Don’t Let Insurance Dictate Your Treatment
There is one question that our patients ask us every single day – “Will my dental insurance pay for that
procedure?” We get why this question is important; however, our goal is to not let the answer dictate
whether you will move forward with the recommended treatment. There are options at Yost Dental!
Skip to the end of this blog if you want the BETTER OPTION.
Dr. Yost and his team provide an extensive evaluation of your oral health and communicate a custom
treatment plan specifically for you based on your individual needs. This plan includes preventive
recommendations to protect and sustain the health of your teeth and gums, as well as restorative
options to address diagnosed problems. It may also include personal cosmetic enhancements that you
have communicated to Dr. Yost as being important. Regardless of cost and insurance, our main focus is
to provide the best and most effective plan.
These valuable treatments work to prevent larger and more costly issues. So, while insurance may not
cover them you should see them as an investment in the overall care for your oral health. At Yost Dental
we truly care about your health and will work with you on options to provide treatment for you
regardless if covered by your insurance such as:
- Flouride treatments that strengthen your enamel
- Sealants for children that provide a barrier to cavities
- Porcelain crown versus a large filling
- Implant for a missing tooth
Just The Facts
Do you enjoy paying monthly for something and not receiving anything in return? That is exactly what
happens when you pay for dental insurance and do not follow through with your dental cleanings,
restorative and preventive care that your dentist recommends. The insurance companies collect the
premiums and then use the money that was left on the table for their personal gain in the form of
bonuses for their executives. Need an example? According to a recent article in Becker’s Hospital
Review, in 2019 one insurance CEO (we will not reveal which company) made $13.4 million, and in 2020,
he made $79 million – almost a 600% raise! I’m not sure about you, but in 2020 I took a pay cut and
certainly did not get a huge raise as in this example.
The Games They Play
This may come as a shock to you, but when you visit your dentist for treatment, your dental insurance
company is working hard to NOT pay for your treatment. As employers complain to insurance
companies and threaten to drop their contract over the rising costs of premiums, the insurance
companies are responding, but at the expense of the patient. Specifically, the premiums are lowered
while the amount they agree to pay for treatment is drastically reduced. Furthermore, the details of
coverage include rules and time exclusions that result in denial of treatment performed.
Some examples of these exclusions are:
- Extending the time between annual bitewings from 1 year to now paying only every 2 years. A
cavity can grow to be much larger by waiting another year.
- Placing age limits on fluoride treatments or orthodontics to pay only for these treatments for
children. Adults can benefit from these treatments too, so why should you be excluded just
because you are over 16 years old?
- Extending the time for when a crown can be replaced from 5 years to 7 years. This means if you
have a crown on your front tooth and it breaks or gets a cavity around it after 5 years, your
insurance will not pay to have it replaced for 2 more years. If you wait two years to replace a
crown, your tooth could be at risk of needing a root canal or even an extraction.
Are you still with me? Another trick that insurance companies will do in order to pay less for your
treatment is to downgrade procedures to a lesser quality procedure. By doing this your insurance will
pay less money towards a cheaper procedure that you do not want, and pay on that instead of paying
towards the procedure you really need. Examples of downgrading include:
- Instead of paying for the white filling that you need and want, the insurance company may
change the code to a metal mercury filling (which dentists don’t even do anymore). This means
more out-of-pocket expenses for you.
- Instead of paying for a natural-looking porcelain crown, your insurance company may pay for a
silver metal crown.
- Instead of paying for an implant to replace a missing tooth, your insurance may pay for a
removable partial denture and make you pay the difference for your implant.
Yost Dental Group Membership Plan
The BETTER OPTION. Tired of paying too much for dental insurance that won’t pay when you really need
it? Are you retired and no longer have dental insurance? Or maybe you are self-employed or work for
a company with no benefits? Then we have an option that may work for you…The Yost Dental Group
Membership Plan. Our plan includes 2 teeth cleanings with x-rays, 2 periodic exams, and an emergency
exam. In addition to all this, our Membership Plan includes discounts on most dental treatment
procedures. It even gives discounts on procedures that most dental insurances do not even pay
towards at all like Invisalign and whitening. Our plan also does not have all the fine print that dental
insurance plans have:
- No Yearly Maximums
- No Deductibles
- No Waiting Periods
- No Pre-Authorizations
- No Pre-Existing Conditions
- No Denials of Coverage
- No Age Limitations
- No Claim Rejections
So if you are ready for a BETTER OPTION, and are tired of your dental insurance, don’t have dental
insurance available to you, or would just like more information about our Membership Plan to find out if
our plan might work for you, click the link below.