According to a 2017 Lincoln Financial Group dental research study, one in four people with employer-sponsored dental insurance say they haven’t been to the dentist in the past year for routine checkups and cleanings due to cost.
So the Florida Dental Association is encouraging patients to talk directly to their dentists when choosing a benefits plan to determine what kind of care they need and what’s covered
Now, during open enrollment season for the Affordable Care Act health insurance marketplace and many employer-sponsored health insurance plans, is the best time to have that conversation, said Chris Bulnes, a general dentist at South Tampa Dental Office and FDA member.
"I think that needs to be a frank conversation,” Bulnes said. “You need to sit down with the dentist and say, ‘These are my options. What is best for me?’ Who knows the dental/oral environment of that individual better than the dentist?"
Bulnes says patients who don’t select a plan -- or who don’t select the right plan -- may choose to forego routine or necessary dental care, leaving them at risk for increasingly complicated and costly dental problems.
"Typically, from a dental standpoint, we don't deal with a lot of catastrophe,” Bulnes said. “We deal with more things that we control. And if we can control those then we can help the patient get the care they need and they're not putting it off."
Bulnes says when choosing a dental plan, it's important to consider more than just the monthly premium. Floridians should consider coverage for preventative care, specialist referrals, annual maximums, and emergency treatment.
The Florida Dental Association says that while a majority of adults believe dental coverage is a “must-have” employee benefit, only half of employees feel that their employer provides enough information about what is covered under their plan.
“If you were to look at maybe a 60-minute presentation with the third-party payer or the benefit provider company that’s presenting to the different companies here in the Tampa Bay area or even nationwide, dental is given about five minutes of that 60 minutes,” Bulnes said.
When choosing a plan, Bulnes recommends patients and their dentists look at:
- How can I choose the dentist I want to choose? (i.e. a PPO or HMO)
- Does the plan allow for specialist referrals?
- The total cost of the plan outside of the monthly premium, like co-pays and deductibles
- Is there an annual maximum?
- Are there any limitations on coverage for preexisting conditions?
- Does the plan cover orthodontic care?
- Do the benefits include emergency treatment?