My dentist of 12 years is no longer in-network with my insurance. Over the years, I had perfect results with crowns from the dentist. But during open enrollment in November, I learned that the dentist is not in my dental plan. I was waiting for this year to use my flexible spending money toward another crown, but I am nervous about the choices I have for available dentists. If I go out of network and back to my former dentist, I am afraid that I cannot afford it. How can I find a dentist with reasonable fees and quality work within a small network of dentists? – Thank you. Reuben from GA

 

Reuben,

Over the years, we have heard and seen many stories of dental care casualties that resulted from dental plan changes that exclude your trusted dentist. Patients often feel forced to switch to a new dentist that accepts their insurance, and sometimes trouble follows.

Why Insurance Companies Exclude Dentists from Their Plans

Insurance companies often exclude dentists from their plans because the company is trying to save money. An insurance company may contact all dentists in an area with a list of their discount fee plans. But dentists who focus on quality care know that they cannot maintain their high standards at the insurance company’s rates.

Other dentists will accept the insurance company’s rates but take shortcuts or skip steps to accommodate patients with that insurance plan. The result is lower-quality care and dental treatment that will not last as long. And it is not easy to find a dentist who offers high-quality crowns and knows how to ensure your new crown is in harmony with your bite.

How to Get Quality Dental Care with Your Current Insurance

Many insurance companies allow you to see the dentist of your choice if you are willing to pay more. You can submit your dental claims to the insurance company, and they might provide minimal benefits. Speak with your former dentist to find out how they can make treatment affordable for you. Some ways include:

• Financing – Some dentists offer no-interest financing through companies like CareCredit®.
• Phased treatment – Many dentists are willing to complete dental work in phases to help you pay for services as your dentist provides them.
• Payment plans – Some dentists have in-office payment plans that allow you to pay for dental services in installments.

What If You Must Switch Dentists?

If you must switch dentists due to insurance limitations, you can find a new one with these steps:

• Ask for recommendations – Talk to friends, family members, or co-workers about their dentist. Ask how long they have been with the dentist and if the dentist completed any major dental work for them.
• Search online reviews – You can find patient reviews on Google, Yelp, and Facebook.
• Schedule consultations – Schedule at least two consultations with dentists. Look online for information about the dentist’s post-graduate training and experience. Ask each dentist how many patient cases like yours they have completed. And ask how often the dentist completes the procedure.
• Examine the dentist’s smile gallery – Some dentists have online smile galleries. But during a consultation, you can ask to see before-and-after photos of the dentist’s work. Ask to see pictures of patient cases like yours.

During the next open enrollment, you can look for available insurance plans that include your dentist.

Best wishes.

Ryan Perry, DDS, of Baton Rouge, sponsors this post.