When a crown fell off my tooth a couple of weeks ago while I was chewing gum, first there was a feeling of panic, then of revulsion, then ... relief. At least I wouldn't have to pay anything to have the ghastly gap sorted out. The dental insurance policy I'd taken out 15 months ago would cover the full cost of an emergency replacement.
I bought an HSA Dental Plan which, as far as suiting the needs of my family, looked too good to refuse. I was right at the time. I've paid out £585 in premiums at £39 a month for the top level of cover but received back payments totalling £1,577.50 - saving us £992.50 in costs. Not surprisingly, perhaps, the "too good to be true" now turns out to be just that.
HSA has just written to its 80,000 policyholders explaining that, because the two-year-old plan "has exceeded our expectations in both popularity and levels of claims", premiums are to go up and some benefits reduced from January 21, 2009. But though disappointed by the increased cost and reduction in cover, our experience to date makes me reckon the policy is still worth keeping, at least for now.
We live in an area of west London where NHS dentists are virtually non-existent. The dental practice we've used for years offers only private treatment, even charging for our two children's check-ups and treatment. The quality seems excellent but fees are correspondingly high - a routine check-up, for example, costs £45 (£15 for a child) as does a visit to the hygienist. Root canal treatment plus crown typically works out at around £1,000.
When we were uninsured, both my husband and I required major bouts of dental work, landing us with sudden, unexpected bills for hundreds of pounds. We were, therefore, keen to find something that would help protect us and the children against such shock costs in the future.
There are a number of plans on the market.
The "capitation" schemes, offered by private dentists in conjunction with a provider such as market leader Denplan, didn't appeal. These plans spread the cost of your estimated dental care over a year with the monthly premium based on the dentist's assessment of the condition of your teeth.
The problem is, capitation plans are expensive for people like me who have a comparatively poor dental history.
The alternative is a dental insurance policy, which doesn't require a dental inspection to get cover, and doesn't tie you to a particular private or NHS dentist, making it much better value for those of us with less than perfect gnashers.
The HSA deal, as it stood at the time, certainly looked good for our purposes. We opted for the top level of cover costing £34 per month for a couple plus £5 for all children under 18. The policy gives 100% payback for all "maintenance" including check-ups, hygienist visits and x-rays up to £150, plus 75% of the cost of treatment including crowns, bridges, white fillings and dentures plus lab fees up to £2,000 per year.
The cover applies anywhere in the world for trips of up to 28 days. Policyholders must be between 18 and 60 years old and, like any standard dental insurance, the policy does not cover cosmetic and orthodontic treatment, such as braces.
We calculated that if we attended all our dentist's recommended check-ups and hygienist visits, our annual bill for the routine maintenance alone would be £420, of which we could claim £360 within the limits.
So, for annual premiums of £468, we felt it was a no brainer - we'd only be spending £108 a year to protect ourselves against the cost of any other treatments. Once we'd taken out the policy we could claim for maintenance visits straight away - we had to wait three months before we could make a claim for any subsequent treatment.
First, my son chipped his front tooth in an accident on holiday (£95), then I needed a filling (75% of £95) followed by emergency root canal treatment (£505) and a crown (75% of £495) all topped off by the previously mentioned replacement of another crown (£65).
And claiming is pretty easy. We pay the dentist for each treatment, then send off the receipt with a claim form signed by the dentist and the payment goes straight into our nominated bank account within a few days, usually with no further questions asked.
From January 21, our monthly premium will go up by just over 25% to £50. Among the most relevant benefit cuts for us, the annual limit for maintenance claims goes down from £150 to £100 per person and we can claim only 50% (down from 75%) of treatment costs, up to a limit of £1,000 instead of £2,000.
For people using an NHS dentist, who want a budget plan offering a lower level of benefits, HSA offers a core plan from January 21 costs £7.70 per adult, £13.95 for two adults plus £2 for up to four children per month.
For us, the insurance odds of our HSA policy still look worthwhile. But we'll be comparing it to what's on offer from some of the newer entrants to the market. Tesco, for example, which also offers two levels of cover under its dental insurance launched in August 2007, would charge us more as a family - £58.60 - for its equivalent premium service. But the benefits are better including 100% reimbursement of dental maintenance costs up to £200 per year and 70% of general treatment costs up to £2,000 a year. By switching though, we'd have to again wait three months before making a claim.
I'll have to chew over that decision with the rest of my family.
How to find an NHS dentist
Finding a dentist willing to do NHS work can be difficult, but it's not impossible. Go to nhs.uk and on the Find Services page click on "dentists" and put in your postcode. Then you have to click on each dentist surgery listed to find out if they are accepting new NHS patients.
Sadly, the number of people seeing an NHS dentist has continued to drop, despite government efforts to improve provision.
Official statistics from the NHS Information Centre show that 27.3 million people saw an NHS dentist in the two years to last December, compared with 28.1 million in the two years to April 2006, when new commissioning and contractual arrangements for dentists were brought in - a drop of nearly 1 million.
Across England, less than half the adult population went to a dentist on the NHS - 49.3% in the past two years to December. A bigger proportion of children - 69.6% - whose treatment on the NHS is free, saw an NHS dentist.
