Discounts, options offered to fill dental coverage gaps
By Alex Nixon
Published: Saturday, Oct. 26, 2013, 8:24 p.m.
Discount dental plans bring a relatively small number of patients into the Bethel Park office of Dr. Mike Gans.
That could change as insurers introduce more alternatives to dental insurance in a bid to capture people whose employers don't offer coverage, industry officials say.
Gans estimates about 3 percent of his patients belong to discount dental programs. He'd happily accept any plan that makes dental treatments more affordable.
“The biggest issue right now is access to care in dentistry,” he said. “I think these plans, anything that can make (dental care) more affordable so they will seek treatment, it's a good thing.”
A discount dental plan carries an annual fee of $130 to $140. It allows members to get dental treatment at prices that are discounted 30 percent to 50 percent from the typical cost. The plans negotiate the discounted rates with dentists. Members, in some cases, pay less than $50 for exams and cleanings that cost $100.
The plans save money for patients who don't have dental insurance by lowering the price for treatment. It also could be beneficial for workers who don't expect to have major oral problems and want to avoid dental coverage that require them to pay premiums — the average is more than $500 a year — and co-payments for each visit and procedure.
Dental plans expect that millions of Americans who lack dental insurance may consider a discount plan. And some of the nation's largest insurance companies are marketing the programs to price-sensitive consumers who are already primed to shop online for coverage thanks to the Affordable Care Act, or Obamacare.
“With health care reform, consumers are going to take a more proactive role” in buying coverage, including dental benefits, said Frank DeFazio, an executive with United Concordia, the dental insurance subsidiary of Highmark Inc.
United Concordia, one of the nation's largest dental insurers, launched a discount dental program in February, joining other national insurers such as Aetna Inc. and Cigna Corp. that see growing demand and responded with products.
Aetna began offering discount plans in the state five years ago, said Marcia Vannuccini, head of Aetna Card Solutions. Roughly a year ago it introduced a prepaid card that offers the same discounts but doesn't charge a yearly fee.
“Buy the card and throw a couple hundred dollars on it and go get the discount,” Vannuccini said.
The catch is that Aetna takes 10 percent of the value loaded to the card, she said. Yet since its launch, the prepaid card is selling well in Pennsylvania, she said.
“The number of people without dental insurance is rising,” said Jenn Stoll, president of DentalPlans.com, a website that specializes in selling discount plans.
Stoll and others put the number of Americans without dental coverage at about 100 million. An estimated 50 million Americans don't have health coverage.
Interest in discount plans will increase for several reasons, Stoll believes. Employers will continue reducing or cutting dental benefits because of rising health costs, consumers are increasingly recognizing the importance of oral health, and they're getting more comfortable shopping online for health-related products and services.
DentalPlans.com sells 42 discount programs with access to dentists across the country, Stoll said. Most work the same way: consumers pay a yearly fee, typically around $130 to $140, to access a network of dentists who agreed to cut the price of services. Unlike insurance, there are no waiting periods or annual maximums.
Still, “it's not insurance,” warns Gans, who is president of the Dental Society of Western Pennsylvania.
Gans accepts discount program members from several major insurers. He said it's important for patients to realize that such programs only reduce the cost of procedures; they don't cover the cost.
United Concordia signed up 2,300 customers in nine months. Spokeswoman Beth Rutherford said 18 percent of sales were in Pennsylvania.
Cigna has sold such plans in Pennsylvania since 2003, said Fred Scardelette, vice president of dental operations.
“We've seen the market growing,” he said. “After medical (coverage), some form of dental benefit is the second-most-needed product in the health-care benefit continuum.”
Discount plans make up about 10 percent of the overall dental insurance market, Scardelette said, but “we're projecting the market to grow fairly significantly over the next three years.”
Alex Nixon is a staff writer for Trib Total Media. He can be reached at 412-320-7928 or firstname.lastname@example.org.
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