Action Alert: 1st Family Dental Removes Crest Toothpaste Containing Polyethylene
September 19th, 2014
Earlier this week, 1st Family Dental became aware of a news report regarding the presence of what are commonly known as “microbeads” in some types of Crest toothpaste. The report stated that dental hygienists were reporting finding these blue “microbeads” under the gum line in some patients.
In general, it is important to ensure the areas at and below the gum line are free of any kind of particles and surfaces for bacteria to collect, which could lead to irritation and gum disease.
1st Family Dental Removes Toothpaste With Polyethylene From Stock:
While there are no specific risks associated with this ingredient, as a precaution, 1st Family Dental has removed any Crest toothpaste products that contain “microbeads” from our inventory and will replace them with an alternative as soon as possible.
More Information About Microbeads:
The ingredient “microbeads” are made of polyethylene. The FDA has listed this ingredient as safe and acceptable to use in personal care products, and no specific risk is associated with the use of Crest toothpaste products.
Procter & Gamble, the makers of Crest toothpaste, have reported that they will remove this ingredient from the majority of Crest products by March of 2015. Until this time, 1st Family Dental will seek alternative products to provide for our patients.
The state of Illinois will be instituting a general ban on all products containing “microbeads” including polyethylene and polypropylene, due to environmental impact concerns on the Great Lakes water system. This ban is set to begin in 2018.
For more information about Crest toothpaste and other products, please contact Procter & Gamble by phone at 800-492-7378, or via online submission here.
A Dental Insurance Primer for Real People – Part 3 – Questions for Your Dental Provider
August 8th, 2014
At 1st Family Dental, we believe surprises can be fun and exciting, but not when it comes to your dental insurance.
We believe all of our patients have a right to understand the fundamentals of purchasing and utilizing the different types of insurance coverage.
In Part 1 of our series, we reviewed the basics about some of the different types of insurance available on the market. In Part 2, we curated a list of questions for you to ask yourself when preparing to shop for coverage, as well as some critical questions to ask your insurance carrier to better understand the benefits available to you in your policy.
Part 3 of this informational series focuses on questions to ask your current or potential dental care provider (meaning, your dentist or dental office), to ensure they can help you to maximize your insurance benefits and ensure the treatment and claims process is as simple and straightforward as possible.
Questions to Ask Your Dental Provider:
– Do you accept my dental insurance coverage? This is a great question to start with. Most dental practices can list the types of insurance plans they accept. If you have a HMO plan, your dental provider may want to confirm with you that you have listed them as your preferred dentist. Also, if you have changed insurance plans, we always recommend checking with your dental office to inform them of the new plan and review coverage.
– Do you pre-verify my insurance benefits before my appointment? Contacting policy carriers to verify insurance benefits can take quite a bit of time. Pre-verifying insurance coverage is not only a courtesy to help reduce waiting time at your appointment, it also means your dental provider is taking the time and effort to review your coverage ahead of time.
– Do you provide treatment plan estimates? Your dental provider should be able to tell you what procedures and services are covered, and at what expected rate, and estimate any copays or potential out-of-pocket expenses prior to providing a service, particularly for major procedures. You should always be comfortably in control of your dental care. If you have any questions or concerns, we recommend that you ask to speak with the insurance expert before starting any treatment.
– Do you file insurance claims with my carrier and follow up on those claims? Many dental practices file insurance claims on behalf of the patient and follow up on the claims to make sure the insurance carrier responds. However, some do not, and patients may be required to pay out of pocket and then file their own claims with the insurance carrier for reimbursement.
– Do you provide specialty treatment in-house, such as molar root canals and wisdom tooth extractions, or do you usually refer to a specialist? Some dental providers may be able to provide specialty treatments without the need for a referral, which can save both time and out of pocket expense.
– What can you do to maximize my insurance benefits and minimize my out-of-pocket expenses? Your dental care provider should be able to discuss strategies with you that can help you get the most out of your dental insurance.
Maximizing your Dental Insurance Coverage
It is very important to note that dental insurance coverage is not guaranteed. After a procedure is performed and the insurance claim is submitted, your insurance carrier may cover a procedure at a lesser rate, and some procedures and services are not covered at all. This is under the sole discretion of the insurance company.
However, your dental provider should be able to provide you with strategies to help maximize your benefits. Ask your dental care provider if they offer any of the following options:
Does your dental care provider monitor your benefit levels and remind you to use any remaining benefits before they expire?
Will you provider recommend submitting a pre-authorization for certain procedures in order to provide you with a more confident estimate of what you can expect your policy to cover?
Will your provider review your comprehensive treatment plan with you, and recommend phasing and prioritizing treatment across the term of the policy to address your dental health needs while maximizing your benefits and reducing out of pocket expenses?
If a procedure is not covered by my insurance or we expect out of pocket expenses, how can your provider help to make your dental care fit your budget? Ask your provider if they offer discounts on procedures, offer interest-free or low-interest financing, or provide other payment options.
