It’s a fact: Americans with access to dental benefits are more likely to go to the dentist, take their children to the dentist, receive restorative care and experience greater overall health according to The Haves and the Have-Nots: Consumers with and without Dental Benefits by the National Association of Dental Plans (NADP).
It’s clear that when provided a dental benefit, patients are motivated to go to the dentist and take a proactive role with their oral health.
There are more uninsured patients than ever.
Fortunately, nearly 77% of Americans have access to a dental benefit through an employer, association, group or by other means. However, 23% of Americans are left without dental benefits. In 2017, the ADA estimated that over 100 million American adults fell into this category.
A large amount of the US population and your patient pool are not taking the same proactive approach to their oral health as those with benefits.
Uninsured individuals are more likely to need extractions or dentures and less likely to have received previous restorative care or treatments for gum disease. Studies have shown that they have reported higher incidences of other illnesses. For example, these individuals are 67% more likely to be diagnosed with heart disease, 50% more likely to have osteoporosis, and 29% more likely to have diabetes.
Not only is their oral and overall health affected, but these individuals are missing valuable opportunities for prevention and early treatment. Many dental treatments are bypassing the dental office completely, accounting for over 2 million emergency room visits annually.1
COVID-19 has expanded demand for insurance alternatives.
The COVID crisis has exacerbated this problem. Millions of Americans have filed for unemployment, drastically increasing the quantity of individuals without access to a benefit. Since many of these individuals previously had access to a dental benefit, they understand the value of receiving regular preventative treatment.
While the number of uninsured patients continues to grow, patient visits have also decreased drastically. Practices that closed now have patients who missed regular cleanings and preventative visits. As patients begin to resume regular visits, the time missed will lead to more patients needing restorative procedures. A combination of lack of access to benefits and increasing demand for expensive procedures will create even more need for an effective, value-based alternative for your patients.
Options for Uninsured Patients
Solutions for uninsured patients exist, but not all are ideal.
Selecting and purchasing a traditional dental insurance plan without employer sponsorship can be confusing and expensive. Traditional dental insurance PPO plans have high annual premiums, long waiting periods and often lack the coverage patients need most. For most individuals and families, particularly seniors and lower income families, traditional PPO plans are not an effective option.
Discount cards are a cost-effective option to a traditional insurance plan and provide increased value to patients. But they rarely cover many of the procedures and services that patients actually need, and the patient/dentist relationship and continuity of care suffer. Dentists have little to no control of the pricing and fee schedules when patients purchase discount cards; and revenue is not guaranteed, as the sale of the card goes to the middleman.
In-Office Plans—Why They Hit the Sweet Spot of Dental Benefits
In-office plans are a relatively new subscription-based membership model that allows a dentist to provide customized dental plans directly to patients and reduce dependency on traditional insurance companies by cutting them out of the picture.
The dentist is in complete control of the services covered and the pricing, enabling a practice to offer plans that focus on value and/or expanded service offerings to patients. I.e., dentists design plans that make most sense for their patients instead of providing a PPO plan where premiums cover procedures that patients may or may not use. Plans can even be targeted towards specific patient groups—e.g. you could create a plan dedicated to seniors that provides routine procedures as well as enhanced offerings for dentures or implants.
And any revenue derived from an in-office plan goes directly to those doing the work—the dental office.
In-office plans can generate additional revenue, create life-long patients, and provide better financial and care solutions for your uninsured patients and small businesses around your office—a win-win situation for everyone. Whether you’re just starting a practice or have been established for years, providing in-office plans can help solve some of biggest challenges your practice will face financially today.
*Based on a $350 annual membership plan created using Bento, plus non-covered services delivered to patient
**Aetna Dental Direct Plan, $445 Premium + $50 Deductible