A Dentist's Perspective On Dental Insurance 

Sadly ,many medical doctors don't consider dentistry as part of "health" -but we are making progress!

Great to be eatin some gubmint cheese Most of us plebs have 2000... and if you're with a fancy company, 3000 and they cover damn near nothing.

Please know that with no insurance coverage, your out of pocket expenses are MUCH higher!

@ddsbyday I still feel much of this is valid. As I outlined in the intro, the cap on dental insurance care in 1970 was $1,000. The cap today is $1000 to $1500. The cap increase is not commensurate with inflation. Insurance companies are producing billions of dollars in profit annually, so I think that they are the biggest "winners" when you have dental insurance. Dental insurance can assist in getting the care you need. The deductibles and copayments are confusing to most patients and they are almost always stunned that their cap is so low. I personally have not seen dental offices that do concierge or membership type plans within the office, but I know they are out there in response to removing dental insurance from their practice and having their patients on a payment plan for their dental needs..

Thank you for watching my video mark hull. I agree, removing the insurance company to address our patient's dental needs directly is much less hassle and cost effective for both the patient and the dentist. Patient's are often surprised that treatment that they may need is not covered on their insurance plan that they chose (or employer offered.) This doesn't mean that its not necessary to do, it's just not a "covered" expense and the dentist didn't select the procedures that are covered under their plan. I am glad you have found a dentist you can work with the get the treatment you need at a price that is comfortable for you. .

It seems like a lot of dental offices are offering what Smile_Doc calls club-type benefits (at around 8:45 in the video where it says "concierge dentistry"). It seems to be almost the same thing as insurance, except you pay the membership fee to the dentist directly. One example of this can be found at ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-qCbybpcD8C0.html. This guy says his clinic offers x-rays, cleanings, and exams for around $240 annually, almost exactly what I'd pay if I bought dental insurance instead. While this eliminates insurance, does this allow a dental clinic to make a profit? I suspect that this is a gimmick like $10-20 oil changes on your car. If you go to Walmart and buy the cheapest oil and filter, you pay more for an oil change than if you go into a shop and have a mechanic do it. Obviously, the auto shop is operating at a loss. By undercharging for one thing, it necessarily forces the business to overcharge for other things to make up for the shortfall. It also creates an extra incentive to sell you more things you don't really need.

Please see my reply down below. I did the same thing with my dentist. We negotiated (or how to explain it) the price something reasonable, and as you so candidly putted it 😃 😃 everyone gets work ⚒ and payment 😃 😃. Simple and no hassle. God's speed. 😊

You are most welcome Dr. Waters!

Hello Dan W and thank you for watching. If there is a suitable material that is cheap, then that is what an insurance plan is going to cover. I know they do this in medicine also- we just aren't aware of it as we aren't given choices. Don't forget- insurance companies are not interested in what you want, they are trying to assist in affording you what is the least expensive but suitable treatment- Its a financial transaction and insurance companies are a business trying to make a profit. (they announce billions in profit annually) As for my practice, my patients don't accept amalgam due to the cosmetic appearance and the concern it has mercury in it, so I haven't placed amalgam in over 25 years!

@@smile_doc5125 excellent feedback and thank you. In medical insurance, eventually new treatments become so commonplace that policies will begin to cover them. It is surprising to me that the with the ubiquity of composite fillings, as well as things like porcelain/highly noble metal crowns, that dental policies don’t in time become more comprehensive - if only to compete and win more subscribers. But then your great video points out the same stubbornness with regard to annual benefit caps. So I guess I should not be too surprised. One company (Delta/AARP) that has low caps allows composite fillings for posterior teeth. But they have low annual caps. Hard to find a carrier that is good with both these issues simultaneously.

You are welcome!

Yes your not alone :( pay the price or pay the price.

Actually much of what she said is extremely misleading.

I hope you find a great dentist to care for your teeth! You may want to see if they offer Care Credit which is interest free financing for a year or two depending on the amount borrowed.

