From the desk of Dr. Afzali 

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My valued patients: As we come to the end of the year, many people are deciding what dental insurance, if any, they are going to get for next year. It’s a very important decision and, unfortunately, not always an easy one.

In my interactions with many patients who have dental insurance, I have come to believe that, in the majority of cases, the consumers (patients) are short-changed by their insurance companies. The whole politics of the complicated system called “dental insurance” is designed to provide maximum profit for insurance companies. The waiting periods, exclusions, downgrades of needed services, and finally expiring all of your unused benefits on December 31st, can bring any unbiased observer to the belief that your dental insurance isn’t designed to take care of you.

In this newsletter issue, I have taken it upon myself to provide more information to our patients so they have a better understanding of dental insurance, and what we offer at Lifetime Dental.

Warm Regards,

Dr. Mary Azadeh Afzali, Founder & Clinical Director

Dental Insurance? How To Make The Right Choice

When choosing your dental insurance, here are some questions to consider:

  1. Are you getting your money’s worth?
  2. Do you have the freedom to choose your dentist?
  3. Does your plan cover cosmetic work and dental implants?
  4. Has your dental bill ever ended up becoming your responsibility due to limitations, exclusions and waiting periods?

Let me explain my understanding of the disadvantages of the various insurance plans (HMO, PPO) and how they affect you.

HMO dental insurance plans

  • With an HMO plan, patients don’t have the freedom of choosing their own dental practice. They are assigned by the insurance plan to a specific office.
  • HMO is basically just a discounted plan. The insurance doesn’t cover a portion. The patient pays 100%.
  • HMO Offices automatically receive a monthly capitation check based on the number of patients assigned to their office, regardless of whether the patient shows up or not. This generally has a negative effect in terms of the office’s quality of patient care and follow up. In fact, HMO offices tend to prefer not to see their patients for their regular cleanings as they collect their capitation check regardless.
  • HMO offices generally make money by upselling patients on expensive procedures the patient may need, which aren’t covered by their HMO plan, and which they must pay out of pocket. Unfortunately, in some cases the process of upselling can go beyond the patient’s actual dental needs.

PPO dental insurance plans

Generally PPO plans cover more than HMO plans, though they are usually more expensive. However, you have to check for yourself. If it covers what you need to keep your teeth and gums healthy, then you should keep it. Some things to check for if you’re looking at a PPO plan are:

  • Does it require a waiting period for basic or major work (such as crowns, fillings, gum treatment)?
  • What are the list of exclusions (only covers certain procedures)?
  • What are the downgrades (only covering lower quality procedures or products)?
  • Your annual maximum becomes an irrelevant matter if the above things are present. So don’t be deceived by the annual maximum as it may not cover everything you need.
  • Also realize that PPO insurances do not allow benefits for cosmetic work and some specialty procedures.
  • Some plans cover dental implants, but advanced non-invasive procedures like laser therapy aren’t covered.

So PPO plans can be better than HMO, but take the above into consideration when deciding on your plan.

Lifetime Dental’s in-house dental savings plan

Our in-house dental savings membership plan is our solution for those who do not currently have dental benefits or feel that their current benefits are insufficient. Our plan provides an affordable, hassle-free way for you and your family to receive the dental care you need. I designed this to promote comprehensive care for everyone in our community and it’s turned out to be very popular! Our low-cost membership includes all preventative care, including two cleanings, exams and x-rays per year, at no additional cost to you, as well as 30-50% discounts on most services, including cosmetic work. More importantly, you’ll be going to a high-quality, clean and family-owned dental practice, who caters to your individual needs. In summary, our plan includes:

  • Two exams, x-rays and regular cleanings per year, at no additional cost to you.
  • 30-50% discounts on most services, including cosmetics and implants.
  • No waiting periods. Immediate eligibility.
  • No yearly maximums.
  • No deductibles.
  • No claim forms.
  • No pre-authorization requirements.
  • No pre-existing condition limitations.
  • No limitation or ceiling of benefits.
  • No hidden fees or bait-and-switch incentives.

Visit our website (www.alifetimedental.com) to learn how to apply for our in-house dental savings plan. For any assistance or questions contact us at one of our locations: 

Lake Forest, CA

Rancho Cucamonga, CA

San Bernardino, CA

 

Or apply online today: