Hi, my name is Dr. Robert Antolak, the owner of thegentledentist.com. We are located in Shelby Township, Michigan. Our phone number is 586-247-3500. I’d like to talk to you today about dental insurance and some limitations on coverages that are, unfortunately there. Dental insurance is not like medical insurance. Medical insurance basically will cover you with limitations of course. But if you have a problem or a disaster taking place, you’ll have limitations of hundred’s of thousand’s of dollars. General insurance is more like a benefit and not necessarily a huge coverage from insurance. It’s more like a benefit. Normally the limitations are on the $1000, $1200 maybe $1600 per year and that’s it. You know insurance was originally made to help with prevention back in the 60’s. I mean it still is used maintenance level in coverages are mostly benefited at a higher level to do maintenance type of things like cleanings, examinations, those types of things.
There are a couple problems. Number 1 is that, dental insurance coverage has not kept up with inflation. Back in the 60’s, that was the amount of coverage. But unfortunately now, you know back then was made $1200. And now it’s $1600. So, it has not kept up with inflation at all. And so what we’d like to do, I just want to discuss that fact that it doesn’t do it.
The problem that we find out, in our office is that a lot of times because we treat a lot of dentistry, because people have avoided the dentist we have lots of care that needs to be done as we hit their maximums per year. Insurance is used as a maintenance program. Maybe a few things here and there, but that’s about it, to have full coverage.
So anyway that’s something fancier. I have some questions on limitations of coverage. You know insurance companies are gonna choose you the cheapest alternative for example if we do a tooth color white fillings in the back of the mouth. Insurance may could just cover for the silver mercury fillings that go there, those are much easier to do than silver mercury ones but, you know it’s not something that I choose to do because of the toxicity.
Also porcelain veneers. They don’t cover porcelain veneers because it’s considered cosmetic.
And implants, they don’t usually cover implants. A few companies are now starting implants. In fact, that prompted me to read this letter that I had a patient of mine ask me. I do write a column each month in the, in the Senior Living News. And in that column, I had a patient who asked the question:
Dr. Antolak, could you explain why the insurances do not cover implants. I am 71 years old and have had dentures a very long time. I also have Sjogren’s syndrome. I have Delta Dental and Blue Cross. Everything that I need is never covered by the insurance. I always, have to pay cash and dentists are the most expensive professionals I have encountered.
Well, unfortunately it seems like it’s the most expensive professional she’s encountered. This is a true letter because of the fact that it seems that way because insurance is just to cover the level of cure that’s necessary. I mean insurance doesn’t keep up even with the direct implants then what it does is appears if that’s the case. But the reality is the benefit we are providing for our patient is substantial.
So, I know it’s not always the best thing but the reality is that you get what you pay for. Give us a call and we can talk more about that insurance if you desire. Our dental office in Macomb County, Michigan phone number is 586-247-3500 and our website is TheGentleDentist.com. Thank you.