Dental Insurance – Part I
“Coverage by contract whereby one party undertakes to indemnify or guarantee another against loss by a specified contingency or peril.” This is one of the definitions found on www.merriam-webster.com for the word “Insurance”. How does this apply to you and your dentist? Let’s break it down:
- “Coverage by contract…”: The dental insurance policy is a contract, which is a legal document. As with any contract, it would be a good idea to read the whole thing before committing to it. Unfortunately, most all the contracts are negotiated between the insurance company and an employer, two parties with zero training in dentistry. So the contract doesn’t always contain language that has the patient’s (i.e. your) best interests in mind.
- “… whereby one party undertakes to indemnify or guarantee another…”: “one party” is the insurance company, and the “another” is your employer. Notice that the dentist is not in there anywhere. As such, the dentist has no say in how the coverage is administered or formulated. Therefore, the only person/people with a voice that the dental insurance company must listen to is you and/or your employer.
- “… against loss by a specified contingency or peril.”: This translates to mean, roughly, that the dental insurance company will financially “have your back” when you incur a dentally related expense. The confusion and/or frustration may begin when determining “how much of your back” they will cover. Typically it can be anywhere from 50 to 80% of the what the actual expenses are.
So, the basic meaning of dental insurance is that it is a contract between the insurance company and you in which they promise (for a premium) to help cover your dental expenses. It must be understood that the dentist has no rights or recourse in this contract. He or she can advocate for you, but you are the one that can legally argue with the dental insurance company.
Almost all the people in our practice that have dental insurance have acquired it through their employer. For some, it is included in what they pay monthly for their medical insurance. For others, it is a separate deduction in their paystub. The next entry will address the question “What do I get for my dental insurance premiums?”




