2 reasons why patients get disappointed quickly at any dental office:

1) Dental Insurance has an annual maximum, while Medical Insurance does not (you pay a lot out of pocket even if you have dental insurance, I will explain below)

2) The average annual maximum has stayed at 1000$ since 1970, in 1970 the average price of a new car was $3,543. (will also explain below)

Explanation:

P.S. – Take 4 minutes to read this and you’ll understand exactly why both dentists and patients are fed up with dental insurance. It’s an eye-opener—don’t skip it.

The average annual maximum for dental insurance is $1,000, meaning once you do $1,000 worth of work, your insurance pays for that work, but any other work past that is fully on you.

For example if you need 2 dental crowns and the cost is $1,200 per crown (x2 crowns = $2,400 total), your insurance would pay $1,000 and if you want to finish your work in the same year you’d have to pay $2,400 - $1,000 which would be $1,400 out of pocket.

That is not true insurance, but rather a discount plan. In medicine, there is no out-of-pocket maximum, meaning they actually cover a lot of the cost (true insurance). Same with car insurance; for my Tesla my deductible is 1,000$ and if I get into an accident, they will cover 300,000$ per accident in bodily injury or $50,000 in property damage. Dental insurance however, covers on average 1,000$ a year.

Dental insurance is thus not dental insurance, but rather a dental coupon disguised as insurance.

Because if you need more coverage than your annual max, which almost EVERY single patient ends up needing, you will pay out of pocket. And that is why a lot of the time people are shocked when they come to the dentist.

And even before you hit your annual max, insurance often doesn’t cover the full cost of what you need. They have their own list of “approved” treatments, and they frequently downgrade what they’re willing to pay for. For example, if your dentist recommends a white composite filling, your insurance might only cover the cost of a cheaper silver amalgam one. If you want the better option, you pay the difference. They also impose restrictions and waiting periods—even on basic procedures—making it harder for patients to get timely care.

As of today, when something like a downgrade happens, guess who is eating the cost - my dental office, because this is No BS DDS and I do not want to surprise the patients with a bill like a hospital or other practices do; patients would blame me when I tell them they owe me when really it’s their insurance’s fault. And yes, that’s why people get surprise medical bills, because of insurance companies deciding to not cover stuff even though their plan clearly says it would be covered - I call that a scam.

Here is what a downgrade is: If a filling costs $400 and your plan says it’s covered at 100%, that doesn’t mean they’ll pay the full $400. What often happens is the insurance only covers the cost of a cheaper silver filling—say $200—and then tells us to bill you the remaining $200. So even with “100% coverage,” you still pay half. See how that works?

The next issue is that annual maximums have not increased since 1970, $1,000 was the average annual maximum of insurance, meaning in 1970 if you went to the dentist and had dental insurance, they covered up to $1,000 of work in 1970. Today, that number is still the same. That's the average.

In other words, $1,000 in 1970, would be worth $8,000 today. Thus, if you wanted to have the same quality of coverage you would have had in 1970, your insurance should be paying $8,000 a year as the annual maximum.

But obviously insurance maximums are nowhere close to that. And why is that? Because as long as the insurance company can keep that maximum the same every year, they're making more and more profit because they're not increasing their coverage with inflation.

And on top of that, your monthly premium increases in price every year. So they're making more and more money off the patient, and paying less and less money to the dentist, and the way they're able to do this is because no one’s talking about it or bringing it up. But here I am bringing it up because this is No BS DDS. Dental insurance is not real insurance; it is a discount code.

Oh, not to mention the times where a tooth obviously needs work and they just deny it outright (common); and try being a dentist and call the insurance for the patient’s coverage or for any issue for that matter — haha please — the average call wait is around 30 minutes. They try to waste our time on purpose in hopes that we give up on getting paid. I can go on and on…

Insurance is an absolute scam, not even close, at least dental insurance is. And until there's reform and until more people talk about it, it will stay like that and patients are going to end up having to pay out of their pocket.

If you’re serious about your teeth, here’s my advice: don’t cut corners on your health. Dental insurance is broken—and often a scam. Many low-cost providers are underpaid and overworked, which can lead to rushed, lower-quality care. That lack of attention to detail shows in the results and how long the work lasts. Choose a dentist you can trust, who takes the time to explain things and stands behind their work. Unfortunately, the current state of dentistry is a mess. Patients aren’t getting the coverage they need, and many dentists aren’t getting paid fairly for the quality care they want to provide. Real change will only happen when lawmakers and advocates start making noise.

Fun fact: Go ahead and Google how much Delta Dental makes per employee.

According to Zippia, “Delta Dental’s annual revenue is $7.9 billion. They have 2,925 employees, which comes out to $2,700,855 in revenue per employee.”

For perspective, my office has four people: two assistants, one front desk, and me. If we were generating revenue like Delta Dental, we’d be bringing in $10.8 million a year. We’re nowhere near that.

In reality, the average dental practice brings in about $119,000 per employee annually. That’s $119K vs. $2.7M.

Insurance companies are profiting massively while patients are told they’re “covered” and doctors are left underpaid. That’s not real insurance—it’s a business model that exploits both sides. I guarantee when they're sailing on their yachts, they're not thinking about you or me. But this is America where we have the freedom to call out BS, welcome to No BS DDS fight with us. Thank You for your time reading this and do your own research. #FreedomofSpeech

-Dr. Mena E. Youssef, DDS