Dentists Dropping Out of Dental Networks

[somarco]

More than 26% of dentists have dropped out of some insurance networks since the start of 2024

The top reasons dentists are dropping insurance networks

Survey reveals 26% of dentists dropping insurance networks in 2024 due to low reimbursement rates and administrative burden, according to ADA report.

www.beckersdental.com

 

[LostDollar]

I wonder if more dentists are not starting to offer their own in house versions of "reduced network pricing for a premium" types of plans?

(My apologies -- I do not have the technical insurance vocabulary to express that more clearly. I think you will understand what I am asking and can expand on it if appropriate.)

Thanks for posting the article, I think I see a slightly different version of that in my city.

Dentists not even starting to accept plans other than BCBSKS or DeltaDentalKS and then dropping out of the other plans. They just sign up with BCBSKS and DeltaDentalKS and leave it at that. You have other insurance, they'll file for you, but you owe them the full remaining balance of their bill after your carrier pays their share of their out-of-network allowed amounts.

One can certainly see the draw of a large MAPD dental allowance that would just make a payout based on a paid dental bill.

When I saw BCBSKS allowed amounts and payment amounts 3 years ago, compared to those of another carrier, I thought then that reimbursement rates were a significant reason I would see only a small number of dentists accepting "other" plans.

 

[scagnt83]

Dental insurance is a rip off for most people unless they have a high utilization rate.

If you get your teeth cleaned 2x per year and rarely anything else.... pay cash and save $500-$1000 a year.

Even group rates are getting expensive and no longer making sense for many people.

 

[somarco]

@LostDollar I am noticing a "trend" where dentists offer a prepaid package. I am in the process of changing dentists and strongly considering a practice that charges $299 per year.

Package include cleaning + exam x2, PRN X-rays, 25% discount on other treatment, and 1 emergency visit.

My most recent routine exam was $190, Rachel's was $240. We self pay, no insurance, haven't had any for years.

Current dentist sold his practice 2 years ago and only works 1 day per week. Office staff turnover is excessive and has been that way since he sold.

Time to move on.

 

[billyb]

None of our local established dentist accept any insurance. They will help you file but you pay up front.

 

[LeeV]

Group dental and vision are not worth it unless you are a high utilizer. We have paid cash for years.

 

[LostDollar]

Group dental and vision are not worth it unless you are a high utilizer. We have paid cash for years.

I think one reason many agents don't see much value in Dental and Vision insurance plans is because they see their payments to the carrier(s ) as Advance Payment for Dental (or Vision or Hearing) Services which must be completely recouped each plan year rather than as premiums for insurance coverage.

 

[LostDollar]

@LostDollar I am noticing a "trend" where dentists offer a prepaid package. I am in the process of changing dentists and strongly considering a practice that charges $299 per year.

Package include cleaning + exam x2, PRN X-rays, 25% discount on other treatment, and 1 emergency visit.

My most recent routine exam was $190, Rachel's was $240. We self pay, no insurance, haven't had any for years.

Current dentist sold his practice 2 years ago and only works 1 day per week. Office staff turnover is excessive and has been that way since he sold.

Time to move on.

Thanks for the suggestion.

I am not sure whether or not I want to do that.

I suspect that is partly emotion rather than logic.

I had a treatment plan worked up early this year for current problems that runs to around $4K of fillings and crown. That probably gets me back pretty close to breakeven on around $90 a month for premiums on two plans for the last 3-4 years. (and I need to defer part of that to 2025 to get insurance network pricing and payments for all services.)

In part, this is another one of those life expectancy and annuity or medical treatment/insurance problems I don't quite know how to assess.

 

[bill3173]

@LostDollar I am noticing a "trend" where dentists offer a prepaid package. I am in the process of changing dentists and strongly considering a practice that charges $299 per year.

Package include cleaning + exam x2, PRN X-rays, 25% discount on other treatment, and 1 emergency visit.

My most recent routine exam was $190, Rachel's was $240. We self pay, no insurance, haven't had any for years.

Current dentist sold his practice 2 years ago and only works 1 day per week. Office staff turnover is excessive and has been that way since he sold.

Time to move on.

IME, when a dentist sells his practice, everything changes. I had a similar situation, and got a referral from a customer/specialist, and got out of there. It's a simple private practice with one "family man" type dentist, with a staff that has been with him since he opened.

 

[somarco]

, when a dentist sells his practice, everything changes

I have been through this twice before, and yes, EVERYTHING changes.

I am slow to pull the trigger since the dentist is also a client, but he is only part-time and has a "not my circus, not my monkey's" approach. He is simply another employee for a few more months. By the time I am going to another practice I doubt he will know that I have left.