Analysis: Dental cover - cost confusion

CIGNA’s Jagielko says that the role of the insurer is to understand user needs, and how they vary.

“People need to weigh up what it is they need most from their benefit,” she says. “Do they want cover for regular treatment or something that is there for catastrophic things?”

Jelf’s Judge believes that insurers must also provide more clarity about benefit levels.

“Dental benefit providers will often provide a total benefit of cover and then provide a schedule of benefits for various procedures but unless you are certain about what treatment you need it would not be really clear if your cover was sufficient,” he says.

He also believes that insurers could be clearer about the potential for shortfalls although he reports that Jelf takes a “realistic view” on the need to practice cost containment to ensure that the benefit, widely claimed on, remains affordable.

Meanwhile, Enrich’s Williams believes that there may be “too much” information about pricing available, resulting in consumer confusion.

“Some insurers have their own pricing maxima for each individual treatment process provided by a dentist whether NHS or private and this does not necessarily tie in with the actual charges made by dentists,” she says. “Although NHS-banded charges are the same across all NHS dentists, private dental practices do not have a general scale of charges for treatment so costs for a specific treatment may differ depending on the dentist chosen.”

Towers Watson’s Anderson, points out that dental benefits will often be part of a broader benefits package, providing intermediaries with the opportunity to practise holistic consultancy.

“You can’t look at this in isolation and the level of reimbursement can vary really greatly from plans doing 100% of NHS to private treatment plans giving specific maximum reimbursement levels and you can get bespoke designs as well,” she says. “There is a myriad of things you see in the market.”

Intermediaries can also draw on their relationships with insurers to secure packages for clients. Lorica’s Chandler negotiates with insurers “to ensure our clients receive the most competitive rates and levels of cover”.

The future

Intermediaries agree that dental benefits remain highly popular.

“The use of dental insurance in a company that provides the benefit is high, indicating that employees like and take advantage of this benefit,” says Lorica’s Chandler. “This is especially true for routine treatment that might otherwise be abandoned.

He believes that the benefit is also important to employers.

“With employee wellbeing being more and more important to employers, dental insurance benefits can provide employers with a way to look after their employees’ wellbeing and by helping to maintain an individual's oral health, the risk of heart disease and strokes can be reduced,” he explains.

Demand for private dentistry is largely driven by the availability, or lack thereof, of NHS dentistry, he says. He believes that pressures on NHS funding, the new contract for dentists and a shift to major restorative treatments being provided privately rather than on the NHS, will determine coverage in future.

Enrich’s Williams agrees that, due to the limitation of NHS dentists, “certain areas of the country are finding a more significant move to dental insurance as consumers have to prepare to pay the cost of private treatment”.

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