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TTC_11_09_16_Vol.13-No.02.p1-16

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Page 10 www.TheTownCommon.com November 9 - 15, 20<strong>16</strong><br />

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By J. Peter St. Clair, DMD<br />

Last week I explained how dental<br />

What do you insurance works. This week I will<br />

break down the general differences<br />

look for in a dentist? between dental insurances, some<br />

things to consider when using<br />

your dental insurance, and when it<br />

• Clean, modern facility<br />

makes sense to consider purchasing<br />

• On-schedule Treatment<br />

insurance if you don’t have it.<br />

• Individual Attention<br />

I get asked daily by patients<br />

• Superior Clinical Skills<br />

who are either self-employed or<br />

• Financial Flexibility<br />

• Friendly/Personable Staff<br />

are not offered insurance through<br />

their employer, “Should I consider<br />

Please call our office to<br />

getting dental insurance?” In most<br />

schedule a complimentary cases, in my opinion, it does not<br />

30 minute consultation. make sense to purchase dental<br />

insurance on your own. This goes<br />

151 Central Street, Rowley | 978-948-2030 | www.jpeterstclairdentistry.com back to last week’s column as to<br />

how dental “insurance” is set up to<br />

begin with.<br />

All dental insurance companies<br />

WE WANT Contact WE WANT YOU... your YOU... Advertising set a limit as to how much they<br />

TO ViSiT Consultant TO ViSiTtoday!<br />

will “pay-out” on an annual basis.<br />

The industry average is $1000 per<br />

The P: Rowley 978-948-8696 The Rowley ‘V’ • F: ‘V’ 978-948-2564 year, which has not changed since<br />

he Town Common<br />

the inception of dental insurance<br />

signed, Refreshed, advertise@thetowncommon.com<br />

Redesigned, Refreshed, and Refined<br />

and back in the 1970’s. The premiums<br />

ays Open Always Daily Open to Daily the to Public the for individual dental insurance run<br />

E Cookout every FREE Cookout 1pm every Patriots 1pm Patriots Game<br />

around the $700 range. This leaves<br />

Tables Lounge • Jukebox • Pool Tables • • Function Jukebox • Function Hall Hall • • and more morethe patient with a net gain of $300<br />

Rowley Veterans Rowley Veterans Association<br />

from the insurance company. This<br />

19 Bradford 19 Bradford St., Rowley St., especially does not make sense if<br />

you typically only have your teeth<br />

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Health & Wellness<br />

If you’re on Medicare, you have<br />

until Dec. 7 to make any changes<br />

to your coverage.<br />

If you have the Original Medicare<br />

and like the coverage you have now,<br />

you don’t need to do anything. If<br />

you have a Medicare Advantage<br />

Plan (or want to change to one), all<br />

of the Original Medicare benefits<br />

are covered, as well as others specific<br />

to your plan.<br />

By now you should have received<br />

your Plan Annual Notice of<br />

change, along with the Evidence<br />

Brighter Smiles...<br />

Dental Insurance Update - Part 2<br />

cleaned a couple of times a year.<br />

The only way purchasing your own<br />

insurance may make sense is if you<br />

are looking to cover your entire<br />

family. You should discuss these<br />

factors with your dental office prior<br />

to making the decision.<br />

In dentistry, there are a few types<br />

of dental insurance available. There<br />

is “indemnity” insurance, where<br />

patients can go to whoever they<br />

want and the insurance will cover<br />

a certain percentage depending on<br />

the procedure. The other types of<br />

insurance are PPO’s, HMO’s and<br />

discount plans or “clubs”. With<br />

these types of insurance, the dentist<br />

has to sign a contract with the<br />

insurance company and abide by<br />

a pre-set limit they can charge for<br />

all procedures. The typical question<br />

a dental office gets with regards<br />

to these types of insurance plans<br />

is, “Why don’t you accept XYZ<br />

insurance?”<br />

Most dental offices are small<br />

businesses, and the decision for the<br />

dentist to sign-up for a particular<br />

plan depends on whether they<br />

feel they can maintain the quality<br />

of care they seek, or were trained<br />

to provide, while still being able<br />

to cover their expenses to run a<br />

business. What corners have to be<br />

cut to make this work?<br />

Large corporate dental offices<br />

take many of the discounted dental<br />

plans that smaller dental offices<br />

don’t or can’t take. The business<br />

model is different in many ways.<br />

Unfortunately, many patients<br />

Senior Scene<br />

of Coverage. (All the plans are<br />

required to send these.) Read the<br />

forms carefully. If changes to your<br />

plan are anticipated for 2017, such<br />

as out-of-pocket costs, this is where<br />

you’ll learn what those will be.<br />

To see what other plans offer,<br />

go online to ww.medicare.gov and<br />

compare what you have to what<br />

else is available.<br />

To review plans in your area,<br />

put “plan finder” in the search<br />

box. Put your ZIP code in the box.<br />

Enter any drugs you take, and your<br />

current pharmacy. When you get to<br />

the screen with your plan options,<br />

your best bet is to click on Sort<br />

by Overall Star Rating. Compare<br />

the annual drug costs, monthly<br />

feel forced to choose a dental<br />

office based on their insurance vs.<br />

choosing the provider.<br />

Continuing education is<br />

important for dentists to improve<br />

skills and to be able to provide<br />

patients with a high level of service.<br />

The amount of continuing education<br />

a dentist takes is generally related to<br />

the resources available from running<br />

the business. Although the type of<br />

dental insurance a dental office<br />

accepts does not always translate<br />

into the level of care provided, it is<br />

an important factor for the patient<br />

to consider.<br />

It is difficult not to get caught<br />

in the trap of – I don’t go to the<br />

dentist because I don’t have<br />

insurance or my insurance only lets<br />

me go to a specific dental office.<br />

People often have the mindset that<br />

dental insurance works the same as<br />

medical insurance. It does not.<br />

This is your health. Advocate<br />

for yourself and choose to get and<br />

stay healthy. There are many things<br />

competing for your discretionary<br />

dollars. Your dental health should<br />

be high on the list, but the conscious<br />

choice must be made by you.<br />

Dr. St. Clair maintains a private<br />

dental practice in Rowley and<br />

Newburyport dedicated to healthcentered<br />

family dentistry. If there are<br />

certain topics you would like to see<br />

written about or questions you have<br />

please email them to him at jpstclair@<br />

stclairdmd.com. You can view all<br />

previously written columns at www.<br />

jpeterstclairdentistry.com/blog.<br />

Medicare Open Enrollment<br />

premium, deductibles and co-pays<br />

for each plan you’re considering.<br />

Look for specifics: Does a new plan<br />

require a referral before you see a<br />

specialist? Is your favorite doctor<br />

still in your plan? Will you be<br />

required to go to only those doctors<br />

or hospitals listed by the plan? Are<br />

there extras like hearing, dental and<br />

vision?<br />

If you need help sorting out your<br />

options, put “SHIP program” in<br />

the search box on the Medicare<br />

site, and you’ll find local resources<br />

for your area, or go directly to<br />

www.shiptacenter.org. You also can<br />

call SHIP at 1-877-839-2675 for a<br />

local referral.<br />

20<strong>16</strong> King Features Synd., Inc.

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