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How to cut your dental bills By Edmund Tirbutt
Since April this year, a new system of NHS dental charges has been introduced in England that will slash the cost of dental treatment for some people. But it will also make it even harder to get dental treatment on the NHS, leaving many of us The new banding system Until now, adults who received treatment from NHS dentists paid 80% of their treatment costs up to £384, above which treatment was free. The new system has done away with over 400 separate charges for different treatments, and replaced them within three payment bands. Patients requiring only check-ups will be charged £15.50, whereas those in need of fillings, extractions or root canal work will pay £42.50 and those requiring more complex work will pay £189. Patients pay the band charge only once, no matter how much work is required. This will mean that someone requiring several fillings, for example, will now pay less than they used to, however those who don't need any treatment when they have their check-up will pay a little more. A lower cap will also apply, meaning nobody will ever have to pay more than £189 for one course of treatment. Many NHS dentists feel that it will create higher costs as a result of most people paying for more treatment than they receive, and that widespread tooth decay will result from patients trying to obtain value for money by delaying a visit until they need multiple treatments. Going private
While treatment will inevitably cost more than it does under the NHS, it's important to realise that you are not making a like-for-like comparison. Private dentists will normally be able to give you more of their time and attention. A private check-up is, for example, likely to last for around 15 minutes, compared to between five and seven minutes for a check-up on the NHS. Charges will, of course, be a major factor behind your decision. However, there are a number of questions you should also be looking to ask your dentist before signing up. Does it have a hygienist? What's the charge for the main forms of treatment and for an initial examination of a new patient, and does this include the cost of X-rays? Perhaps even more importantly, parents should enquire about the dental practice's attitude towards treating children. Although children, along with all the other previously exempt categories, can still receive free NHS treatment, some dentists are refusing to treat them on the NHS if they are treating their parents privately. You will also need to know which funding options private dentists allow. Some, particularly the newer private practices, insist that you either sign up to making regular payments to a capitation or maintenance plan or to at least pay a modest amount for a registration fee - which commits you to attending for one year. The majority, however, will allow you to choose between signing up to one of these schemes or pay-as-you-go. Capitation plans
These, of which Denplan is the best-known provider, are not actually insurance contracts, they simply cover the costs of regular examinations and routine treatments, although they are likely to provide some added benefits including insurance in the event of a dental accident or emergency. Patients pay a fixed monthly fee. Denplan quotes an average cost of £16 a month for its core Denplan Care product, but you may have to pay considerably more than this because the amount will depend on the band your dentist feels you need to join at the outset, based on an assessment of your teeth and gums. Maintenance plans These provide a slightly different option. They do not cover actual treatment costs - although they might offer a discount on them. Instead they cover the cost of two check-ups and two hygienist appointments a year. A maintenance plan with Practice Plan, a leading provider, costs between £9.50 and £10.50 a month and includes a 20% discount on any necessary treatment. Graham Penfold, operations director at Practice Plan, says: "Capitation plans require you to be dentally fit to join. It could cost you as much as £3,000 to become dentally fit at outset, and the more work you need to have done to become a plan member, so higher the band you are likely to be put in. There are therefore losers as well as winners with capitation plans, but with our maintenance plans everyone pays the same and they only pay for what they actually need." Pay-as-you-go
If you plan to pay-as-you-go, you can either pay out of your own pocket or you can take out an insured dental plan or cash plan to cover costs as they arise. It's also worth asking whether the practice offers interest-free deferred payment terms if you need major work. Dental insurance plans
These reimburse you when treatment is actually needed, regardless of whether it is received privately or on the NHS, and they don't restrict you to one particular dentist or require an assessment of your dental health at the start of the plan. Policies typically cover general dental treatment (including routine treatment), dental emergencies, and dental injuries. Serious oral problems such as cancer may also be included. Non-emergency treatment is not covered in the first three months of the policy. Boots offers three levels of cover, starting from £9 a month for those with NHS dentists, £13.50 for a plan designed to help towards private dentist charges, and £19.50 a month for a more comprehensive plan with a higher level of reimbursement. WPA offers a slightly different plan which charges £12.48 a month for those aged 18 to 49 and £15.90 for those aged between 50 and 69. Unlike the Boots plan, this is a shared responsibility plan and therefore policyholders need to pay 25% of their costs, with WPA covering the remainder. If you need a lot of work, WPA will meet 100% of costs if you have had to fork out more than £500 in one year. Cash plans
These will offer you a cash benefit when you have check-ups and treatments with most NHS and private dentists, without requiring an initial assessment. A cash plan also provides a basket of additional benefits for other minor healthcare costs, from eye tests and prescription charges to consultation fees and sessions with complementary therapists. Premiums can be cheap, but dental cover limits tend to be very low, so you won't be able to rely on a cash plan to cover all your costs. Westfield Health's Good4you, for example, has one of the most generous cash plan benefit structures. Its level four cover, which costs £20.59 a month, will cover routine dental costs up to an annual maximum of £132 a year - as well as providing 18 other healthcare benefits. The fact that neither cash plan nor insured dental plans have particularly generous benefit structures reflects the fact that providers know that those most likely to take out the cover are those most likely to claim. Many people might therefore feel it makes more sense simply to put aside cash in a high-interest savings account and use this to pay-as-you-go for treatment, as and when it's required. But whatever funding approach you use, and whether you are registered with an NHS dentist or a private one, always remember that prevention is better than cure. That means brushing those teeth every morning and night.
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