Will your medical aid pay your dental fees?

By Staff Writer

With dental fees rising above inflation your medical aid cover may not be enough to keep your teeth in the best condition.
Dr Gareth Hayton, managing director of Dental Information Systems, told the Weekend Argus that only about two million of the country’s 8.5 million medical scheme beneficiaries have cover where the costs of dentistry come from their general benefits. Others have their dental costs covered by their  medical savings account.


Dental costs are also escalating making a trip to the dentist unaffordable for many people. Maretha Smit, CEO of the South African Dental Association, (SADA) said there were many reasons why dental costs were rising above inflation.
“The current exchange rate has an impact on everything including the price of imported equipment like X-ray machines and dentist chairs as well as consumables such as composites and gloves,” said Smit.


Besides these costs, electricity and water is used on a constant basis and on a big scale at dentistry practices. The increased cost of these services have had an impact on dentists as well.


“The dental industry has become a soft target when it comes to cost cuts by medical aids because there is not enough appreciation for the value of preventative care,” said Smit.




She said that dental care is in fact an important part of healthcare because, with proper oral care, people can lead a healthier life.


Smit added that consumers needed to be educated about the real cost of dental procedures because, in many cases, the actual cover for dentistry by medical aid schemes does not even reimburse the costs of the actual material in dental treatments let alone the time of dentists.


She advised consumers to look into separate insurances, from their medical aids that tailored for sophisticated dental care that is not always covered by a medical aid.


Will it help consumers if prices are standardised?
Last month the Health Professions Council of South Africa (HPCSA) appointed healthcare actuary, Shivani Ramjee, to assist with the process of setting a guideline tariff to be used to assess overcharging by medical practitioners.


Medical guideline tariffs have been fiercely opposed by the medical profession and Smit feels that it will not help alleviate high dental costs.


“Consumers should be allowed to shop around for the best price in the market rather than pay a standard rate. This will keep dental costs under control. Price regulation is dangerous. Should standardised rates be too low, many dentists could opt to leave the profession altogether because it will no longer be worth their while. If these standardised rates are too high, dentists will be required to charge patients this inflated regulated rate. Either way, the consumer will ultimately suffer,” said Smit.


 

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