Insurance Executives Are Getting Rich Off Our Cavities

Dental insurance is a corner of our costly, inefficient health care system that does not get enough spotlight. And before you tell me that you have great dental insurance through your employer or your spouse, hear me out.

First, some basics about dental insurance: 

• Most states do not regulate medical loss ratios when it comes to dental plans. What is a medical loss ratio, or ‘MLR’ if you’re into health care insider speak? It’s the percentage of insurance premiums (the money we pay for our insurance) that must be spent on patient care and not on company overhead – including the salaries, bonuses, and other compensation paid to executives and employees of an insurance company. This means that in your state, chances are good that dental insurance companies do not have to spend much of the money they rake in from your payments on your dental costs and can pocket an exorbitant amount for themselves. 

• For an example, I invite you to research California Delta Dental and their executives’ salaries. The company’s 25 executives are paid more than $500,000 per year with the CEO pulling in $9.5 million annually – and they are all smiles!

  

• Second, if you’ve ever had a dental procedure beyond a cleaning or basic cavity filling, you know that dental events can often cost $1,000 or more. Well, most dental insurance companies cap your annual benefit at between $1,000-$2,000, so your insurance doesn’t go a very long way for you if you need a crown, a root canal, or God forbid, a dental implant. Even with that great dental insurance you think you have, you’ll be paying out of pocket for any non-minor treatment. I know, because even with the Cadillac dental plan, I spent over $15,000 on these services last year. And the benefit maximums have barely budged in over a decade. Seems a bit unfair, given the salaries your premiums are likely paying according to the link above, right?

• And third, people don’t always realize that high-quality dental care is critical to overall health. Many chronic diseases can be traced to poor dental health, but not enough regulatory attention is given to dental insurers.

I recently went for a preventive dental visit here in California, the land of millionaire dental insurance executives. The cost, including cleaning, was $250. My dental plan states that my premiums cover two cleanings per year, yet when I filed my claim, it was initially rejected.

No clerical error or reason was provided. It took me multiple phone calls and re-sending receipts just to finally gain reimbursement from my dental insurer. Something tells me that is a feature and not a bug in that particular insurance company’s process. (It’s not Delta Dental). I did the math and they could cover 156,567 cleanings with what they pay their executives each year, but I’m only asking for one (maybe two if I can squeeze it in later this year). 

Gotta make sure their Vice President of Profit “Extraction” can afford to dock his boat in San Francisco Bay, I guess.