@@smile_doc5125 We have some savings that should cover us and not need to borrow, I just thought having insurance why not use it but then realized it's really a worthless policy. I wound up scheduling an appt for next week with the dentist I felt will do the best work and one that had high recommendations from others. Thanks for commenting on my comment. Knowledge is such a powerful and helpful thing, thank goodness for youtube freedomn

Its good information to know when you are picking your dental benefits once you get a job after college.

Dental insurance allows a lot of people to receive dental care that they may not be able to otherwise afford. However, when an insurance company in network dictates the cost of care by allowing minimal fees to cover the procedure, the provider must cut the costs of providing said care and therefore you are not receiving optimal materials, products, time, staff etc. As a consumer, most patients do not understand this. Many dentists will not provide inferior products and therefore will not participate in network insurance plans.

@@smile_doc5125 I've also come to know the practice of non upfront pricing that dentists offices practice. If I ask for pricing on a 3330 no one will tell me. They want me to pay for exam and x rays first get that 100 dollars from me and then tell me how much it costs. Why is there no request for x rays I've had at other places? Other medical practices do this. I find the non upfront disclosure of pricing poor customer service. Especially when the same procedure could be hundreds of dollars difference from place to place. Yes I do understand the argument that you are paying for experience and expertise, but shouldn't that still be my choice without having to fork over a hundred dollars to get the same x rays done again and you tell me I need the same procedure as the last dentist told me?

@@TonyJordan987 It sounds like you have had a bad experience in a dental office and I'm sorry to hear it. Thankfully there are thousands of dental offices, so you can find one that is open about pricing and will share radiographs with other treating doctors. Most doctors will ask that you do a consultation (or limited exam) prior to rendering treatment so they can determine the treatment plan, any possible complications, and share the financial aspect prior to treatment. Not all doctors agree on a treatment plan so by doing an exam they can give you their opinion on what treatment is necessary. I don't do root canals in my practice, so I can't tell you how much I charge for a 3330 :)

"ITEMS PLACED IN YOUR MOUTH".......No Different than a Prosthetic.....NONE.

Hello Pratima Paudel. I would choose an insurance that helps cover extractions. Good luck!.

Hello @edgarserpai7700 and thank you for watching my channel. It sounds like you may need the assistance of a periodontist to treat your gum disease and recession.. You should find a doctor that you would like to do the treatment and ask if they can assist you with a plan or a payment plan to address your needs.

We always welcome new patients in our practice. I would love to see you as a patient @shahnazjan6052.I am currently treating another patient that found me via RU-vid:)

I agree Chazz-US Marine. Thank you for watching my video!

I just did the same 😃 I talked to my dentist (I am not from the USA) and for sure, yeah the State offer some insurance Yada Yada stuff 🧐 (too complicated to explain 😃 here) so we just agreed 🤝 that I paid for the work ⚒ upfront in four 4⃣ payments - "going along with the salaries of each month) and the dentist and me accepted, 🧱a kind of🧱from one salary🧱to the next🧱salary payment🧱per month agreement🧱between us two✌️🧱. A little bit high the price than the insurance but not to high either. It worked out great. 😊 😊 And I am forever grateful for her trust in me.💝💖💞💞 At the time of the deal 🤝 I lived near by and we always had a upfront talk regarding the dental work ⚒ as the financial aspect of the process. 😊 Labor 🔬 vs payments. We all have to eat. If you ask a carpenter to do a job you talk about cost, material and payment *and* how and when you will and H A V E to pay. In my case she was really understanding (because it was a bit of a risk for her, it could have been worse aka no payments but I am honest and I was upfront about my salary). 😊 💞

I'm sorry- I haven't encountered that problem before. Let me see if my patient coordinator has any recommendations.

Hi klagterooq. I don't know what your portion would be as I don't know what procedures you need or what plan you have. I would contact your plan administrator and ask for a list of your benefits. I have yet to hear of a plan that pays 100% of normal procedures, but you may be lucky and have one. The office can estimate what your deductible and copay are once you share your information and once they know what procedures you will require.