Ask about guarantees on work and services. Ask your dental provider if they offer guarantees on services and procedures such as fillings, crowns, dental implants, and dentures. With proper home care and maintenance, as well as regular visits to the dentist for checkups, many dental restorations can last a very long time. However, occasionally, work may need to be re-done or repaired. Ask your dental provider if they provide quality guarantees on any dental procedures.
As always, we welcome questions, comments and suggestions. Please feel free to leave a message below, or send us an email at email@1fd.org.
A Dental Insurance Primer for REAL People (Part 2): How to Choose a Plan
July 24th, 2014
At 1st Family Dental, we believe surprises can be fun and exciting, but not when it comes to your dental insurance. We believe all of our patients have a right to understand the fundamentals of purchasing and utilizing the different types of insurance coverage.
In Part 1 of our series, we reviewed the basics about some of the different types of insurance available on the market. In Part 2, we have curated a list of questions for you to ask yourself when preparing to shop for coverage, as well as some critical questions to ask your insurance carrier to better understand the benefits available to you in your policy.
Get familiar with your dental health needs and goals
Insurance carriers often offer a variety of policies with different coverage levels. It is important to select a plan with features that reflect your needs. Here are some questions to ask as you plan:
Who will be covered by this policy? Policies usually offer individual, individual plus partner/spouse, and family
Are there any special dental needs for those covered by the policy? For example, do you anticipate that you or others may need braces or orthodontic treatment in the near future
Do you or others have existing dental restorations such as crowns, bridges, or dentures? Restorations need regular maintenance and periodic replacement, including restorations over dental implants.
Do you or others have existing treatment plans and know or expect you may need treatment in the near future? Are you experiencing any pain or dental issues right now?
Do you or others have an existing or previous diagnosis of periodontal (gum) disease?
Do you or others have health issues or take medications that may put you at greater risk of developing gum disease or other oral health issues?
Review Your Options: What to Ask the Insurance Carrier
Put yourself in a position of power by asking the right questions to be able to compare different policy options. Here is a list that can help you select a plan that most closely matches the needs you have identified for your dental health.
Is the policy on a calendar year or annual? Does the benefit period begin on January 1 and end December 31 (calendar), or does it begin during another point during the year (annual)? This is important because it will help you and your dental provider keep track of your benefits and ensure you get the most out of them.
Do benefits end with the policy term, or do they accumulate/roll over? Most dental plans have a use-it-or-lose-it policy with benefits, but some policies may allow you to roll over benefits into the next policy term.
What is my annual maximum benefit allowance, and are there deductibles or co-pays required? Most plans limit dental benefit coverage to a maximum for each policy term, which can impact potential out of pocket expenses. Some policies also have deductibles which must be met before insurance benefits are applied or co-pays for office visits. If you have a partner or spouse on your plan, or a family plan, you should also check if those maximums and deductibles are shared between the people on the plan.
What preventive benefits will I receive? Regular visits for check up and cleanings are absolutely essential to a healthy smile for life. Regular cleanings can help prevent the need for other, more costly and extensive treatments down the road. Find out how many cleanings are covered for each policy period for each member on the policy, as well as x-rays and regular checkups. If your plan has a deductible, you should check to see if the deductible applies to regular preventive services.
What are the coverage rates for regular (often known as basic) treatments such as fillings and extractions, and specialty (often known as major) treatment such as root canals and surgical extractions? Many insurance policies divide treatment into “Preventative”, “Basic”, and “Major”, and then define coverage percentages for each category. Your insurance carrier will be able to tell you which procedures fall into each category.
Are periodontal (gum health) treatment benefits included in my plan? Gum disease affects approximately 50% of adults in the United States. If you have had gum disease in the past, or may be at risk, periodontal treatment such as scaling and root planing, as well as regular periodontal maintenance treatments are important to your dental and whole body health.
Are adult and/or child orthodontic benefits included in my plan? If you or a family member may need orthodontic treatment, orthodontic coverage can be an excellent option to include in a dental insurance plan.
Are dental implants included in my plan? Dental implants are now known as the best possible option for replacing missing teeth. If you or someone on your plan are interested in dental implants, you may be interested in obtaining a policy with this option.
Is there a waiting period for any dental procedures? Some insurance policies and carriers set waiting periods on certain types of procedures before they are covered under the plan. If you have an existing treatment plan or dental care issues you know you need to attend to, this waiting period may have an impact on your treatment planning.
What are the replacement periods on dental restorations such as crowns, bridges, partial, and full dentures? Insurance carriers often regulate how often they will replace dental restorations. If you have existing dental restorations or are planning to have treatment done, knowing when your plan benefits will cover replacement will be important to your future oral health.
Congratulations! You have armed yourself with knowledge and information that will help you to choose an insurance policy that works best for you. In the next part of our series on dental insurance, we will be helping you to get the best possible value from your insurance by knowing what questions to ask your dental care provider.
