Dental Benefits Are Often Misunderstood, Underused

Skipping preventive care can lead to greater expense later on

By Stephen Miller, CEBS Jul 18, 2017
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One in 4 employees who have dental insurance say they haven't been to the dentist in the past 12 months for regular checkups and routine cleanings due to cost, a new study shows. This indicates that employees may lack adequate understanding about their dental benefits, because dental plans typically cover preventive care, outside of any deductible, the study authors said.

While a majority of U.S. adults believe dental coverage is a "must-have" employee benefit, only half of employees feel that their employer provides enough information about what is covered under their plan, according to the 2017 dental research study by benefits provider Lincoln Financial Group, which received responses earlier this year from 1,000 adults across the U.S.

"Consumers may not be taking full advantage of their dental benefits due to a simple lack of knowledge about their insurance plans," said Christopher Stevens, head of dental product management at Radnor, Pa.-based Lincoln Financial. "Often, dental insurance will fully cover the cost of preventive care such as annual or biannual dental checkups and cleanings. If one-quarter of these individuals—who indicated they have dental coverage—responded that they aren't going to the dentist because of cost, they're probably not making that connection."

Among other survey findings:

  • 65 percent of consumers want their employer to provide general information about what's covered by their dental insurance plan.

  • 54 percent say they'd like their employer to provide a list of local in-network dentists.

  • 34 percent say they would appreciate ratings or rankings of in-network dentists.

Older Workers Less Satisfied

Overall, just over half (51 percent) of respondents agreed that their employer was a good resource when they needed to understand exactly what their dental benefits cover, which suggests that employers should step up their communication about their plans, Stevens noted.

"The share of those satisfied with employer information declines steadily with age, in line with older workers' increased use of dental services," he pointed out. Among older Baby Boomers, for instance, just 34 percent agreed that their employer was a good resource for dental benefit information.

[SHRM members-only HR Q&A: Are dental benefits covered under COBRA?]

Addressing Misperceptions

"Sometimes people forget that they have dental coverage, or how imperative it is to go for regular treatment," said Scott Towers, president of the Eagan, Minn.-based dental division at Anthem, a national health insurance provider. "If you don't have a regular dentist that you see, you aren't getting those reminders that it's time for your next visit," he noted.

While fear of the dentist—or "dental anxiety"—is one thing that prevents people from getting regular checkups, misperceptions about the cost of routine dental services is also a leading reason why so many go without care, Towers explained.

For instance, employees facing higher deductibles on their medical plans may not realize that under most dental plans—well over 90 percent—diagnostic and preventive treatment are fully covered outside of a deductible, Towers said. (A similar issue affects medical plan use, with many enrollees not knowing that annual physicals and other preventive health services are fully covered outside of their health plan's deductible.)

Higher Out-of-Pocket Costs

While plan enrollees aren't taking advantage of diagnostic and preventive services covered outside the deductible, they are paying more out of pocket for nonpreventative dental services and for plan premiums, Towers acknowledged.

For instance, while many employers formerly provided dental care as a fully employer-funded benefit, "We've seen an increase in dental insurance as a voluntary benefit, with coverage becoming either fully employee-paid or with employees paying at least 50 percent of the premium cost," Towers explained. A decade ago, a $25 individual deductible and a $1,000 annual maximum for a dental plan were common, but "today, the most frequent plans that we offer have a $50 individual deductible and a $1,500 annual maximum," he said.

While some employees worry that a dental visit will reveal a need for treatment that they will then have to pay under the deductible, "appropriate preventative dental services ensure that less serious and invasive procedures are needed down the road, especially for adults running into periodontal issues," he said. Avoiding the dentist, in other words, can be expensive—a message that should be emphasized in dental benefit communications.

Getting the Message Across

"We're seeing the increasing use of interactive tools, including online apps and digital platforms, where information on dental coverage is provided along with contact links for in-network dentists," Towers said.

For at-risk populations with chronic medical conditions, "health coaches can reach out to remind them of the impact that their oral health can have on their medical conditions," he noted. For instance, oral infections caused by periodontal disease can pose serious health risks for diabetics or those with chronic heart disease. Care managers can reach out and remind enrollees from at-risk populations when they haven't been to the dentist in six months.

Under an integrated care management approach, medical, vision and dental insurance typically are still provided through separate plans, but "outreach and communications are coordinated to address care issues across the spectrum of health benefits," Towers said.

Related SHRM Article:

Give Your Dental Plan a Checkup, SHRM Online Benefits, August 2015


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