We ask because sometimes we will lose a long-time patient when their employer no longer offers a dental insurance plan we take. Many times, the patient is very happy with the care he/she receives at The Toothboss. Knowing how it can be difficult to find a dentist or any doctor that you are happy with and comfortable with, it made me think about making a change based on insurance alone.
Patients with receive dental insurance plans typically pay 350-400 per year for an individual plan, $1800 for a family (frankly, both numbers are on the conservative side). And those plans come with limitations on such things as X-rays, exams, etc.
Now, if you asked most people why they chose to have dental insurance plan, most would say, “In case I need it for something major.” Fair enough, but almost all dental insurance plans limit the benefit at $1500. For most dental insurance plans, that’s a figure that has not changed since the 1970s.
One thing to consider about the $1500 benefit is that the insurance company applies a deductible to your first charges every year, outside of a cleaning, to the tune of $25 to $100. So, your benefit is not really $1500.
Second, besides some procedures not being a covered benefit, insurance plans only cover a percentage of the fee. For example, if you have a root canal, the insurance company will pay 50-80 percent of the charge (a crown is always 50 percent), until you reach your yearly max.
Having a root canal, a post buildup and a crown, which is necessary to restore tooth that needs a root canal, will far surpass the benefit allowed, which leads to out-of-pocket expense. Sometimes if the dentist is aware and concerned (like me), you can spread out your benefit over two years (e.g. have part of the procedure done in one benefit year and the remainder in the following benefit year). Not all dentists will do that and that could leave you with a rather large bill on your hands.
Another advantage to the Toothboss Benefit Program is there is no limit to the 20 percent discount because there is no yearly maximum.
Now, $1500 is nothing to sneeze at. If you’re looking at a dental bill that’s, let’s say, more than $2000, your dental benefit will certainly help you afford the treatment. And if you seem to have at least one more serious issue with your teeth every year or every other year, dental insurance plan does make some sense. Yet if you are comfortable with your doctor and you’re taking good care of your teeth and rarely have more than a couple of cleanings per year, year after year, that’s another story.
The Toothboss recently introduced a benefit program for people who do not have insurance. For $300 per year for an adult—it’s $250 for children in your household up to the age of 26—you can receive all the basics—cleanings, x-rays, etc. Essentially, what you would get in two office visits per year (the full details are in the brochure on our website). The fee is 20 percent of what it would cost to pay for those services out of pocket.
Most importantly, with the Toothboss Benefit Program, there are NO LIMITATIONS on the services you receive. http://www.toothboss.com/benefit-program
For some of the more complicated dental issues, we work with a team of specialists handpicked by the Toothboss. Those in the plan will receive a 20 percent discount on the service that Toothboss provides, but the specialist will have their own fee schedule.
This is not to say if you have a dental insurance plan that we accept here at The Toothboss that you should forego that dental plan and fee and join our program because your teeth are in pretty good health (though you could). It’s more to illustrate that if you are happy with your dental care here at The Toothboss, your teeth are in good health and you somehow find yourself without dental coverage because your employer switched to a provider we do not accept, you do have a much more affordable option without going through the process of finding and working with a new dentist and team of hygienists.
For the record, The Toothboss accepts all dental insurance plans except Mass Health and Medicare. We have a contract with: Delta Dental, BCBS, Altus and Met Life.