Showing posts with label Dental Insurance. Show all posts
Showing posts with label Dental Insurance. Show all posts
Thursday, May 23, 2019
My Insurance! My Insurance! My Insurance! - Do you know anything about your insurance?
This is a true story.
A patient of ours was in the other day. We had just made new dentures for him and his wife.
We said we would send it to his insurance company to see if they would pay but he right away knew that they would not pay since he didn't have coverage for dentures. Of course, shortly after that we heard from the insurance company that he has no coverage for dentures (major coverage).
He did tell us that he pays $170 dollars a month for only dental insurance for himself and his wife.
$2040 dollars a year for him and his wife and there was no major coverage.
My staff were flabbergasted. They almost never have fillings to do and their cleanings amount to about 2 months of their premiums
So they pay their premiums faithfully every month but never get value. In other words, in their case, it is not worth it to get insurance. Pay your dental bills out of pocket and they would be left with a larger sum of money in their pockets.
Is this the case for everyone? Of course not but it was the case for them. Many people when they come to see me, say that they haven't been to the dentist for years because they didn't have dental insurance so they couldn't afford it. I always explain to them that dental insurance costs money and that if they put that same money aside to go to the dentist they would be surprised by what value they get.
The morals of the story?
1. Check what you are actually getting when you buy dental insurance. How much does it cost and is it really worth it.
2. You can still go to the dentist even if you don't have insurance.
All the best
Dr. Ron Barzilay
Having fun practising dentistry in Hamilton Ontario Canada
www.rondentist.com
PS. If you have any questions just send a reply to the post.
Wednesday, May 29, 2013
My Insurance pays for a cleaning every 9 months. Do I need a cleaning more often?
My Insurance pays for a cleaning every 9 months. Do I really need a cleaning more often?
I have heard this question many times. The answer is quite simple. Insurance plans are financial arrangements between the employer/patient and the insurance company. One insurance plan allows cleanings every 9 months, one plan allows every 6 months, one plan every 3 months. Other plans allow a certain amount of cleaning per year. Yet other plans allow unlimited cleanings. This variation occurs across the broad spectrum of treamtments done by dentists among the thousands of dental insurance plans that exist.
We as dentists treat patients and your needs as patients. The dictates of insurance companies are really between the patient and that company. What the patient needs to remember is that if you go the route of "I only want what is covered" then you have to be prepared for the consequences. For those people with naturally "good" teeth there may be no consequences as they never really need much in the way of cleanings and dental work. Most of us are generally not that lucky and if we don't maintain our teeth then we suffer.
So, yes the answer is quite simple, if your dentist says you need it then you need it! You have to ask yourself, "How important are my teeth to me and what am I willing to do to keep them?"
All the best
Dr. Ron Barzilay
www.rondentist.com
A Hamilton Dentist having fun in Hamilton, Ontario.
I have heard this question many times. The answer is quite simple. Insurance plans are financial arrangements between the employer/patient and the insurance company. One insurance plan allows cleanings every 9 months, one plan allows every 6 months, one plan every 3 months. Other plans allow a certain amount of cleaning per year. Yet other plans allow unlimited cleanings. This variation occurs across the broad spectrum of treamtments done by dentists among the thousands of dental insurance plans that exist.
We as dentists treat patients and your needs as patients. The dictates of insurance companies are really between the patient and that company. What the patient needs to remember is that if you go the route of "I only want what is covered" then you have to be prepared for the consequences. For those people with naturally "good" teeth there may be no consequences as they never really need much in the way of cleanings and dental work. Most of us are generally not that lucky and if we don't maintain our teeth then we suffer.
So, yes the answer is quite simple, if your dentist says you need it then you need it! You have to ask yourself, "How important are my teeth to me and what am I willing to do to keep them?"
All the best
Dr. Ron Barzilay
www.rondentist.com
A Hamilton Dentist having fun in Hamilton, Ontario.
Wednesday, September 12, 2012
Why do I have to pay the Co-pay? (Why do I have to pay what my insurance doesn't?)
This question we get asked from time to time here in Southern Ontario.
For those who don't understand the term. The Co-pay is that portion of the cost of treatment that the insurance provider does not pay and is the responsibilty of the patient. For example, if the insurance provider pays 80% of the cost, the patient must pay the other 20%. Or if the inusrance pays 100% on an older fee guide then the patient must pay the difference. This is called the Co-pay. Some patients ask the Dentist if the Dentist would accept whatever the insurance company pays as full payment. In our jurisdiction, the Province of Ontario, this is not allowed. A dentist caught doing this, in our province, would face consequences visa vie his dental liscense and from the insurance companies. The reasoning behind not allowing this discounting of the fee to the patient is that if the provider discounts his fees to the patient then he should also be giving that same discount to the insurance company. Although everyone thinks what is the big deal the insurance company is paying, well the insurance company is no different from anyone else. The way you look out for your money so do they. If you get a discount then they want one too. I don't know what the laws are in other jurisdictions but I would imagine that they are similar.
We are always trying to help out our patients but as professionals our word truly is our bond and any Dentist who does not collect this fee is in violation of the terms of his certificate and will suffer the consequences if caught. Any dentist who plays fast and loose with the rules, at the end of the day is not the type of person you want performing your dentistry either.
