why dental isn't under the umbrella of health insurance is mindboggling. Same for vision and hearing. It's like requiring separate auto policy for your tires, steering wheel and head lights. if you are lower income, you are SOL when it comes to dental.
@@smile_doc5125It’s my understanding the dental community didn’t want to be part of the medical insurance world back when medical insurance was first introduced.
I have dental insurance as a federal employee. My dental insurance has no upper limit. However things like crowns, bridges and implants are still very expensive even when the insurance pays 40-50 percent.
11:50: That pretty much clarified my dental insurance situation: Trying to get my money's worth out the the premiums. May as well pay the doctor out of pocket using, hopefully, a good payment plan option with his/her office. Thanks for posting, Smile_Doc.
This video is 3 yrs old. I would like to see if your opinion has changed given the nation wide shortage of dental auxiliary and overhead costs today. Insurance premiums have continued to rise as well as reimbursement restrictions. I personally would estimate overhead at 90% and on the rise. A new dental model needs to be developed. More videos like this to educate patients would help.
@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..
Right now we have dental insurance through MetLife and it is fantastic. My husband is retiring soon and we will be buying a dental insurance policy. We will hopefully also be able to get care for more expensive dental care at a very close dental school. They have 3 levels of cost based on if a student does the work or a dentist already practicing. Of course the students are overseen by professionals ;) Thank you for explaining insurance in more detail.
Thank you, very informative. Have had some crowns done and wanted to look into insurance plans. You answered my questions. Appreciate you taking the time to explain dental insurance
I have identified some plans that max out at $5000 per year, after first two years with a lower cap. But it seems most plans cap fillings for posterior teeth at the amalgam fees, and patients must pay the difference for resin fillings. That seems shady unless you think that amalgam is just as good in all cases for posterior teeth.
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.
Well the realitt is that dentist treatments are very expensive and takes alot of money. While you may tell people what they need in spite of insurance ...people won't get it done. Thank you for the information.
Just because a dentist is in network does not mean they are corporate. There are many dentists in private practice that are in network. The dream is to be FFS. A new dentist starting from scratch almost has to be in network. To be called “corporate” is insulting.
Another issue with Dental Insurance is that a high majority of Dentists are not in Network with any Dental Insurance company. Many of them though will treat you out of network. However when doing that they don't have to agree to the fees the Dental Insurance Company pays for those procedures. That being the case they balance bill the customer the difference. So the best way to benefit from a Dental Insurance plan is to stay in network. Dental Savings plan are a great alternative to traditional insurance. However with those you absolutely must go to a Dentist that agrees to take those plans, no out of network on them at all.
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.
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?
So basically Dental insurance is balked at by dentists because the dentists normal fee vs what the insurance will allow them to bill for that procedure is usually 30- 50% less.
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 :)
I don't like insurance. It's just a hassle most of the time. I go to the dentist getting a filling etc...they tell me how much and I get a pretty nice discount for paying upfront with no insurance.
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 love it when the dentists who charge ridiculous and exhorbitant fees give advice on dealing with costs at the dentist. Kind of like the robber giving us advice on home security and loss prevention.
As an insurance broker, I can say that there is really no such thing as a good dental plan. My preference is for DMO or discount plans as they have no waiting periods or caps. DMOs have a menu of set charges, thus no surprises. My dentist office suggested a specific discount dental plan via a specific insurer. It is cheap and offers some nice discounts when you use it.
Hi. I just watched ur video, I am more interested to know if I come to Georgia, would you take new patients? I live in Florida right now. I had a dentist in CA , she was the best I just remember her first name was Kern. I had free medical, which was way too good n once I moved to Florida we couldn’t use it anymore. I’m so hopeless n scared to get my teeth fixed without insurance.
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 TH-cam:)
I noticed that I have gum recession and my teeth are getting sensitive. I havent been to a dentist in 6 years and I am 24 years old. Do you recomend any good dental plan i should get???
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.
