Most people I know don't enjoy visiting their dentist's office; yet, they are fiercely loyal to their dentist. That's a conundrum. But, I think it's because people recognize the importance of good oral health and they want to use their benefits. So, imagine if you don't have access to coverage.
One benefit of the Patient Protection and Affordable Care Act is the expansion of dental insurance coverage for children. It's designed to foster a promising future for millions of kids (5.3 million, in fact) who, until the PPACA came along, didn't have access to dental insurance. Seems like a good thing, right? Well, sure. But, as with everything, there are upsides and downsides.
The upsides: First, studies show that people without dental coverage don't visit a dentist regularly. Second, tooth decay is the number one chronic health problem among children. These two items in combination create a sobering result, which is that a common dental problem (tooth decay) may only get treated through expensive procedures. Essentially, the decay is allowed to progress too far and, ultimately, subjects our kids to greater risks of more serious diseases. The upside is that the ACA extends coverage—and care—to kids at greatest risk.
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Now, further consider this additional upside for you, as an advisor. Nearly all dental insurance sold today in the United States is separate from medical insurance and, perhaps even more surprising, only a little over half of all Americans have access to dental coverage. So, the potential for growth in dental insurance is huge, especially now that the government is mandating that all children subject to the ACA have dental coverage.
The downsides: But, now, let's discuss the downsides (you knew there had to be some). The most significant is the increase in premium that will be needed to cover the cost of care—as much as 20-30 percent for children's coverage. After all, someone has to pay for the increased access to care.
The other unintended consequence is that, due to the complex structure of the PPACA (which is far too cumbersome to delve into here), kids may be covered under a different plan from their parents and may be required to see a different dentist. Essentially, premiums will increase and family dental care may become fractured. That's a "one-two punch" that leads many experts to worry that some parents will drop coverage on themselves and cover only their children.
How an advisor can help
The bright side is that dental insurance is highly desired by the working population. And, because only half of all Americans currently have coverage, there is significant potential for organic growth in the market. As you can see, the market is alive and well. Nonetheless, providing benefits within the context of the PPACA is a complex topic for employers to maneuver, which is why it presents the perfect opportunity for advisors.
As an advisor, here are some tips that you can share to help employers and their employees make the most of their health care dollars.
- Help raise awareness of the importance of oral health and the impact to overall health;
- Become familiar with the PPACA and its implications on dental plans;
- Encourage full family dental coverage and help construct options to achieve that; and,
- Promote cost-conscious utilization, such as seeking services from in-network providers, using preventive care to help reduce the risk of more advanced, costly oral issues and practicing good oral hygiene habit—brushing, flossing, fluoride use, etc.
I want to emphasize that last point—good oral health is based on good dental habits. The best way to instill good habits is to help our children develop them at an early age.
And, given that February is National Children's Oral Health month, the time is right to promote the fact that brushing, flossing and getting routine check-ups is our best offence. Over time, this will reduce dental health care expenses, effectively lower insurance costs and give our children a healthier future.
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