Is Dental Insurance Worth It?
For most people, it is not difficult to have health insurance. Even if you are fairly healthy, you want to be sure that in the event of something serious, your insurance will cover most of the outrageous medical costs.
What about dental insurance? There is usually a $ 1,000 to $ 2,000 per year limit on treatment, which can make you wonder what you are really getting in return for your monthly premium. According to Statista, in 2017, about 52% of dental services were paid for by private health insurance, and 48% of services were paid out of pocket.
Below we will take a look at what dental insurance really covers and who should consider buying it.
How dental insurance differs from regular health insurance
Once you’ve reached your annual insurance deductible, you don’t have to pay anymore, right? Not when it comes to dental insurance.
Restorative dentist Daniel Balaz explained that a dental insurance deductible works differently than a health insurance or auto insurance deductible. “Yes, you have a deductible,” he explained, but said it was more like a cost-sharing plan. In addition to the maximum amount your plan pays per year, you will have to pay out of pocket for dental work.
What dental insurance actually covers
Dental insurance usually covers most of your running costs for cleaning, x-rays, and sometimes a couple of fillings. But let’s say you slip and fall, knock out a tooth and need an implant. “You are probably out of luck,” Balaz said. “At best, you pay half the cost up to the maximum level. Then you are on your own. “
“Dental insurance typically covers 100% preventive care, 80% for basic treatments that include filling and simple removal, and 50% for basic services like root canals,” said John Barnes, CFP and insurance agent. “However, each operator is slightly different.”
Dental insurance usually includes a waiting period for major procedures. “Sometimes the waiting period is canceled if you have continuous dental coverage,” Barnes said. But for many plans, for example, if you need to fill a cavity before the waiting period, you will pay 100% of that cost and, in fact, not get coverage for the job.
How to decide whether to get dental insurance
What about costs? Despite all the caveats of dental insurance, it might seem like a coin toss is the best way to decide whether to buy it or not. “For people who have a lot of work to do, the dental company is not going to cover a lot,” Balaze said. “For those who don’t need to work at all, the dental benefit plan usually costs more than it is used.”
If you can get dental insurance through your employer for a few dollars a month, it’s probably worth it. Families with children and the elderly should consider dental insurance as they are more likely to need dental care, Barnes said.
Let’s say you don’t have access to employer-sponsored insurance. If you regularly go to the dentist for cleaning and rarely need additional treatment, you may want to cancel your insurance. “People who have kept their teeth in good shape and can afford to pay for any major service out of pocket,” are good candidates to opt out of dental insurance, Barnes said.
Medicare insurance agent Michael Lovell recommends considering the following to determine if dental insurance is right for you:
· Do you see your dentist for cleaning twice a year? · Is your dentist online? · Is your annual fee equal to or less than the cost of two cleanings, two examinations, and one set of X-rays?
If the math is correct, Lovell recommends getting coverage. “It breaks your big spending into a manageable monthly budget,” he said.
As an example, let’s say your employer offers dental insurance for $ 10 per pay period. If you have 26 pay periods, your annual premiums are $ 260. If you call your dentist to find out how much cleaning and yearly x-rays cost without insurance, which is more than $ 260, it is worth getting insurance just to cover your basic visits.
Before you make a final decision, it is important to make sure that your dentist is part of the network you are considering. PPO plans can give you more freedom to choose a dentist, but usually have a higher monthly premium.
This post was originally published in 2019 and was updated on April 24, 2020 to correct the percentages in the second paragraph.