I work for the state of CA which offers several different dental plans. I went with a PPO type plan. Doesn’t cover much other than the basic preventative stuff. My issue is not financial, I can pay for what I need. My issue has been all the scumbag dentists I’ve encountered along the way to my current dentist, who is outstanding. I form this conclusion by all the useless medical procedures and products I’ve been recommended over the years by previous dentists that my current dentist, under his medical opinion, says I don’t need and never did. The whole industry needs to be re hauled and re regulated.
Outstanding video. I'm one of those people that a dental plan will benefit because in my youth and into adulthood I didn't take my dental care as seriously as I should have. Consequently I have had a root canal on one tooth, have crowns in my mouth, and certainly fillings. As they're tooth colored I frankly don't know how many crowns I have but as you know way better than I crowns have a shelf life and so do fillings. I've no idea when I have my semi-annual checkup if there will be a need for an old filling to be redone or if a crown could crack on me as happened once during a meal. My question is how do I judge which is a great dental insurance company among the multitude that exist. I can do my own research on coverages, pricing, waiting periods and the like but then potentially pick a plan that seems wonderful but the company turns out to have poor customer service, is conceivably brand new, or heaven forbid goes out of business on me leaving me out all I paid into it! What is your advice?
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.
Hi Doc, thank you for making this video. I was just going over my options and we have Aetna's DMO, I noticed that no dentist in the area seems to participate with this and when you said a corporate entity I think I get it. Pretty sure I'm going to just see the dentist I want to see (my old one retired) and pay cash out of pocket. I may need a lot of restorative work.
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
How to get BOTH THE MEMBER ID# AND THE SSN ON AN EAGLESOFT E-CLAIM?????? PLEASE. INSURANCE GETS ONE AND SAYS THEY NEED THE OTHER ONE IN ORDER TO STALL!, DR. SANDERS
Hi Doctor, Forgive me, I'm only seeing this in April of 2024. I'm 62 and have unfortunately had a long history of dental issues, including root canals, and in the past 10 years, getting 5 or 6 implants. I still have at least 3 or 4 more implants that I would "like" to do, although the costs do continue to rise. Personally, I think my implant Dentist has been fair with his fee of $2300 for each implant, (maybe I'm wrong), but it's been the crowns that have risen from $900 to at present $1500. So, at $4000 an implant, I'm trying to see if getting insured would make any kind of sense. Obviously, I would have to pay the monthly fee, then I was hoping the insurance could cover half of the price for the crown, though that yearly cap does make it more difficult. I've paid out of pocket for many years, and I'm fortunate that my regular Dentist and the implant specialist allow me to pay on a monthly basis. So, that all being said, I'm gathering that the insurance road probably isn't something for me. (maybe when I reach 65?) Oh, one last thought, I was considering what the Health Connector could provide instead of directly going through the insurance companies, but even if I wanted to try this option, I can not sign up till the 2025 plan year. Thank you, Doctor and the others who have passed along their experiences. I think the Doctor summed it up best when talking about the lack of coverage going up over the past 50 years and counting.
@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!
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
Hello and thanks for the helpful video! I visited a dental office to be a new patient and a sign at the check-in station states "If you have insurance you will be asked to pay the deductible and your portion", this was not a large chain dental company, but a one building dental office, so what do I need to pay? What is my deductible? What is my "portion"? What exactly do they mean by "Portion", I have a Delta Dental PPO High plan that pays 100% for normal procedures, Thanks!
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. 😁😁
What if I wanna do dental surgery like canine teeth extractions? I have to do two canine teeth extractions. Would you suggest me please which dental insurance I need to choose?
Great information! ☺️ Have you always been Fee for Service? I know that many dentist contact with dental insurance companies to attract patients because most patients are insurance driven. How do you attract patients?
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.
