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In the Medical Market Place—Another Way to Pay for Dental Care
Trudy Lieberman | July 30, 2012
Across the country some 200 dentists have begun selling a package of basic dental services with a membership plan similar to those offered by big retailers like Costco and Sam’s Club. The brainchild of an Oregon dentist named Dan Marut, Quality Dental Plan (QDP) targets people who don’t go to the dentist mostly because they can’t afford it. More than fifty percent of Americans don’t have dental insurance, and fixing teeth can be expensive.
Marut told me that he based QDP on the idea that promoting preventive dental care would be a win-win for doctors and patients. “By helping dentists offer a savings program that truly benefits patients, dentists can do well while doing good,” he said. In the dental savings plan model, patients get preventive care, and dentists get new patients. Dentists pay QDP a fee which Marut says equals a couple hundred dollars each month.
Here’s how QDP works. Participating dentists offer patients a yearly membership whose price varies from dentist to dentist. The price is low—around $200 or $300 a year —which buys a bundle of services that usually includes two cleanings, x-rays, an oral exam, and sometimes “extras” like special mouthwashes. Some dentists offer discounts on expensive services like crowns and implants.
With traditional dental insurance, your premium covers services you may not need, which, of course, is the case with any kind of insurance. For example, with QDP, coverage does not include the costs of a crown or filling cavities, services you may not need, which makes QDP cost less.
Dentists are free to design their own package of services and tailor them to patients’ needs. Some patients may need a full set of x-rays; others only bite wings. “We want each dental practice to create a bundle based on their standard of care,” Marut explained.
To see what a typical QDP practice actually offers, I visited one in New York City to ask about the plan. The agreement was simple and straightforward with little fine print, but there was a list of twenty-two service exclusions that included implants, oral surgery requiring the setting of fractures, and loss or theft of dentures.
For a yearly fee of $350 I could get annual exam x-rays, two simple teeth cleanings (simple was not defined), a take-home kit for whitening teeth, a 10 percent discount on certain kinds of braces, a 10 percent discount on a Sonicare toothbrush, and a 20 percent discount on any other procedures. If I wanted to add family members, it would be an extra $300 for each one.
If you need the expensive stuff like a crown or implant, you’re on your own. And that’s where the real money comes in. The New York City dentist charged $1500 for a crown, but the receptionist said I would pay only $1200 with my discount. Filling cavities would also be cheaper. If you have traditional dental insurance instead of Marut’s savings plan, most likely these services would be covered with some reimbursement, a point that’s not part of the QDP sales pitch.
Increasingly, dentists are offering financing arrangements to cover costs of their services through banks such as JP Morgan Chase and CapitalOne. The New York dentist I visited offered two of these plans, CareCredit and Springstone. As I explained in a previous post, these financing deals come with lots of questions about the rights and protections patients have under existing consumer protection laws. My recommendation remains: buyer beware!
Someone who buys a membership in a dental savings plan like QDP and needs costly treatment may still face financial challenges. That’s not to say that the annual fee might not be worth it. The best way to find out is to do some online comparison shopping and ask several dentists what they would charge for routine care like exams, cleanings, and X-rays. Assess whether the free goodies and the discounts on more costly services will be worth it. And like buying at Costco or Sam’s Club, maybe you’ll save money. Maybe you won’t.
More Blog Posts by Trudy Lieberman
Trudy Lieberman, a journalist for more than 40 years, is an adjunct associate professor of public health at Hunter College in New York City. She had a long career at Consumer Reports specializing in insurance, health care, health care financing and long-term care. She is a longtime contributor to the Columbia Journalism Review and blogs for its website, CJR.org, about media coverage of health care, Social Security and retirement. As a William Ziff Fellow at the Center for Advancing Health, she contributes regularly to the Prepared Patient Blog. Follow her on twitter @Trudy_Lieberman.
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