Will My Insurance Cover it?

We all are required to have and carry car insurance to drive on public roads. This is intended to protect the owner driver as well as other drivers in the event of an accident. Our car insurance is intended to cover catastrophic events and have deductibles that must first be paid by the owner driver.

Now, what happens to our insurance premiums?

Our insurance premiums are put into a large pot of money that we all hope we never have to use. Plans have deductibles intended to discourage use of the system unless there are major events that take place and also have caps (vehicle is totaled). Insurance does not cover things like routine maintenance (oil changes, brake changes, fluid changes, wiper blade changes, etc.) or things like tire changes.

How does this relate to “dental insurance” and coverage?

There are many similarities and differences between dental insurance and car insurance – even medical insurance. A major similarity is that there is a large pot that money is put into. There are individuals that oversee how that money is used and dispersed – they charge a fee for this. This fee goes to the CEOs and other employees of the insurance company – thus decreasing the total amount that can be paid for patient services. Companies work to make sure that the numbers favor the house – they want their end of year bonus! One way of guaranteeing that the numbers will make sense is that there is a maximum that the dental insurance companies will allow any individual to take out of the system in any given year – VERY different from medical insurance. Think of dental insurance as a coupon book! The dental insurance companies will also limit services provided and say they are “not covered” or have waiting periods to make sure that you have paid what they deem enough into the system before taking money out.

In many ways, paying dental insurance premiums is betting against oneself. If more money goes out of the system than in then it simply does not work – meaning “the house always wins”. Participation in an insurance plan may make sense if the premium was subsidized by an outside source (employer). This would decrease the amount the patient would be paying for the premium – thus decreasing the risk while keeping the reward the same.

Another thing to keep in mind is that the insurance companies will try to limit the services provided by having contracted (“in-network”) offices that have agreed to the rules the dental insurance companies have put in place. But the thing is, companies often pay out a similar amount even for non-contracted offices.

This makes one stop to think if paying for “dental insurance” makes sense or “will my insurance cover this?” are the right questions to ask.

Maybe the right question to ask is –  Could one create and manage their own “dental insurance plan” by placing money in their own pot and decide how and where it is used?