Not ALL dental insurance companies are created equal! 1st, as a Dental Network Manager, I can tell you that your statement about dentists increasing their office fees in order to take a discount is 99% false. Are there providers that will increase their fees, yes.... It is very very infrequent. And yes, I know when they are trying to do that! 2nd, Providers that are in network, with our insurance company are given a choice on non covered services. Most, opt to be paid their full UCR if it is a non-covered service. 3rd, in regards to having an insurance company dictate care, MOST providers will lay out a care plan irregardless of insurance. It is usually with the office manager or insurance coordinator that will let the patient know what is covered what is not. The patient will do what they can afford at that time. As someone who spends a lot of time in the chair myself, I know that without insurance I couldn't do a lot of what I have done in a year if I had to pay FFS. MOST providers that are INN care very much about their patients health, they don't have to be FFS to care. You cannot roll over medical benefits either. Sure, if you rarely need to see a dentist except twice a year for cleanings, then you probably don't need insurance. 65% of americans without dental insurance don't go to the dentist! That percentage is much much higher than those with insurance that don't have a procedure done because of out of pocket expenses. I honestly feel your blog is to justify why you are a fee for service provider!
Hi, How should i handle a dentist that tends to pressure very high dollar costs procedures and little transparency. Im concerned that im being counted as a number and not a patient.
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!
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
I think emergency that people can’t afford should be able go to ER because I suffer so bad for a very long time do to no funds.. the pain was so bad I was on hydrocone 10s and antibiotics the swelling went down but still couldn’t afford a dentist
Look for a dental clinic that serves the community and they base the fees on your income. In Georgia, we have the Ben Massell Clinic. The emergency room sometimes has an oral surgeon on duty. If you call ahead you can ask if there is an oral surgeon for the hospital you are visiting. I hope your pain level is better and this is helpful for you.
If you have 2 different dental insurance plans is it better just to have 1 or 2 cover better Or is it worth having 2 different insurances this at the same time
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.
I couldn’t help to notice how little knowledge on how dental insurance works is displayed here. As in most insurance products, providers are a big part of the problem. If you want to milk the cow till the last drop and have a “relationship with your patients” that puts them with their pockets up side down when they enter your office then by all means do not take at all insurance. Contracted rates are the first line of benefits for dental insurance if the provider is in network and accepts the plan. Dollar for dollar dental insurance is one of the few insurance products where you can get ahead of what you pay in premiums but of course, providers are the ones who makes or break the deal. Another issue is that the income of the front desk employees is tied to the daily production of the practice which opens a whole new different can of worms in coding and billing. With that said it will be a dream come true the day we go back to the time where a compassionate and ethical service was the norm for the entire medical and dental professions.
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.
doctor， i am a single mom😢, I need to get a dental bridge, one teeth will cost me 1500 without any insurance, is it a good price, I know nothing about it, hope you could reply.
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.
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. 😃
Dental insurance is a joke. There is really no point to it- the procedures beyond basic care- the procedures that fix the things that cause pain and pose true health threats are essentially not covered. It’s all extortion.
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why dental isn't under the umbrella of health insurance is mindboggling. Same for vision and hearing. It's like requiring separate auto policy for your tires, steering wheel and head lights. if you are lower income, you are SOL when it comes to dental.
Sadly ,many medical doctors don't consider dentistry as part of "health" -but we are making progress!
@@smile_doc5125It’s my understanding the dental community didn’t want to be part of the medical insurance world back when medical insurance was first introduced.
Dental IS HEALTH........It should NOT be separate.
"ITEMS PLACED IN YOUR MOUTH".......No Different than a Prosthetic.....NONE.
I have dental insurance as a federal employee. My dental insurance has no upper limit. However things like crowns, bridges and implants are still very expensive even when the insurance pays 40-50 percent.
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.
11:50: That pretty much clarified my dental insurance situation: Trying to get my money's worth out the the premiums. May as well pay the doctor out of pocket using, hopefully, a good payment plan option with his/her office. Thanks for posting, Smile_Doc.
So in layman’s terms I’m really screwed.
Yes your not alone :( pay the price or pay the price.
