Dental insurance and medical insurance are two totally different animals. Medical insurance is about investing a small amount to hedge the risk of a potentially catastrophic medical emergency. By contrast, dental insurance is about investing a small amount to gain what an insurance company has deemed “the average allotted dental care” for an individual for a one year. Oh yah, it also has a maximum.

Imagine if you will a meeting with your physician where he/she sits you down to tell you that you have been diagnosed with cancer. If you are lucky enough to be an individual with medical insurance you can feel confident that your chemo and radiation therapy will begin very shortly. However, what if you sit down with your physician and you hear something like this: “We are sorry Mrs. Robinson but you exceeded your limit when you had your emergency gall bladder operation this spring. You will not be eligible for coverage until the new year. If you aren’t willing to wait feel free to use your own finances for your treatment.” Or maybe they may say something like this “The procedure your require Mrs. Robinson exceeds your maximum limit. You will be financially responsible for the remaining portion of your treatment”

Something to keep in mind is that every patient has different needs and these needs are completely independent of their insurance coverage. Consider patient Joe Schmoe. He is a truck driving, big gulp drinkin, non flossing, chain smoking son of a gun. His dental needs are tremendous. Yes, mostly due to his habits or lack thereof, but we can agree he requires alot more work than Sally Sue.

Sally Sue is a prim and proper flossing, tongue brushing, soft tooth brush using dental marvel. Sally hasnt had a cavity since 6th grade. Joe hasn’t had a year without a cavity. Both Sally and Joe have the same insurance. Let’s put it this way. Sally Sue is probably going to use more of her insurance. Why? Because she cares about her mouth and will make regular checkup and cleaning appointments. Mr. Schmoe will show up when something breaks or abscesses and wont get it repaired because to fix one tooth with a root canal , post and crown will exceed his yearly maximum.

So how then can an insurance company tell you what you need for dental insurance? Everyone is different. I get it everyday “I am not getting another cleaning this year because my dental insurance doesnt pay for it.” This from the guy that has 10mm pockets and builds up calculus that looks like barnacles on his teeth. Its like he lives on the bottom of the ocean with Sponge Bob. People think that the insurance company knows best. They are thinking “If insurance won’t pay for it then obviously I don’t need it”. Well I hate to be the bearer of bad news…Insurance companies are in business to make money. If they actually cared about you…they would go out of business.

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