Is Dental Insurance Worth The Cost?


Through Marilyn Lewis / MoneyTalksNews

You need medical insurance, if only to protect yourself against the cost of an accident or illness so costly that you could be financially bankrupt. But do you really need dental insurance?

This is an interesting question, because you can avoid the most likely causes and expense of dental problems, cavities, and gum disease by diligently brushing and flossing. But some teeth are more prone to problems, and when they do have a problem, the costs can go up quickly.

The price of insurance

On 64 percent of Americans have dental insurance. Almost all are covered by work or a group plan like AARP, Medicaid, Tricare (for military families) and the Federal Children’s Health Insurance Program, according to Evelyn Ireland, executive director of the National Association of Dental Plans. , in an email interview. .

Most preferred dental provider organizations and regular insurance (compensation) plans have an average deductible of $ 50 and a maximum annual benefit of $ 1,000, according to Ireland. Only 2% to 4% of Americans with dental insurance use their maximum annual allowance.

Workplace dental plans are generally one of three types:

  • Compensation scheme: You choose your provider and your plan pays a percentage of the fees.
  • OPP: Preferred provider organization plans have groups of practitioners who accept reduced rates for patients within the network. Your costs are lower with dentists in the network. You can see dentists outside the network, but it will cost you more.
  • HMO: Health maintenance organizations reduce costs by forcing their members to use only providers within the network.

Premiums for group dental care plans in 2014 (latest information available) averaged $ 19 to $ 32 per month ($ 228 to $ 384 annually), said the NADP.

Is Insurance Worth It?

NADP describes these hedging elements in a typical plan:

  • Preventive care: periodic examinations, x-rays and, for some age groups, sealants – 100 percent.
  • Basic procedures: office visits, extractions, fillings, root canals (sometimes), and periodontal treatment – 70 to 80 percent.
  • Major procedures: crowns, bridges, inlays, dentures and sometimes implants and root canals – 50 percent or less.

Orthodontic coverage can usually be purchased as a jumper, NADP said. Cosmetic treatments are not covered.

Dental insurance is not always worth the cost. It depends on your plan, your needs and the cost of the services offered to you.

To decide if an insurance plan is right for you, weigh:

  • The annual premium
  • The cost of the dental care you need
  • Your policy’s limit on the amount of benefits it pays and whether you can roll over unused benefits from the previous year
  • Police coverage

“While many dental policies focus on preventative measures by offering two annual visits, you will really start to save money with more expensive treatments, like root canals and crowns.” according to Angie’s list.

Affordable Care Act Help

The ACA requires providers to provide dental insurance for children under the age of 18. said the American Dental Association. Adult dental coverage can be offered as part of a comprehensive health plan or as stand-alone dental insurance. Learn more about ACA and dental coverage:

Dental insurance is not the only way to reduce dental bills. In fact, 36 percent of Americans do not have dental insurance. Here are 10 more ways to cut your costs:

1. Self-payment

It can be cheaper to pay out of pocket than to buy a plan. Fees vary by dental office and geographic region. Here are the average U.S. costs for several common procedures, taken from the 2013 ADA Health Policy Institute Dental Fee Survey (latest available data):

  • Adult teeth cleaning (prophylaxis): $ 85
  • White dental filling (one side, anterior): $ 149
  • Silver fill (one surface, primer or permanent): $ 125
  • Porcelain crown fused to noble metal: $ 1,003
  • Complete set of intraoral x-rays: $ 124

    2. Preventive care

In many cases, the best way to save on dental care is to take good care of your teeth and gums, and to teach children healthy dental routines. For example, did you know that fruit juices, carbonated drinks and acidic foods can contribute to the wear and tear of your tooth enamel?

ADA tells you how to brush properly, how to floss efficiently and provides more information on dental health.

Delta Dental, an insurer, has more advice on preventive care.

3. Reduce to one cleaning per year

Several studies have shown that visiting the dentist twice a year does not provide any noticeable benefit over having an exam a year. If you don’t have serious dental problems, you can probably get by with one cleaning a year.

But don’t skip this annual cleanup and review. This could save you costly and serious problems.

4. Discounts on dental plans

Discount plans charge an annual fee in exchange for discounted services offered by network providers. Before subscribing to a plan, check its list of covered procedures to see if these are the ones you’re likely to use.

PolicyGenius, an independent insurance broker, compared five dental insurance plans and dental discounts. Costs vary a lot depending on where you live and because the state insurance markets created under the ACA offer different plans. It’s hard to compare dental plans: Companies don’t easily share cost and coverage information until you buy, PolicyGenius found. Despite this, “the five plans we reviewed offered better value than paying in cash.”

A word of advice: The cheapest dental plans don’t offer much value, but don’t settle for an expensive plan – do your research. “If you know you’re going to be spending time in the dentist’s chair soon – and especially if you need expensive dental work right away – the right reduction plan could save you hundreds of dollars. ” PolicyGenius writes.

5. Ask for 10 percent off

Some dentists will take 10% off the cost of a visit or procedure if you pay at the time of the visit. Some offer cash back.

If your dentist doesn’t offer a discount, ask (politely, of course) if they can. Or find a dentist, collecting recommendations from friends, then calling those offices to find out if they offer a discount.

6. Charity clinics

Look for low cost or free dental clinics in your community offered by local volunteer dentists.

Find opportunities in your area through the American Dental Foundation. Another charity with volunteer dental professionals is Heart dentistry, a global non-profit organization. Or ask the dental association of your state on low-cost care.

7. Dental schools

Dental schools at many colleges and universities in the United States often offer free or discounted care. Approved programs are listed in the the ADA website.

8. Health centers approved by the federal government

Private health centers offering dental services exist in cities and counties across the country. They get some government funding and charge what you can afford. Use the clinic locator on the website of the Federal Administration for Resources and Health Services.

9. Think about dental tourism

Dental tourism – traveling to other countries for treatment, often at a fraction of the US cost – is a huge business. Mexico, Thailand, Spain, Turkey, Czech Republic, Costa Rica, Poland, Philippines and Hungary are among the major countries which have thriving dental industry for foreigners.

“Dental tourism companies and corporate dental chains are increasingly advertising” all-inclusive “travel packages that include dental procedures, hotel room reservations, trips to tourist attractions. and plane tickets to attract international customers, “said an article in the International Journal of Contemporary Dental and Medical Reviews.

Do plenty of research to make sure you are getting safe, high quality care. Some resources:

“The decision to go to another country for dental treatment should go beyond simply comparing prices or even evaluating the expertise of dentists. Countries differ in their infection control and safety standards. The use of cool gloves, sterile instruments and potable water is not standard practice in all countries. Without these precautions, patients could become infected with diseases such as hepatitis B.

10. Get out of town

Dentists’ fees in rural counties are generally lower than in urban areas. Make comparisons to find out which procedure you need by calling ADA member dentist offices outside your metro area and asking what the fees are. here’s how locate an ADA member dentist.


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