As always, we welcome questions and comments. Please leave a comment below or send us an email at email@1fd.org.
A Dental Insurance Primer for Real People (Part 1)
July 11th, 2014
At 1st Family Dental, we believe surprises can be fun and exciting, but not when it comes to your dental insurance. We believe all of our patients have a right to understand the fundamentals of purchasing and utilizing the different types of insurance coverage.
We have a developed a multi-section, basic guide that can help you understand your current policy or shop for new one, and to help you understand what you should be able to expect from your insurance provider, dental plan, and dental care provider. Please consider this guide as a helpful, objective tool. This guide does not cover every aspect of dental insurance plans, so please be sure to review your plan carefully. We do not endorse or recommend any specific plan or product.
Part 1 of this series reviews the most common types of insurance plans available.
Understanding Basic Types of Plans – HMO, PPO, Medicaid/Managed Care, & Discount Plans
HMO (Health Maintenance Organizations)
HMOs are a type of managed care, which means patients are only covered if they visit a dentist or specialist within the approved network of providers for that plan. Patients also need to list their provider with the insurance carrier either when signing up for the plan, or before the first dental appointment. Patients may have co-pays for office visits. Referrals are required from the primary dentist if specialty treatment is needed. Typically, HMO plans have a set fee schedule, which means the plan will cover a certain dollar amount towards procedures (rather than a percentage). Patients are then responsible for the difference between the amount covered and the actual cost of the procedure.
Pros: HMO plans usually have a lower monthly premium compared to PPO plans. HMO plans are typically straightforward and have fewer conditions or “fine print” when it comes to coverage.
Cons: HMO coverage amounts are limited, and not all dentists accept HMO plans, which means the selection of dentists is usually smaller. If you are traveling outside of the network, coverage may not be available. Out of pocket expenses for general procedures such as fillings may ultimately be greater than PPO plans, so the actual potential cost to a patient may be higher over the course of the term of the plan, depending on what treatment is needed.
PPO (Preferred Provider Organization)
PPO plans typically offer more flexibility when it comes to choosing a dental care provider. Patients can usually see any general dentist or specialist within the plan’s network, or even outside of the network if needed. However, referrals or pre-authorizations may be required for certain procedures. PPO plans usually cover procedures and services at a percentage rate. There may also be a deductible that must be met before coverage begins. Typically the deductible does not apply to preventive services such as checkups and regular cleanings. If services are not covered at 100% once the deductible has been met, patients are then responsible for the difference between the coverage and the actual cost of the procedure. PPO plans also have annual coverage maximums, meaning that coverage is in effect until the patient has met the coverage amount for the term of the policy. Once that coverage limit has been met, patients are responsible for all remaining fees until the end of the term of the policy, which is usually one year.
Pros: PPO plans usually offer more choice of providers because more dentists and practices accept PPO plans. Total out of pocket costs for a policy period may be lower than with an HMO plan for patients who need general or specialty treatment. Some PPO plans also offer coverage for specialty services, including braces and orthodontics and dental implants, which can offer more options for long-term solutions for oral health.
Cons: Monthly and annual premiums for PPO plans are often higher than for HMO plans and can often involve a deductible, so short-term cost is usually higher. Although many PPO plans cover a wider range of services, plans can be more complicated when it comes to requirements for pre-authorizations. Most plans have a use-it-or-lose-it policy, meaning that if patients do not use all of their available insurance benefits during the policy term, those benefits are gone.
With each type of insurance plan, insurance carriers reserve the right to change coverage levels at any time. There is always a risk that the policy will not cover a service or procedure.
Medicaid & Managed Care Plans
Although dental insurance is not yet mandatory via the Affordable Care Act (ACA), Illinois recently expanded eligibility requirements for Medicaid and is reorganizing the administration of the program, which includes dental benefits for adults and children. Individuals must prove financial need in order to be considered eligible for Medicaid benefits. In the coming months, recipients of Medicaid benefits in Illinois will be choosing from a menu of managed care plans with a network of approved providers, similar to how an HMO is organized. It is very important to note that like any managed care service, Medicaid dental coverage contains restrictions and limitations. We will provide more detailed information on these changes soon.
Dental Discount Plans
It is important to note that discount plans are not a form of dental insurance. We have included information here because discount plans are becoming more popular. Discount plans usually charge a monthly or annual membership fee. Patients can choose from a list of dental providers that accept the discount plan. The discount plan usually pays a certain dollar amount towards each procedure, and the patient is responsible for the difference between the amount paid via the discount plan and the actual cost of the procedure.
In the next installment of this series, we will review some of the most important elements of dental insurance plans, and questions to ask of your insurance carrier to help you understand the plan you currently have, or to shop for insurance with coverage that meets your dental health needs and goals.
As always, we welcome comments, questions and suggestions. Please feel free to leave a comment below, or send us an note at email@1fd.org.
