Insurance Myths


Discover The REAL Truth About Dental Insurance
Dental insurance plays a role in helping people obtain dental treatment. Since we strongly feel our patients deserve the best possible dental care we can provide, and in an effort to maintain the high quality of care, we would like to share some myths and facts about dental insurance with you.

Myth #1 Dental insurance is meant to be a PAY-ALL.
Fact - Dental insurance is meant to be an aid.

Myth #2 Plans pay up to 80% or 100%.
Fact - In spite of what you're told, we've found most plans cover about 40% to 50% of an average fee. Some plans pay more some less. The amount your plan pays is determined by how much your employer paid for the plan. The less he paid for the insurance, the less you'll receive.

Myth #3 The insurance company will pay the fees that the dentist charges.
Fact - It has been the experience of many dentists that some insurance companies tell their customers that "fees are above the usual and customary fees" rather than saying to them that "our benefits are low". Remember you get back only what your employer puts in less the profits of the insurance company.

Myth #4 All services are covered by insurance.
Fact - Many routine dental services are NOT covered by carriers.

Myth #5 Insurance over the years has kept up with inflation.
Fact - When dental insurance first came on the scene in the 1960's there was an average yearly maximum coverage of $1,000 per year. Now 60 years later the average yearly maximum is still $1,200. Using the annual Consumer Price Index (CPI) for just the past 40 years the yearly maximum should be over $15,000 now in 2016 !
Question Have the premiums increased over the past 50 years?

If they have where has this additional increase gone?
Only one guess allowed !!

Question What do you know of that has not increased in price in the past 40 years??

Myth #6 The new alternative insurance plans are the same as the traditional plans.
Fact - The new alternative insurance plans such as:
Dental Maintenance Organization (DMO)
Preferred Provider Organization (PPO)
and others like them are simply DISCOUNT PLANS. All these type plans require participating dentists to discount their fees on average between 35% and 45%.

Another word concerning alternative insurance plans

Although this is a "different" type of dental insurance, some basics NEVER change. In any insurance plan there are four parties involved - the PATIENT, EMPLOYER, INSURANCE COMPANY and DENTIST.

In discount plans

  • The PATIENT enjoys the lower costs for the "same" care.
  • The EMPLOYER enjoys the fact that they can still stand in front of their employees and tell them they have dental insurance (at less cost to them)!
  • The INSURANCE COMPANY still make their same profit
  • The DENTIST absorbs the loss.

But, Don't think it is in the doctor salary! Practically all loss is made up in quality of care.

  • Less expensive materials are used.
  • Less time is allowed per patient per procedure.
  • Another thing that I have seen NUMEROUS times is that a patient coming to my office for a 2nd opinion on dental treatment diagnosed from a (usually multi-doctor) discount insurance office has been told they need MUCH more treatment than they actually do. Why? Because the discount office must make up business with volume of dentistry performed.
  • Etc, etc.

It is a very simple decision in regards to these type plans. Do I wish to discount my fees so that more new patients are "guaranteed"?? No, I (and other dentists like myself), would rather do the absolute best we can, and not hurry a large number of people through the office. I have personally seen what can result from quick treatment in some of these plans.

Please do not be hesitant in asking us any questions about our office policies. We want you to be comfortable in dealing with these matters and we urge you to consult us if you have any questions regarding our services and/or fees. We will do all we can to assure you of maximum benefits.

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Dr. Maury Hafernik
11645 Angus Road, Suite 10
Austin, Texas 78759
P: (512) 345-5552

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