@@smile_doc5125 Sometimes you get lucky. 😊 I know a guy who could life on a LIFETIME rental contract (the house 🏡 company did a miscalculation regarding popularity of the area 🏘️🏚️🤣🤣 they thought 💭 it would be hard to find Tennants so they offered lifetime contracts and NOW he is paying a "peasant rent" but lives like a dentist in luxury area and they had to renovate his apartment due to codes, laws and regulations, so yeah 🕺 sometimes wonder happens. But it does not go unsaid that the COMPANY tried to evict him but under current contract law enforcement, they are not allowed to evict him. 😁😁

Typically you pay into a "club" annually, so if the successor chooses to continue the "club" there would still be the same opportunity.

Thank you for your insight! I'm glad you found a plan that works for you.

I have yet to find a patient who is totally happy with their dental plan for all the reasons you just outlined. Coverage goes down each year and dental premiums go up. If your employer is not paying the premiums, you will often pay out of pocket the same amount you get back in coverage. perhaps start a dental account and pay monthly into it so you are able to address the issues as they arise. Your dentist can also come up with a plan to start updating older restorations so you don't have numerous teeth to treat at once. I have seen a few new dental insurance companies coming into the marketplace, I am not sure how long they will survive so I would stick to the larger companies if you are concerned. Each state has a company they tend to use for all of the federal and state employees- find out which company is used in your area and perhaps you will find a suitable plan that way.

Hello E Mincey. I'm sorry you don't trust your dentist and their recommendations. I would ask for an explanation of what is being proposed and perhaps to see intraoral photographs and radiographs that support the treatment plan. If the recommendations are cosmetically based and you are not interested in this type of procedures, you are probably in the wrong office.You could also get a second opinion. I hope this was helpful!

find a new dentist

Hi Stacy. Most people get two dental plans so they have a higher allowance per year or they want to minimize their out of pocket expenses once they go to the dentist. If you wish to have those two perks, seek dual insurance, but it may be more expensive than its worth.

@@smile_doc5125 ok

Hello @qianxu6689 - I suggest you ask what material is being used for your bridge. Likely it is zirconia and that is an average price for a quality material. If they are using porcelain fused to metal (not fused to gold) it is on the higher side in pricing.

@@smile_doc5125 thank you so very much for your reply. I went to another dentist , he will charge me 4000 for a 3unit one, i just don’t trust my old dentist , my teeth basically were ruined by him. It is so hard to find a honest and caring dentist nowadays.

@MoMuzic13 Thank you for watching my video. It sounds like you have had a great relationship with your dentist thus far, perhaps ask them if they have a suggestion on insurance plans that they have had good outcome for patients or financing options that they can offer for you. For example, I offer a cash/check discount and we also offer Carecredit to our customers. Carecredit is interest free financing (the dentist is paying the interest) that you can pay over a year. When looking for dental insurance plans make sure they will help cover the implant crown on a tooth that has been missing for awhile. Also, make sure you can get your dental work right away as some plans make you wait a year before you can get reimbursed for treatment. THEN, do the math and see if the insurance plan makes sense financially or if paying out of pocket is actually more beneficial. Keep Smiling!

I only paid 1,200 for the first two & 1,400 for other 4 and one wasn't put on far enough and I am black onto by gum. Best of luck

wow $4k for an implant I just finished a implant and it was over $7k wonder if there is a quality difference. I have heard in dentures you get what you pay for. So I wonder if quality of implant hardware and crown that explain cost difference

Thanks for watching PureHeart! I have always been fee for service and we acquire our best patients by referral from other patients who prefer high quality and individualized customer care and also specialists who want to work with high quality restorative dentists (ie endo, perio, ortho, and oral surgeons). We recently did a campaign to ask ALL of our patients to write a review on google and we got numerous new patients because of SEO. I worked briefly in a insurance driven corporate owned practice right out of school and it was not for me.

@@smile_doc5125 Thank you for replying and again… great information. I am looking to move more into fee for service. I’ve talked to a few dentists who think I won’t be able to attract patients without insurance. However, I like your philosophy… quality care will attract quality patients. Thanks again, your words have been an encouragement.

she attracts patients by lying to them and misleading facts as she has done in the video

Thank you for watching Piku. Most dentists in the USA get paid 30-40% of their collections so it truly depends on how many patients you are treating as well as the treatments you provide. The research for dental salaries in the USA show a range from $75-350,000.