All the Best
Dr. Ron Barzilay
Having fun in Hamilton Ontario
www.rondentist.com
For those who don't understand the term. The Co-pay is that portion of the cost of treatment that the insurance provider does not pay and is the responsibilty of the patient. For example, if the insurance provider pays 80% of the cost, the patient must pay the other 20%. Or if the inusrance pays 100% on an older fee guide then the patient must pay the difference. This is called the Co-pay. Some patients ask the Dentist if the Dentist would accept whatever the insurance company pays as full payment. In our jurisdiction, the Province of Ontario, this is not allowed. A dentist caught doing this, in our province, would face consequences visa vie his dental liscense and from the insurance companies. The reasoning behind not allowing this discounting of the fee to the patient is that if the provider discounts his fees to the patient then he should also be giving that same discount to the insurance company. Although everyone thinks what is the big deal the insurance company is paying, well the insurance company is no different from anyone else. The way you look out for your money so do they. If you get a discount then they want one too. I don't know what the laws are in other jurisdictions but I would imagine that they are similar.
We are always trying to help out our patients but as professionals our word truly is our bond and any Dentist who does not collect this fee is in violation of the terms of his certificate and will suffer the consequences if caught. Any dentist who plays fast and loose with the rules, at the end of the day is not the type of person you want performing your dentistry either.
All the Best
Dr. Ron Barzilay
Having fun in Hamilton Ontario
www.rondentist.com
Tuesday, May 22, 2012
I have no dental insurance so I can't go to the dentist!
I have no dental insurance so I can't go to the dentist!
Well I hear this line at least 2-3 times a month from either a new patient or an emergency patient and everytime I hear it, my blood just starts to boil. Why? It is just not true. This may be what the patient believes but they are Wrong!
The new patient maybe coming in after years of neglect but now he has dental insurance and now he can afford the dentistry. Many times he is about to be surprised. Most plans have yearly maximums and because of the neglect he is going to be way past that. His options may come down to extractions and dentures.
The emergency patient comes in with pain. By the time we do the exam, x-rays and treatment you can be sure he is leaving with a hefty bill. If he continues this way at the end of the day he will have no teeth.
So why am I angry? How do I know what someone can afford and what they can not?
Well here is the reality. Taking care of your teeth is not expensive. Excuses are very expensive.
When your teeth are healthy, a visit to the dentist from time to time is not expensive. If you are in financial distress cut the time period so that you are visiting less often but still visiting from time to time for a check up. In this situation, if you have a small filling or even a few fillings, they can be done while they are still small. You can do them once a week or once every two weeks or once a month or once every two or three months. Do it at your own pace by what you can afford and believe me, once you start you will finish and you will have a healthy mouth. Remember, a small cavity from time to time everyone can afford but a small cavity that has now become a root canal treatment and crown is ten times more expensive than the filling. Now you may not be able to afford it and if it is in multiple teeth you are in trouble.
Now we all know that when we drive our cars we need to change the oil from time to time and do some minor service or else we are going to have to kick in big bucks to change the engine.
Lesson to be learnt: YOU CAN STILL GET ALONG JUST FINE WITHOUT DENTAL INSURANCE - JUST TAKE CARE OF YOUR TEETH AND VISIT YOUR DENTIST FROM TIME TO TIME!
All the best
Dr. Ron Barzilay
A dentist having fun in Hamilton Ontario
www.rondentist.com
If you like this or any of my other posts go ahead and join the site.
If you want a blog on a particular subject let me know.
Well I hear this line at least 2-3 times a month from either a new patient or an emergency patient and everytime I hear it, my blood just starts to boil. Why? It is just not true. This may be what the patient believes but they are Wrong!
The new patient maybe coming in after years of neglect but now he has dental insurance and now he can afford the dentistry. Many times he is about to be surprised. Most plans have yearly maximums and because of the neglect he is going to be way past that. His options may come down to extractions and dentures.
The emergency patient comes in with pain. By the time we do the exam, x-rays and treatment you can be sure he is leaving with a hefty bill. If he continues this way at the end of the day he will have no teeth.
So why am I angry? How do I know what someone can afford and what they can not?
Well here is the reality. Taking care of your teeth is not expensive. Excuses are very expensive.
When your teeth are healthy, a visit to the dentist from time to time is not expensive. If you are in financial distress cut the time period so that you are visiting less often but still visiting from time to time for a check up. In this situation, if you have a small filling or even a few fillings, they can be done while they are still small. You can do them once a week or once every two weeks or once a month or once every two or three months. Do it at your own pace by what you can afford and believe me, once you start you will finish and you will have a healthy mouth. Remember, a small cavity from time to time everyone can afford but a small cavity that has now become a root canal treatment and crown is ten times more expensive than the filling. Now you may not be able to afford it and if it is in multiple teeth you are in trouble.
Now we all know that when we drive our cars we need to change the oil from time to time and do some minor service or else we are going to have to kick in big bucks to change the engine.
Lesson to be learnt: YOU CAN STILL GET ALONG JUST FINE WITHOUT DENTAL INSURANCE - JUST TAKE CARE OF YOUR TEETH AND VISIT YOUR DENTIST FROM TIME TO TIME!
All the best
Dr. Ron Barzilay
A dentist having fun in Hamilton Ontario
www.rondentist.com
If you like this or any of my other posts go ahead and join the site.
If you want a blog on a particular subject let me know.
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