Nearly everyone is the United States carries health insurance. It is the law after all. But dental insurance is a different story. According to the executive director of the National Association of Dental Plans, Evelyn Ireland, only about 64% of Americans have dental insurance. She recently told CBS News that most have coverage through work or a group plan, like AARP, Medicaid, Tricare (for military families) and the federal Children’s Health Insurance Program. But because it isn’t required, many choose to not splurge on what they consider “optional” coverage. Is the cost worth it? Is it cheaper to pay for coverage or necessary treatment if/when the time comes? Many struggle to answer these questions.
Many dental plans have an average deductible of $50 and a maximum yearly benefit of $1,000. But Ireland says that only about 2-4% of Americans with dental insurance use their entire yearly maximum allowance. If you purchase a plan via workplace, chances are it’ll be one ot these three types:
- Indemnity plan: You choose the provider and your plan pays a percentage.
- PPO: Preferred provider organization plans have groups of practitioners who have agreed to accept reduced fees for those patients within the network. You can see out-of-network dentists, but it’ll cost more.
- HMO: Health maintenance organizations cut costs by requiring members to use only providers within the network.
In 2014, the average premiums for group dental plans averaged around $19 to $32 a month, or $228 to $384 annually. But is it worth it?
Dental insurance usually covers treatments that fall in three different categories: Preventive care (periodic exams, X-rays, sealants, etc) at 100%, Basic procedures (office visits, extractions, fillings, root canals, etc) at 70-80%, and Major procedures (crowns, bridges, dentures, etc) at 50% or less. Orthodontics coverage can typically be purchased as a rider, while cosmetic dental procedures usually aren’t covered at all.
When deciding if dental insurance is right for you, you should consider the annual premium vs the estimated cost of the dental care you need. You’ll need to weigh how much the policy covers and whether you can roll over unused benefits from the previous year. While you likely won’t get your money’s worth with biannual office visits alone, throw in X-rays and a filling or two, and you’ve definitely saved some money. Consider the out of pocket costs for typical services (note: fees vary by dentist off and geographic region):
- Teeth cleaning (prophylaxis) adult: $85
- White dental filling (one surface, anterior) $149
- Silver filling (one surface, primary or permanent): $125
- Porcelain crown fused to noble metal: $1,003
- Complete series of intra-oral X-rays: $124
You can see how costs can add up quickly, making dental insurance a great idea. While there are certainly some individuals who wouldn’t benefit much from paying the annual premiums for coverage, they are the exception. Between covering basic treatments and preventing more serious, more expensive health issues, purchasing dental insurance is almost always a great idea.