This video is 3 yrs old. I would like to see if your opinion has changed given the nation wide shortage of dental auxiliary and overhead costs today. Insurance premiums have continued to rise as well as reimbursement restrictions. I personally would estimate overhead at 90% and on the rise. A new dental model needs to be developed. More videos like this to educate patients would help.
@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..
Right now we have dental insurance through MetLife and it is fantastic. My husband is retiring soon and we will be buying a dental insurance policy. We will hopefully also be able to get care for more expensive dental care at a very close dental school. They have 3 levels of cost based on if a student does the work or a dentist already practicing. Of course the students are overseen by professionals ;)
Thank you for explaining insurance in more detail.
Thank you, very informative. Have had some crowns done and wanted to look into insurance plans. You answered my questions. Appreciate you taking the time to explain dental insurance
Please know that with no insurance coverage, your out of pocket expenses are MUCH higher!
I have identified some plans that max out at $5000 per year, after first two years with a lower cap. But it seems most plans cap fillings for posterior teeth at the amalgam fees, and patients must pay the difference for resin fillings. That seems shady unless you think that amalgam is just as good in all cases for posterior teeth.
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.
Well the realitt is that dentist treatments are very expensive and takes alot of money. While you may tell people what they need in spite of insurance ...people won't get it done. Thank you for the information.
Good video! What you are saying is consistent with what I have encountered over the years.
Just because a dentist is in network does not mean they are corporate. There are many dentists in private practice that are in network. The dream is to be FFS. A new dentist starting from scratch almost has to be in network. To be called “corporate” is insulting.
Actually much of what she said is extremely misleading.
Blessings from Colombia 🇨🇴
Another issue with Dental Insurance is that a high majority of Dentists are not in Network with any Dental Insurance company. Many of them though will treat you out of network. However when doing that they don't have to agree to the fees the Dental Insurance Company pays for those procedures. That being the case they balance bill the customer the difference. So the best way to benefit from a Dental Insurance plan is to stay in network. Dental Savings plan are a great alternative to traditional insurance. However with those you absolutely must go to a Dentist that agrees to take those plans, no out of network on them at all.
Or and hear me out on this, Dentists and the whole field of dentistry could just stop robbing people and have a little more compassion.
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?
So basically Dental insurance is balked at by dentists because the dentists normal fee vs what the insurance will allow them to bill for that procedure is usually 30- 50% less.
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 :)
I don't like insurance. It's just a hassle most of the time. I go to the dentist getting a filling etc...they tell me how much and I get a pretty nice discount for paying upfront with no insurance.
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 love it when the dentists who charge ridiculous and exhorbitant fees give advice on dealing with costs at the dentist. Kind of like the robber giving us advice on home security and loss prevention.
As an insurance broker, I can say that there is really no such thing as a good dental plan. My preference is for DMO or discount plans as they have no waiting periods or caps. DMOs have a menu of set charges, thus no surprises. My dentist office suggested a specific discount dental plan via a specific insurer. It is cheap and offers some nice discounts when you use it.
Thank you for your insight! I'm glad you found a plan that works for you.
Hi. I just watched ur video, I am more interested to know if I come to Georgia, would you take new patients? I live in Florida right now. I had a dentist in CA , she was the best I just remember her first name was Kern. I had free medical, which was way too good n once I moved to Florida we couldn’t use it anymore. I’m so hopeless n scared to get my teeth fixed without insurance.
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 TH-cam:)
I noticed that I have gum recession and my teeth are getting sensitive. I havent been to a dentist in 6 years and I am 24 years old. Do you recomend any good dental plan i should get???
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.
I work for the state of CA which offers several different dental plans. I went with a PPO type plan. Doesn’t cover much other than the basic preventative stuff. My issue is not financial, I can pay for what I need. My issue has been all the scumbag dentists I’ve encountered along the way to my current dentist, who is outstanding. I form this conclusion by all the useless medical procedures and products I’ve been recommended over the years by previous dentists that my current dentist, under his medical opinion, says I don’t need and never did. The whole industry needs to be re hauled and re regulated.
