One of the good deeds insurers and benefits advisors can do this challenging year is to speak up for children’s teeth.
Brokers “understand the importance of dental benefits for both employers and employees, both from a health perspective and from the perspective of employers being able to attract and retain the most talented employees,” says Barbara Springer, a vice president at Delta Dental of Colorado, Denver.
When the Delta Dental Plans Association, Oak Brook, Ill., conducted a survey of parents and other people who care for young children, it found that 87% of the parents and guardians agreed that getting good dental care for children is as important as getting children good medical care.
The trick is persuading benefit clients’ employees, and individual customers, to do what they ought to do about dental care for children at a time when cash levels are low and stress levels are high.
Medicaid and State Children’s Health Insurance Program plans are now supposed to pay for dental care for low-income children and moderate-income children.
Most traditional group and employer-sponsored voluntary dental plans offer “family coverage” at the cost of less than a latte per day.
On the individual market, insurers are advertising family “discount only” programs and true dental insurance programs at a cost equal to about 200% to 300% of the individual rate.
In Kansas City, Mo., for example, one carrier advertises a dental indemnity insurance policy with an annual maximum of $1,200 for about $35 per month for an individual and about $80 per month for a family.
In New York City, another company offers true dental insurance, with a $1,200 maximum, for about $60 per month for individuals and about $172 per month for families.
Another company sells an individual discount program in both markets for about $9 for an individual and about $11 for a family.
Despite all of the public and private options available, the oral health of children in homes with incomes over 200% of the federal poverty level-children who should at least be enrolled in a dental discount program-may be deteriorating.
The U.S. Centers for Disease Control and Prevention conducted one series of dental survey exams from 1988 to 1994 and a similar series from 1999 to 2004.
One indicator of dental care quality is the percentage of 8-year-olds with teeth protected by sealants. The percentage of 8-year-olds in relatively high-income homes who were protected by sealants increased to 42% in 1999-2004, from 35% in 1988-1994.
But the percentage of the children ages 2 to 11 in relatively high-income homes who had seen a dentist in the previous 12 months fell to 72%, from 74%, and the percentage with untreated decay in baby teeth increased to 15%, from 14%.
The percentage of relatively high-income children ages 2 to 4 who already had cavities in their baby teeth jumped to 24% in 1999-2004, from 18% in 1988-94.
The recession could make the situation worse. In Spokane, Wash., for example, an increase of 10,000 in the number of unemployed people appears to correlate with a 5.95% decrease in insured residents’ use of dental cleanings and routine dental exams, according to a team led by Brian Quinn, a researcher at the Robert Wood Johnson Foundation, Princeton, N.J.
Some studies “suggest that high-stress situations may make preventive care a lower priority,” Quinn and his colleagues write in a paper published in the journal Health Services Research.
The good news is that, now more than ever, employers and their employees value dental benefits.
When employers offer dental benefits, most “have a family option, and most employees with families take advantage of the benefits,” Springer says. “Very few employees [with children] take the dental coverage without taking advantage of the children’s coverage.”