Click HERE for your copy of the umbrella chart.
Have you ever wondered why your dentist can’t always confirm if you’re in-network or why your estimates can seem unreliable? The answer is due to the overlapping and complex structure of umbrella plans.
This system isn’t designed for your benefit—it’s tailored to maximize insurance company profits while undermining patients and providers. Let’s break it down:
🔍 The Unfair Reality:
Multiple Layers of Umbrellas: Insurance carriers like Humana operate under multiple umbrella networks AND have different names for many of them. (e.g., Humana Gold, HumanaDental). But it doesn’t stop there—some umbrellas even cover other umbrella networks. Just look at the dark red entries scattered across my color-coded Excel chart to see this tangled web!
The Dentemax Puzzle: Dentemax is a prime example of this problem. Not only do they fall under multiple other umbrellas, but they also list four entire pages of dental carriers under them. Why? Because they offer the cheapest reimbursements. And guess who benefits? Privatized insurance companies, not patients or doctors.
Dentemax has released its 2025 fee schedule, and it’s downright insulting. For many procedures, the increase is less than 1%. Yup, that’s right, PENNIES.
Adult Prophylaxis (cleaning): $59.08 in 2024, unchanged in 2025.
Exams: $30.27 in 2024, a mere $30.49 in 2025.
4 Bitewings: $38.78 in 2024, unchanged for 2025.
So, where do your premium dollars go? It’s certainly not to the doctors providing your care. This stagnant compensation isn’t just unfair—it’s unsustainable. Dentists and their teams deserve at least the rate of inflation to continue offering quality care.
💡 These structures challenge accurate cost estimates, leaving patients hit with unexpected out-of-network fees and fostering mistrust. Meanwhile, insurance companies reap the benefits of these low reimbursements while your dental practice struggles.
📬 The 2025 Game Plan:
For Dental Offices: Start planning to reduce participation in networks that undervalue your services. Assess your patient base and phase out contracts strategically to gain freedom and prioritize transparency.
For Patients: Know that dental benefits aren’t the same as health benefits. Benefits may still be available to doctors not directly contracted. Contact your HR or broker to confirm coverage and avoid unpleasant surprises. And don’t get mad at your dental office, this is a systematic problem!
Let’s step into 2025 informed, assertive, and dedicated to a system that supports genuine patient care over insurance profits. Get loud, get involved—your dentist deserves better, and so do you.
#EndInsuranceMonopolies #StopProfitingOffPatients #FairReimbursements #DentalCrisis #PatientsOverProfits #ProtectPrivatePractices #InsuranceTransparency #ReformDentalCoverage #HealthcareInjustice #AdvocateForDentists #FightForFairPay #InsuranceExploitation #ChangeHealthcare #HealthcareAccountability #ExposeInsuranceAbuse #ProfitOverPeople #HealthcareTruth #standwithdentists #ReclaimPatientTrust
