By Kristen Gerencher
A DOW JONES COLUMN
Got teeth? If you lack dental insurance or have a skimpy policy,
your options for scoring a better dentistry deal are growing.
Out-of-pocket costs for pricey work such as crowns, implants and
root canals can catch people off guard, even if they have
insurance. And seniors are sometimes surprised to learn that
traditional Medicare typically doesn't cover dental work.
The dental-care marketplace is turning its attention to
individuals as more insurers and discount outfits offer individual
plans. Some insurers, such as Aetna Inc. (AET) and Cigna Corp.
(CI), are stepping up their efforts to help members with certain
medical conditions prevent tooth and gum problems that can wreak
havoc on their overall health--and lead to costly medical bills.
Meanwhile, a new website called Brighter.com offers members
discounts at participating dentists.
About 10 million Americans have lost their dental insurance in
the past few years as the recession weakened the reach of employer
plans, the dominant source of coverage. Fifty-four percent of
people had some form of dental benefit in 2009, down from 57%
between 2006 and 2008, said Evelyn Ireland, executive director of
the National Association of Dental Plans, a Dallas trade group. The
group's website, www.nadp.org, offers consumers a directory where
they can search for individual insurance and discount plans in
their state.
Brighter.com, which launched in May in all states except
Florida, Montana and Vermont, gives subscribers access to a network
of 25,000 dentists offering discounts on cleanings, crowns,
implants, root canals, whitening treatments and other procedures.
Jake Winebaum, founder of Brighter.com of Santa Monica, Calif.,
said savings range from 20% to 60% off the price an uninsured
patient would be charged.
Consumers can sign up for a free one-month plan or opt for the
premium plan, which costs $79 a year for individuals and families.
There also is an option for small-business owners, which costs $49
per employee per year, Winebaum said.
The website shows dentists' location, prices for a wide array of
services, including cosmetic procedures, and consumer feedback and
reviews of providers.
For seniors and people who don't have dental coverage through an
employer, a growing number of options are emerging for individual
coverage.
Insurer Humana Inc. (HUM), for example, sells policies directly
to consumers on its website. People who are 50 and older and
members of AARP can sign up online for AARP's branded policy
through Delta Dental. The AARP plan has two options, including one
that pays a higher percentage of covered services and has a higher
annual benefit maximum. That option typically costs $50 to $60 a
month for individual coverage, depending on geography, said
Elizabeth Risberg, public affairs director for Delta Dental
Insurance in San Francisco. A cheaper option, which pays a lower
percentage of covered services and has a lower annual benefit
maximum of $1,000, runs about $10 to $20 less a month.
Meantime, some health insurers are taking a more-active role in
helping members prone to complications from dental distress keep
current on their office visits--in the hope of preventing the need
for costly health care down the road. For instance, many insurers
now cover an extra cleaning for pregnant women after research
showed that preventive dental care is linked with a lower rate of
birth complications.
Aetna's oral-health integration program is designed to identify
members with chronic conditions such as diabetes who haven't had a
recent dental visit. After the company's nurses and health coaches
made 250,000 telephone calls, more than half of the targeted
patients resumed regular dental visits, said Aetna spokeswoman Kate
Prout. Patients enrolled in the program also can receive certain
periodontal treatments at no cost.
Cigna has expanded enhanced benefits to all members of its
dental plan, even if they have medical coverage through another
carrier. (Previously, those benefits were only for people who had
both dental and medical coverage through Cigna.)
The company also has added four new medical conditions--stroke,
kidney disease, head and neck cancer radiation treatment, and organ
transplant--to the list of diagnoses that allow members to have
services that treat gum disease free of charge, said Miles Hall,
chief dental clinical officer for Cigna in Dallas. Cigna already
covers the dental services for members who are pregnant, have
cardiovascular disease or diabetes.
"If you treat and maintain gum disease, you can observe
medical-cost savings on an annual basis," Hall said.
Of course, trying to cut health-care costs by stimulating higher
dental-benefits usage sometimes requires a more basic approach. It
involves helping lapsed patients overcome the common fear of
sitting in the chair and hearing the dreaded drill.
"A lot of people who don't use their dental plan don't go
because they're afraid of the dentist," Hall said.
(Kristen Gerencher is a writer for MarketWatch. She can be
reached at 415-439-6400 or via email at
AskNewswires@dowjones.com.)