Feb. 03--A Eugene dental practice is trying to make dental care more accessible and affordable by introducing a new kind of dental health plan.
"To my knowledge," it's the first plan of its kind in Oregon, said Dr. Leigh Colby, who founded Oregon Dental Care in 1995.
Today, the practice, which is near Valley River Center, has five full-time dentists, five full-time hygienists and serves 11,000 patients in the Eugene-Springfield area.
Oregon Dental Care's new plan isn't insurance. It is more like a membership club -- along the lines of Costco, Colby said. For an annual fee of $48, a member receives steep discounts on Oregon Dental Care's services, from routine cleanings to more advanced procedures, such as braces, crowns, implants and dentures.
For an additional $48 a year the member's spouse, children and even grandchildren under age 23, can be included in the plan.
The plan applies only to services provided by Oregon Dental Care's general dentists. It does not apply to work referred out of the practice to third-party specialists.
The plan is available only to people without dental insurance -- nationally, about half the population has no dental insurance.
Oregon Dental Care is introducing its plan against the backdrop of national and state efforts to try to improve health care, while cutting costs.
Colby said he came up with the idea for his plan after seeing many of his patients lose their jobs -- and dental insurance -- in the recession.
"We saw those patients come in a year or two later," he said. "They were coming in in pain and they had problems, many of which could have been prevented with preventive care." And cost was the biggest hurdle stopping these people from receiving preventive care, he concluded.
"It's very expensive for people on limited incomes to come in and get their teeth cleaned on a regular basis," he said.
Colby said he later learned at a dental convention that insurance administrative costs account for 40 to 50 percent of the cost of individual dental insurance. So, he reasoned, why not eliminate insurance companies from the equation, reducing administrative costs?
"They add costs," he said. "They add restrictions. They do not add value."
Under this new plan, Oregon Dental Care doesn't bill an insurance company when a patient is seen. Instead the bill goes directly to the patient, and so does the discount that otherwise would have gone to the insurance company.
Carolyn Becker, 65, a semi-retired Veneta resident, said she "didn't hesitate" to sign up when Colby told her about the plan.
In the past 15 years that she has seen Colby, "he has never steered me wrong," she said.
Patients said they appreciate the discounts the plan passes on to them and like that Oregon Dental Care lists the price of various procedures.
"Everything was upfront," said Sheldon Siewert, a new Oregon Dental Care patient and plan member. "It was clearly described. It gave a list of services and prices charged with the discounts. Nothing is hidden, which is a very professional way of doing things and, frankly, a little uncommon," said the 76-year-old retired Florence resident.
Kim Kelly, a plan member and Oregon Dental Care patient for the past 4 1/2 years, said the plan eliminates the hassles of dealing with dental insurance companies.
"There's just too much fine print in the dental insurance policies," said Kelly, 59, an insurance agent who sells Medicare and long-term care policies.
"You're going to see more of this as you go on," Kelly predicted, noting that similar approaches are being tried with other medical services.
Locally, Cascade Health Solutions' primary care clinic in north Eugene and Exceptional Health Care, a medical clinic on Coburg Road, provide primary care medical services to patients who pay a monthly fee.
The discount that Oregon Dental Care plan passes on to patients amounts to 45 percent off its regular fees for preventive care -- 50 percent for seniors 65 and older -- and a 25 percent discount on orthodontics and on restorative and major services, such as fillings, extractions, crowns, root canals and dentures.
For example, a patient under age 65 would pay $356 under Oregon Dental Care's plan for a yearly exam and cleaning, X-rays, and one filling.
The same services, plus insurance premium, would cost $837.50 with an Oregon Dental Service individual dental insurance policy, according to a cost comparison prepared by Oregon Dental Care.
A patient age 65 or older would pay $2,286 with Oregon Dental Care's plan for an annual exam, two annual cleanings, X-rays, a filling, crown and a root canal.
Those services, plus premium, would cost $3,422 with Medicare's dental plan, according to Oregon Dental Care.
Unlike many dental insurance plans, Oregon Dental Care's plan does not require a one-year waiting period, or set any limits or annual maximums on the amount of preventive services or treatment a member can receive, said Louise Brown, Oregon Dental Care's financial manager.
The plan has 2,000 members so far, and could expand well beyond that, Colby said. Even if hundreds more joined the plan, there would be no need to cap enrollment, he said.
"That's a problem I dream about," Colby said.
The office can expand as demand grows, he said.
"We have 16 operatories," Colby said. "We're an unusual practice. We have room to add six more (operatories) and room to add two more dentists and four or five more dental hygienists. I'd love to be able to have that opportunity and maintain the same level of care we provide."
Ron Frederickson, consumer advocacy manager at the state Insurance Division, said virtually all insurance decisions -- other than mandated coverage, such as auto insurance -- boil down to what you think your expenses will be, including the unexpected, vs. the premium you pay to shift that risk to an insurance company.
For dental services, "figure out what it would cost to get cleaning and X-rays a couple of times a year. Factor in your age, and whether you anticipate some of the higher-cost services, like a crown. Then decide whether it's worth the premium," he said.
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