at the heart of the promise dental insurance makes to its patients .

With that, and with more and more people waking up to the fact that paying your dentist directly, with a flat monthly membership fee that covers procedures, exams, and all the preventative care you need, is the best deal all around. 

Next to dental insurance, direct dental care is a better deal in every way. 

And That’s Why It’s Rising

If you’re tired of high premiums, surprise bills, and a dentist that’s hard to even get a hold of, consider Direct Dental Care. 

And if you’re in the Phoenix area, give the Rising Dental Club team a call to find out how our excellent care, flat membership fees, and transparent pricing can get your teeth to their healthy, showable, best. 

Sign up and become a member today!

What is Direct Dental Care?

What is Direct Dental Care?

by | May 15, 2022 | General

Third party dental insurance really hasn’t changed much in twenty years which is opening the door for new solutions like direct dental care. While the traditional, employer-sponsored insurance model came on the scene as a way to keep healthcare costs affordable, it’s dwindled down to problems and headaches that we’re all too familiar with.

  • Long office waits to see the dentist
  • Rising deductibles
  • Waiting periods
  • Co-pays
  • Confusing coverage limitations
  • Surprise bills in the mail after your visit

Unfortunately, the insurance model only pays dentists for work done on patients… and this awkward structure comes with even more problems:

  • Dentists pushing aggressive, rather than minimal treatment
  • Schedules crammed full of patients
  • Disincentives to focus on preventative care
  • Dentists who can’t be reached when patients need them
  • Inflated costs
  • Incentives to push services and aggressive treatments
  • Strain on the dentist-patient relationship.

So… if the dental insurance model is broken, if it confuses patients and families, and if it nudges dentists toward aggressive treatment that’s often not needed instead of total, preventive oral care, why does everyone stay on it?

Probably because they’re not aware of the alternative—a system of direct, monthly pricing that saves costs, doesn’t smudge the numbers, and brings patients into partnership with their dentists for preventative oral care.

Now, if only this alternative had a name…

How about Direct Dental Care?

Direct Dental Care, (DDC) is an innovative model that’s exactly what the name implies—direct, membership based dental care without hidden costs, surprise bills, or third party interference. In DDC, employers and patients directly pay their dentist / practice for a set of defined dental care services to maintain their optimal oral health.

It’s a superior, win-win scenario for a system that’s broken for patients, dentists, and dental practices.

Through an affordable membership fee, patients have access to modern dental care, creating an experience that far surpasses the current, confusing “fee-for-service” model. In fact, when patients contract directly with a dentist / practice, the need for third-party insurance coverage disappears entirely.

Membership and Price Transparency

What makes this model the solution? Far superior to the current approach? Let’s count the ways.

First, insurance limitations, unpredictable costs, and lack of price transparency are no longer roadblocks for patients wanting to receive optimal dental care. Providers have more time to give because they are not financially driven by production and even patient turnover.

Second, patients and their health outcomes become central to treatment, which results in a more trusting and therapeutic relationship. Modern patient-provider communication through technology, longer face-to-face time, and opportunities to promote honest preventative care define DDC.

Imagine a dental visit where all recommended treatment is covered by your membership fee. You will know that your provider isn’t pushing treatment you don’t need because there’s no longer a fee-for-service incentive. In the DDC model, prevention and trust, along with the patient’s optimal oral health, are central.

Patients Empowered by Direct Dental Care

Finally, with the thicket of third party billing, fee-for-service, and fluctuating costs cleared away, the Direct Dental Care model empowers patients. High-functioning, optimal oral care begins with patient choice. In DDC, patients have extraordinary access to the dentist of their choice… often for as little as $75 a month in a flat membership fee. Patient choice incentivizes dentists to build enduring and trusting relationships with their patients, while focusing on preventative oral care that saves their patient time, money—and teeth—in the long run.

The direct model means dentists are accountable first and foremost to their patients; not to third party providers. It also means they no longer have financial incentives to push aggressive treatment or ‘upsell’ services that sometimes aren’t even needed.

For Better Outcomes, Join the Club

In short, everyone wins. For patients, Direct Dental Care means superior health outcomes, not to mention better access to dentists and comprehensive care. For dentists, happier, more trusting patients mean a focus on preventative oral health, without meddling and interference from third parties.

While the traditional model won’t change anytime soon, more and more people across the country—both patients, dentists and even other healthcare professionals—are opting for membership.

Isn’t it time you opted in to Direct Dental Care and became a member? If better access to your dentist, preventative treatment that saves you money, and flat monthly fees that start at $75 sound good to you, then drop a line.

Sign up and become a member of Rising Dental Club today.