Lombard dentist, Dr. Julie Glud Hilbrenner gives her patients an alternative to traditional private dental insurance or going uninsured. In today’s blog, you’ll learn about:
- Going Uninsured
- Dental Insurance
- Dental Membership
- Benefits of Membership
- Smile Membership Cost
All the Uninsured Smiles
According to Yahoo Finance, 68.5 million adults in the USA do not have dental insurance. Furthermore, 35% of adults don’t see the dentist even once a year. Does this describe you?
As for kids, about half don’t see the dentist annually. The CDC says kids miss 34 million hours of school due to needing emergency dental care.
Attending preventive six-month checkups and cleanings, paired with twice-a-day brushing and flossing, can reduce or eliminate the need for emergency dental care. If you think about it, it’s
more comfortable and predictable attending two, hour-long dental checkups and cleanings each year it’s more comfortable and predictable than suffering dental health emergencies, like agonizing toothaches, sore gum tissue, and tooth loss.
Here are some facts you may not know about oral health:
- Gum disease afflicts about half of the population
- Gum disease is the leading cause of adult tooth loss
- Gum disease increases the risk for many systemic diseases
- The risk for low-weight and premature birth increases in pregnant women who have gum disease
- Tooth loss leads to jawbone deterioration
- Tooth decay and abscesses can allow bacteria to enter the bloodstream
- Endocarditis can begin with S. mutans, the same bacteria that cause cavities
About Private Dental Insurance
Many people opt out of dental insurance offered through their employer because it doesn’t provide good coverage for dental procedures. Crowns, bridges, dentures, implants, and orthodontic care may be unaffordable, even with dental insurance. Dental insurance also does not offer any coverage for cosmetic procedures.
Money.com tells us that over 90% of Americans delay dental care because of the cost. Insurance often pays 100% for checkups and cleanings, but patients don’t follow through with a treatment plan due to unaffordability.
How Private Dental Insurance Works
Once you sign up for private dental insurance, you’ll search the insurance website to find your preferred dentist and to determine whether he or she is in or out of the network. Coverage for using an out-of-network dentist can be much more expensive than using an in-network provider.
Your plan will have a deductible. This is the amount you pay out-of-pocket before dental coverage kicks in. Checkups and regular cleanings are often exempt from the deductible.
Look at your plan’s copays and co-insurance, too. Your policy will state that you either have a copay or co-insurance. A copay is a specific dollar amount you can expect to pay for a visit or procedure. The fees the insurance will compensate an in-network dentist for are less than the dentist’s regular fees. This is why using an out-of-network provider is more expensive, even with insurance.
Co-insurance ranges from 20-80%, which means you’ll pay the remainder of 100%. For instance, let’s say you have 50% co-insurance for dental crowns, and a crown costs $900. You’ll pay $450 and your insurance company will pay $450.
Generally, dental insurance coverage is 100/80/50. This means that 100% of checkups and other preventive care is covered, 80% of basic procedures; and 50% of major procedures. The definition of “basic” and “major” procedures varies by insurance policy.
Take a look at your annual maximum, as well. Usually, the total annual max is $1000-2000. After your insurance pays this amount, you’ll pay for 100% of the costs.
A waiting period may be required before your insurance covers any portion. This means, you can go for your checkups and cleanings with 100% coverage, but following through with a treatment plan that involves fillings, crowns, bridges, or other dental work must be on hold until the waiting period expires. A waiting period may range from six to 12 months. Yes, you may have to pay for coverage for a year before the policy will pay for dental work!
Furthermore, pre-existing conditions may not be covered at all. So, if you sign up for dental insurance but already have a treatment plan in place, the services may not be covered by your insurance at all.
We recommend you thoroughly read your policy before signing up for dental insurance. You need to know exactly what your premium buys.
Lombard Dentist’s Dental Membership Solution
A dental membership is a subscription-based alternative to having dental insurance or going uninsured. As a respected Lombard dentist, Dr. Glud believes everyone should have access to affordable dental care. Our Smile Membership provides just that.
Benefits of Smile Membership
- No waiting periods
- No limitations for pre-existing conditions
- No pre-authorization required
- No yearly maximums
- No denial of claims
- No deductibles
Included Services
- Youth Plan: 2 exams, routine cleanings, fluoride treatment, and x-rays
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- Adult Plan: 2 exams, routine cleanings, and x-rays
- Periodontal Plan: (for patients with gum disease) 2 exams, 3 periodontal maintenance cleanings, and x-rays
- Emergency Dental Care: 1 visit per year
- Oral Cancer Screening: 1 per year
- Cosmetic Consultations: 1 per year
- 15% discount on all other services
Smile Membership Costs
Youth: $299 per year ($473 value)
Adult: $399 per year ($480 value)
Perio Plan: $649 per year ($777 value)
Call Our Lombard Dentist for Details
Are you ready to sign up for the Smile Membership? Before you do, we want to answer all of your questions and make sure you understand the coverage, so you’ll know what your money buys. The Smile Membership is available for patients of all ages and with all oral health conditions.
Our Lombard dentist is accepting new patients now, so give us a call at 630-629-5700 or email info@dentalcareoflombard.com for membership plan details or to schedule your appointment with Dr. Glud.