Thank you Dr Michelle
You are welcome!
Outstanding video. I'm one of those people that a dental plan will benefit because in my youth and into adulthood I didn't take my dental care as seriously as I should have. Consequently I have had a root canal on one tooth, have crowns in my mouth, and certainly fillings. As they're tooth colored I frankly don't know how many crowns I have but as you know way better than I crowns have a shelf life and so do fillings. I've no idea when I have my semi-annual checkup if there will be a need for an old filling to be redone or if a crown could crack on me as happened once during a meal. My question is how do I judge which is a great dental insurance company among the multitude that exist. I can do my own research on coverages, pricing, waiting periods and the like but then potentially pick a plan that seems wonderful but the company turns out to have poor customer service, is conceivably brand new, or heaven forbid goes out of business on me leaving me out all I paid into it! What is your advice?
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.
Hi Doc, thank you for making this video. I was just going over my options and we have Aetna's DMO, I noticed that no dentist in the area seems to participate with this and when you said a corporate entity I think I get it. Pretty sure I'm going to just see the dentist I want to see (my old one retired) and pay cash out of pocket. I may need a lot of restorative work.
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
How to get BOTH THE MEMBER ID# AND THE SSN ON AN EAGLESOFT E-CLAIM?????? PLEASE. INSURANCE GETS ONE AND SAYS THEY NEED THE OTHER ONE IN ORDER TO STALL!, DR. SANDERS
I'm sorry- I haven't encountered that problem before. Let me see if my patient coordinator has any recommendations.
Why don’t dentists participate in Medicare?
Great info. Thanks Dr. Chartier‼️
You are most welcome Dr. Waters!
All Very Helpful Info. Thank You. 👍 and Subscribed
Hi Doctor,
Forgive me, I'm only seeing this in April of 2024. I'm 62 and have unfortunately had a long history of dental issues, including root canals, and in the past 10 years, getting 5 or 6 implants. I still have at least 3 or 4 more implants that I would "like" to do, although the costs do continue to rise.
Personally, I think my implant Dentist has been fair with his fee of $2300 for each implant, (maybe I'm wrong), but it's been the crowns that have risen from $900 to at present $1500.
So, at $4000 an implant, I'm trying to see if getting insured would make any kind of sense. Obviously, I would have to pay the monthly fee, then I was hoping the insurance could cover half of the price for the crown, though that yearly cap does make it more difficult.
I've paid out of pocket for many years, and I'm fortunate that my regular Dentist and the implant specialist allow me to pay on a monthly basis.
So, that all being said, I'm gathering that the insurance road probably isn't something for me. (maybe when I reach 65?)
Oh, one last thought, I was considering what the Health Connector could provide instead of directly going through the insurance companies, but even if I wanted to try this option, I can not sign up till the 2025 plan year.
Thank you, Doctor and the others who have passed along their experiences.
I think the Doctor summed it up best when talking about the lack of coverage going up over the past 50 years and counting.
@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
Hello and thanks for the helpful video!
I visited a dental office to be a new patient and a sign at the check-in station states "If you have insurance you will be asked to pay the deductible and your portion", this was not a large chain dental company, but a one building dental office, so what do I need to pay? What is my deductible? What is my "portion"? What exactly do they mean by "Portion", I have a Delta Dental PPO High plan that pays 100% for normal procedures, Thanks!
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. 😁😁
When it comes to the "Dental Clubs" what happens when the Dentist closes shop?
Typically you pay into a "club" annually, so if the successor chooses to continue the "club" there would still be the same opportunity.
Thanks!
Little more than a limited pre paid examination plan. (typical "dental insurance")
Agreed. Examination, hygiene and a couple of fillings.
What if I wanna do dental surgery like canine teeth extractions? I have to do two canine teeth extractions. Would you suggest me please which dental insurance I need to choose?
Hello Pratima Paudel. I would choose an insurance that helps cover extractions. Good luck!.
