Source: Wall Street Journal (online.wsj.com)
Author: M.P. McQueen

At a time when workers are shouldering an ever-greater share of health-insurance costs, some insurers surprisingly are increasing benefits in dental plans.

A growing number of plans are rewarding patients who get regular preventive care by allowing them a higher maximum yearly allowance. More plans are paying for services that were formerly excluded, including tooth bleaching and dental implants to replace missing teeth. And more plans also are covering additional cleanings or gum treatments for patients who are pregnant or have chronic health conditions.

The new features are showing up in employer-provided group plans and some are finding their way even into individual plans.

A Way to Fight Disease
Experts say the enhanced preventive care is aimed at reducing overall employer health costs by reducing the prevalence of serious disease. A growing number of studies have linked gum disease to such conditions as pre-term births, diabetes and heart disease, although the relationship is not always well understood by science.

(All dental plans aren’t available in all areas, however, and some of the new features are included only if an employer chooses to offer them.)

Delta Dental of California, New York and Pennsylvania and Affiliates, one of the largest dental plans in the U.S., recently introduced a plan that doesn’t count diagnostic and preventive care toward the annual maximum. That enables patients to conserve more of their annual benefits allowance, usually capped at $1,500 to $2,500, for such big expenses as bridges and crowns.

Guardian Life Insurance plans are allowing patients to roll over a share of the unused portion of their annual limit for future years provided they file at least one paid claim a year.

The changes are intended to reward patients for getting regular, routine care, insurers say.

When it comes to patients with chronic diseases, Principal Financial Group just started offering extra cleanings for patients undergoing treatment for cancer of the head and neck, saying research indicates they are at greater risk of complications from dental procedures.

Delta Dental last year added a third paid exam and a free extra cleaning per year for pregnant women, and an additional deep cleaning for those with signs of periodontal disease.

Guardian is covering up to four routine or periodontal maintenance cleanings at the recommendations of the dentist, without additional verification, says Richard Goren, DDS, second vice president.

Expanded Coverage
More insurers also are paying — usually 50% — for dental implants, which formerly were excluded. Others are paying part of the cost of tooth whitening or providing a discount for it. Evelyn Ireland, executive director of the National Association of Dental Plans, says insurers are doing this to entice consumers into visiting the dentist for necessary routine care.

Many insurers also are adding interactive online tools to make it easier to shop for providers and compare fees. That’s useful because insured patients usually must share about 20% of the cost of basic services such as fillings and extractions, and 50% of major restorative work like bridges. MetLife, Principal Financial, Delta Dental and Guardian all have introduced cost estimators to calculate the average costs of services in a given Zip Code.