Is dental insurance going the way of the company pension plan?

dentist lady looking down into your mouth....Are we about to become a toothless nation?

Once upon a pre-recessionary time, dental insurance -- along with matching 401k's and other now long-forgotten benefits -- was a pot-sweetener among American corporations trying to lure the best and the brightest to come work for them. Now, it seems that dental insurance may fall the way of the company pension -- just one more thing employers used to provide but are increasingly sacrificing because of cost-cutting and bottom-line greed.

The pity is that history shows that dental insurance is the only thing standing between healthy teeth and a nation of folks dining through a straw.

According to a recent Gallup-Healthways poll, almost 35% of Americans haven't seen a dentist in the past 12 months. And that may be because 45% of the population doesn't have any type of dental coverage, says the National Association of Dental Plans. More than 33% of employers aren't providing dental coverage and those that do offer limited benefits. In some places, like South Dakota, only 19% of all employers offer dental insurance.

The state with highest percent of companies offering both health and dental insurance was Alaska -- 80.8%. The lowest was Vermont at 43%.

Once you leave the corporately employed arena, the picture worsens quickly. Many corporate retiree plans provide medical benefits until a retiree turns 65 and is eligible for Medicare. But not many have dental insurance as part of the package. The same is true for vision care. These services aren't covered at a time when many need them most -- as we age, our teeth and vision weaken.

For the millions who were laid off from jobs, COBRA provides a dental and vision care continuation (assuming you already had those benefits while working). It lasts, with extensions, for up to 18 months in most states. Then, assuming you haven't found another job to provide dental insurance, you are out on the limb alone hoping the tooth fairy stops by. Insurers do write dental policies for individuals and family but, as a rule, they cost a lot and limit what they cover.

An example: Delta Dental in California writes an individual family policy that maxs out what they'll pay for at either $1,000 or $1,500 per year depending on the plan. These policies cost about $2,000 a year and won't cover any major procedures for the first 12 months. So basically you can get your teeth cleaned and treat the errant cavity (at 50%) but don't even think about a root canal, bridgework or braces for the kids.

There are also dental plans -- not insurance -- which negotiate what they consider "deep discounts" starting at 10% with dentists who agree to cut you a break. The deal is you have to go to those dentists. Some of these plans are capped at $2,200 per family as well.

Dan Callahan, the former public relations director for Delta Dental Plan of Minnesota and editor of Health Care Issues, says that dental insurance has always been regarded as "nice to have, but not essential." It's an attitude that leads many to simply not go for routine checkups and cleanings and only head for the dentist in emergency situations.

Dental insurance, he says, is more of a prepayment system. You have a combination of deductibles and co-pays and premiums that really require you to follow through on all your preventative care and maintenance visits to even get your money's worth.

The best advice may be the simplest. Talk to your dentist and explain the situation. Ask him for a discount and buy yourself a good toothbrush.
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