Editor’s Note: “Ask the Dentist With Dr. Clarke Woodruff” is a new monthly column about dental health and information writtten by S. Clarke Woodruff, D.M.D., whose practice is located at 800 Main St., Hellertown, Pa. This is the first in a two-part series about understanding dental benefits.
In this fourth and final quarter of the calendar year, many employees have the opportunity to customize their benefits package with their employer. Patients often ask for advice in the selection of these benefits, so a short review of dental benefits is appropriate. Note that I did not say dental insurance. A typical insurance contract is one that helps to protect an individual from catastrophic loss due to an accident, fire, death, etc. You pay a premium and you or your beneficiaries are reimbursed or compensated for your loss. For example, you have a car accident and the insurance company pays to repair the car minus the cost of deductibles and coinsurances according to the terms of the policy. The probability of a car accident is relatively low.
The typical dental benefits an employer may provide for their employees is a financial contract to help reimburse them for dental expenses. It is NOT insurance. How can you insure against something that has a 90-95 percent chance of occurring? Everyone has some level of dental disease. It is the most common ailment in our society–more common than a cold. You can’t insure against it like you can insure yourself with auto, life or homeowner’s insurance.
So the dental benefit, not insurance, will reimburse the individual according to the terms of the policy/contract. Usually this means a limit in the total benefit for a year; annual limits, with deductibles and co-insurances. Coinsurances are rates of reimbursement/payback for different procedures. For example: 100 percent for checkups and cleanings, 75 percent for fillings, 50 percent for dentures and nothing for some procedures. Now compare that to an auto insurance policy. It would be the same as GEICO, for example, paying 100 percent for repairs to the hood of a car but only 50 percent to repair a door, and paying nothing for damage to the roof. Of course GEICO would pay the same for all parts of the car. Do you see the difference? So dental insurance is NOT insurance, it is a benefit package.
Dental benefits are a great tool for helping many people afford dental care who otherwise could not afford it. Don’t let your dental benefits drive your decisions about seeking dental care. Remember that no one cares more about your dental health than you and your dentist.
Clarke Woodruff has lived and worked in the Lehigh Valley most of his life. He left the region to complete dental school in Philadelphia and to serve four years as an officer/dentist in the U.S. Air Force. A member of Freedom High School’s first graduating class, Dr. Woodruff earned his undergraduate degree from Lehigh University. He received his Doctor of Dental Medicine degree (D.M.D.) from the University of Pennsylvania in 1976 and opened his Hellertown dental practice at 800 Main Street, Suite 102, in 1980. He was named a Fellow of the Academy of General Dentistry in 1987, after successfully completing a comprehensive examination and more than 500 hours of continuing education. Dr. Woodruff maintains active membership in the American Dental Association, Pennsylvania Dental Association, Lehigh Valley Dental Society and American Academy of Cosmetic Dentistry. In addition to his private practice, Dr. Woodruff is devoted to the education of tomorrow’s dentists and as such is currently chair of the Department of Dental Medicine, Lehigh Valley Health Network. His outside interests include vintage race cars, woodworking and singing. Find him on Facebook and check out the blog on his website, here. For more information or to schedule an appointment, please call 610-838-6597 or contact him via email.