Of course, we in dentistry all know this. It’s the consumer that somehow gets confused. Understandably, because it’s presented to them as a form of health insurance. But we’re left explaining to patients why they have to pay for so much of their dentistry even with their dental plan.   I’ve made this short video on how to explain the difference between their health insurance and their dental coverage, with an analogy that I think you’ll like and find useful.

You may remember last year, when the CEO of Washington Dental Service explained on the news why they were cutting reimbursements to dentists in an economy where absolutely nothing else is dropping in cost.  He flippantly said that “dentists could work more” to make up for the slashing of their profit.  Read my blog about it here, if you like.

The premise was that WDS, a division of Delta, needed to offer lower-cost premiums in order to stay competitive–even though they control 80%+ of the state’s dental insurance business. (Can you say monopoly?)  What’s fascinating is what they’re actually doing with the money is running television advertising promoting their product.  Gotta love that non-profit approach to making a lot of money for the executives. (The CEO makes $1.2 million. Talk about biting the hand that feeds him.)

Anyway, we’re stuck teaching people the differences in their coverage, and putting them in a position where they make bad health decisions because they have this implicit trust of their health care providers.  So they say things like, “I only want to do the dentistry that my insurance will pay for,” and, “Do I really need this work done, or do you just want to make more money?”

My advice is to sit every new patient down in the first visit and explain clearly that, unlike health insurance, where the coverage is based on what is actually wrong with them, dental coverage is simply a discount plan on some range of basic services, set by their employer and totally unrelated to the condition of their mouth or their dental care needs.  And that you will do your best to treat them in a way that is most affordable, but your professional responsibility as a dentist is to make them aware of their condition and the options for getting themselves back to a healthy smile.

Most of them will understand, and the rest, well, it’s crown-a-year dentistry for them!

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