Question:
I just canceled my HMO dental "insurance". After many years of paying my
dues I realized that this kind of insurance is not really insurance at all.
It is a discount program, creating the illusion of insurance. All it
provides is cheap cleaning, that's all. The dentists are paid zilch by this
"insurance".
Therefore, the dentists who accept this fake insurance often resort to
underhanded tactics to sell unneeded services, such as scaling, gum
treatments etc, which have a high profit margin. The whole thing is a
racket.
In view of the nature of dental work, there is no such thing as "insurance"
in the sense that insurance distributes risk and pays for any calamities. At
its best, all dental insurance is a prepaid reimbursement plan because
everyone needs to have teeth cleaned and needs minor dental work sooner or
later. Fire insurance is real insurance, dental insurance is a swindle.
Is there any "real" dental insurance where people pay a fairly high premium
and where the insurance company actually pays the dentist?
How does the "Western Dental Insurance" work? Another scam?
Answer:
Yes it is, you have figured out the scam. That is exactly why I ignore the
"free" HMO dental insurance I get at work. It is worth the price. I find it
best to go to a "Fee for service" dentist, get treated right, and pay my bills.
No dentist can work for free and somewhow make it up in volume. Also,
scaling and gum treatments are not always uneeded.
Not always, just usually. You have correctly identified the problem with
dental insurance, it is like buying "gas insurance" in case your car ever
happens to need a fill-up. You are "insuring" against a sure thing!
Yes there is, you can buy true indemity dental insurance, but (as you have
guessed) it is expensive and often pays a maximum of only $1,000 per year. Just
because they offer a "real" insurance plan, it does not mean that they are not
crooks. I just fired my indemity dental plan because they took months to pay
claims, apparently throw every third claim in the wastebasket without action,
and deny claims for no apparent reason. I find it to be far less hassle and
agrivation and no more expense to just pay the man when he does the work.
There is another type of dental plan that works fine and puts the screws to
the "dental insurance" industry. It is called "Direct Reimbursment" (DR). It
works very simply, your employer just pays a portion of your actual dental
expenses up to some negotiated maximum per year. Remember, an insurance company
acts as a middleman and makes money by paying less in benefits than they take in
in premiums. With DR, every dollar that your employer provides for dental
care, goes directly to dental care for the employees.
A REAL solution to FAKE insurance would be a plan that would cover
absolutely everything with zero co-pay. You get a cavity the doc
repairs it. You need root canal, you get that plus the
crown-lengthening and crown. No dental cosmetology would be included.
This would be for people wishing to control dental costs, not make
something on the system.
You pay nothing, per procedure.
Its all included.
You could not neglect your teeth and then get the insurance just as
without a fire plug within 200 yards of your house, your rates become
much higher.
You might have to commit for ten or twenty years, unless death
precludes that. The premiums might be $500 or $800 per year, paid to
the dentist, not to the middleman.
Quality control would be an essential part, making sure that you got
the necessary treatment, just as the auto body shop must call in the
adjustor to verify exactly what is needed in terms of repair.