Great information! ☺️ Have you always been Fee for Service? I know that many dentist contact with dental insurance companies to attract patients because most patients are insurance driven. How do you attract patients?
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
Not ALL dental insurance companies are created equal! 1st, as a Dental Network Manager, I can tell you that your statement about dentists increasing their office fees in order to take a discount is 99% false. Are there providers that will increase their fees, yes.... It is very very infrequent. And yes, I know when they are trying to do that! 2nd, Providers that are in network, with our insurance company are given a choice on non covered services. Most, opt to be paid their full UCR if it is a non-covered service. 3rd, in regards to having an insurance company dictate care, MOST providers will lay out a care plan irregardless of insurance. It is usually with the office manager or insurance coordinator that will let the patient know what is covered what is not. The patient will do what they can afford at that time. As someone who spends a lot of time in the chair myself, I know that without insurance I couldn't do a lot of what I have done in a year if I had to pay FFS. MOST providers that are INN care very much about their patients health, they don't have to be FFS to care. You cannot roll over medical benefits either. Sure, if you rarely need to see a dentist except twice a year for cleanings, then you probably don't need insurance. 65% of americans without dental insurance don't go to the dentist! That percentage is much much higher than those with insurance that don't have a procedure done because of out of pocket expenses. I honestly feel your blog is to justify why you are a fee for service provider!
Hi, How should i handle a dentist that tends to pressure very high dollar costs procedures and little transparency. Im concerned that im being counted as a number and not a patient.
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
Mam how much do you make as a dentist now? Nice video.
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
I think emergency that people can’t afford should be able go to ER because I suffer so bad for a very long time do to no funds.. the pain was so bad I was on hydrocone 10s and antibiotics the swelling went down but still couldn’t afford a dentist
Look for a dental clinic that serves the community and they base the fees on your income. In Georgia, we have the Ben Massell Clinic. The emergency room sometimes has an oral surgeon on duty. If you call ahead you can ask if there is an oral surgeon for the hospital you are visiting. I hope your pain level is better and this is helpful for you.
If you have 2 different dental insurance plans is it better just to have 1 or 2 cover better Or is it worth having 2 different insurances this at the same time
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
My dentist is the biggest crook. They make a killing off of insurance! The dam dentist benefits the most of so called insurance.
Aren't they supposed to though
I want a dentist who is a noncarsinogene halogen dentist. No fluoride or xrays unless absolutely necessary
I couldn’t help to notice how little knowledge on how dental insurance works is displayed here. As in most insurance products, providers are a big part of the problem. If you want to milk the cow till the last drop and have a “relationship with your patients” that puts them with their pockets up side down when they enter your office then by all means do not take at all insurance. Contracted rates are the first line of benefits for dental insurance if the provider is in network and accepts the plan. Dollar for dollar dental insurance is one of the few insurance products where you can get ahead of what you pay in premiums but of course, providers are the ones who makes or break the deal. Another issue is that the income of the front desk employees is tied to the daily production of the practice which opens a whole new different can of worms in coding and billing. With that said it will be a dream come true the day we go back to the time where a compassionate and ethical service was the norm for the entire medical and dental professions.
Madam how much dentists typically earn in usa? Nice 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.
Very informative!
Its good information to know when you are picking your dental benefits once you get a job after college.
doctor， i am a single mom😢, I need to get a dental bridge, one teeth will cost me 1500 without any insurance, is it a good price, I know nothing about it, hope you could reply.
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.
There is a dental plan that has no max benefit per year or lifetime
Mine is unlimited, thank God. No deductible, either.
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
You had no insurance information.
Concierge medicine great for doc not for patients. Enjoy it.
Anyone here know a good dentist in Florida Jax? I need name n contact information please.
Dental insurance is a joke. There is really no point to it- the procedures beyond basic care- the procedures that fix the things that cause pain and pose true health threats are essentially not covered. It’s all extortion.
wish i could afford to get my wisdom teeth removed
When I hear too many "It just depends on" I know it's time to click on another video.
Why don’t dentists participate in Medicare?