Hello Piku Sarker, Thank you for watching my video, The average income for a dentist in the United States according to Salary Explorer is $120,000- 370,000

Dentists care very much about their patients and their fees are based on the cost of the materials, staff, equipment etc just like any other product and business. Inflation has hit every industry and dentistry especially suffered because of the new requirements for personal protective wear.

Hello Doctor, Thank you for the great discussion! I am deeply grateful for dentists with a heart. I live on a pittance, yet found an superb endodontist that did my root canal today for $ 780.00 ( normally $ 1,560.] and accepted Care Credit. I like what you said about the quality of materials and the costs to dentists. He uses the best materials, has tons of awards, yet is a decent human who works with me,. Knowing my situation, he offered the lower price. Knowing the quality of care I am getting and his expertise I am deeply touched. Thanks for having a heart and working with your patients. It means a lot to folks. Please know you are appreciated. ❤

What insurance do you have?

Whats your insurance? Help😅

Some insurance companies do offer unlimited. You have to pay $300 a month or so to the insurance company buuuut the day you need dental care/help you are well covered unlimited. 😃

not true my unlimited and its only 18 bucks a month

Dentists train for eight years and continue to train to provide a service to their patients. You should watch my video on how much it costs to become a dentist to understand the numbers involved with this field of health. Dentistry requires a huge investment in the education, equipment, facility, materials ,and highly trained staff. We give our loyal customers discounts and freebies when we can and very often don't charge for our time and continuously volunteer to assist those in need in our community.

Exactly!! Especially when you can go to Florida, Costa Rica and Mexico and get even better care for Half the price!

The Medicare agent signed me up a plan with Aetna that covered up to $1,500 a year for $62 a month and he said it was the best plan. I cancelled it but six months later decided to get it and called Aetna. They sold me a plan that covered $3,000 a year for about $70 a month. But with these plans you have to wait a year before they will pay anything 4 crowns or major work. So I got another plan for $30 a month that will give you 50% off of crowns with no year waiting. I need a crown and it will pay for itself. The plan says it doesn't pay my dentist anything, it's simply strong arms them to give me 50% off their overpriced crowns. 😂😂😂 When I called my dentist and told them about both plans and that I needed a crown because my tooth is cracked they gave me a dentist appointment. I wanted to get this fixed right away before the tooth cracks in half and can't be fixed because it's the only two that I have to chew on as I'm missing teeth on the other side. Because the insurance company will pay for exams and cleanings she decided to schedule me for that and fix the crown later. I'm pissed because these insurance companies that pay for x-rays cleanings and exams will end up getting you a hundred head x-rays and exams that you don't need just because the insurance companies willing to pay for it. One hygienist was honest enough to tell me that dental cleanings cause cavities because they scrape the enamel off your teeth. So the dental insurance pays for the work that causes you health and dental problems but then you got to pay for your medical problems and the death of work caused by the cleanings. It's all a scam 200 years ago before they invented sugar, toothpaste, toothbrushes, dental cleanings, dental schools that promise to make dentist rich and dental insurance, nobody got cavities. Now there are more dentist then there are liquor stores. People need to wake up and we need a good dentist that will actually fix the problems that the insurance companies and college universities caused. The money you pay your dental insurance should go to sue the food processing companies that put sugar in everything to cause people cavities and that money should be used to pay for all your dental work. Nobody seems to be asking the question why we are getting cavities when no one got cavities 200 years ago? So no cavities are not caused by not brushing your teeth or not going getting cleanings. They are caused by cleanings and abrasive toothpaste because nobody got cavities before they invented these two.

@@smile_doc5125 My dentist wants to charge above the negotiated rates for crown work. This is the 3rd dentist that rejects doing the work for the rates set by the insurance. Although in-network, they aren't willing to do the work as they don't make the expected margins. I don't mind paying a small % above the rate but their markup is way above the negotiated rates. And the more work you give them, the more gridded they get.

@@rozuerd2614 when you are in network there are some procedures that have copayments ( ie: crowns) - Is this the case or are they simply refusing to accept the in network fees for certain procedures?

Aren't they supposed to though