You and your Medical Insurance cover

You and your Medical Insurance cover

  • February 18, 2013
  • By Enhance Dentistry
  • News

Has your medical insurance company ever tried to influence your choice of dentist? In a bid to reduce their costs (while increasing premiums), medical insurance companies may seek to subtly influence your choice of provider with schemes such as “members select” or “preferred provider” or by setting up their own clinics and recommending them to you. Can you be sure you’re getting the best quality care when your dentist may be more worried about what the medical insurance companies say, than what you do?Cash Profit Bag

No one likes standing in queues, so to save you time, we can process all items from all medical insurance companies with HICAPS at the completion of every visit. The decision of how much an item of treatment is rebated lies with the medical insurance company as determined by your level of cover and its business rules.  This is not determined by your dental practitioner. Our primary duty is to our clients and our objective is to provide our clients with the best possible care that suits them. Hence we are proudly not affiliated with any particular medical insurance company.  Being affiliated in schemes such as preferred provider or ‘Member’s Select’ requires the dentist to sign an agreement with the medical insurance company which then refers patients to that dentist.  In exchange the dentist agrees to a set of fees for performing certain procedures.  This creates incentives for the dentist to carry out certain treatments and not others.

By not signing a contract with them, we keep the primary relationship with our clients and have no other influence in clinical decision making other than what is best for you. Therefore we always offer all the options to you and suggest what is in your interest (rather than what is in our best interest or the interest of the medical insurance company).

Taking time means taking care

The old maxim “you get what you pay for” is as true for dentistry as other goods and services. Quality dentistry requires taking time to conduct thorough examinations and investment in modern equipment. It requires using high quality materials and working with the best dental ceramicists and technicians.

When a dentist agrees with an insurance company to cut their fees for certain complicated treatment items they must make a decision on where they are to cut their costs to remain profitable. They might reduce the time they spend with you, potentially reducing the quality of care you receive. They might fail to invest in the latest equipment, potentially missing the opportunity for early detection of problems or possibly requiring more invasive treatment techniques. Some might choose to use lower quality materials, potentially reducing the lifespan of their work, while others work with offshore technicians (for crowns and veneers) who are cheaper but provide poorer quality colour matching, fit and construction.

You’ll notice at Enhance Dentistry we spend more time with you on your first visit (minimum 1 hour), taking the time to get to know you and what you want. We conduct thorough examinations with the latest in diagnostic equipment such as lasers, intra-oral cameras and digital x-rays, increasing the chance of identifying and fixing problems early, meaning cheaper and easier treatment for you.

We’re so committed to taking time to provide high quality care that we’ll never compromise our standards by chasing the insurance company referrals. We hope that instead our clients will value our services enough to compliment us by referring others.

What if you don’t have medical insurance? 

Ultimately the choice to have extras cover is one that each individual and family will make. Some decide that they won’t take on extras cover, but it’s important to remember that your teeth need looking after whether you have cover or not.

In some ways looking after your teeth is a bit like looking after your car. Cars that are well maintained run better and seldom need expensive work done. The same is true of your teeth, a regular six monthly check up coupled with a good oral hygiene routine is very inexpensive, costing only a few hundred dollars a year.

However, just like when you hear a grinding noise under the bonnet that you ignore and hope will go away (resulting in breaking down in the middle of an intersection during peak hour), ignoring problems with your teeth can lead to a bad toothache at the worst possible time (during an exam, or a job interview, a wedding or an overseas trip).

When that delayed visit is finally undertaken, people are often surprised at just how little they get back from the medical insurance companies. If you’ve had medical insurance for a while, see if you can remember what your limits for dental were when you first got it. We wouldn’t be surprised to hear you say they haven’t changed in years, yet the cost of staff, materials, equipment and premises have been increasing every year. That means you’re paying a bigger gap every year on top of your premiums

So, whether you have insurance or not is up to you, but don’t let a medical insurance company decide what happens to your teeth, they’re far too important for that.

Clients first, not shareholders

As members of the Australia Dental Association, we abide by a code of ethics which means we put our clients’ needs first. Our unyielding commitment is that we will only ever recommend to you treatment we have determined in our professional opinion to be required for functional or cosmetic reasons, nothing more or less.

By protecting our relationship with our clients from the influence of medical insurance companies, you can be assured that our treatment recommendations are for your benefit, not for the benefit of an insurance company’s shareholders.