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