Is Dental Insurance Worth it

You have been enjoying taking care of your teeth. One day, it strikes: a nasty toothache. A glass of water suddenly becomes painful, and your focus shifts to the discomfort. Unfortunately, as you may understand, you know it will only get worse and worse. What you need is a dentist, but you’re also wondering how much it would set you back?

The answer changes if you have dental insurance and what your plan covers. Different dental insurance plans sometimes only cover preventive work alongside basic checkups, but others can provide services for crown placement and even oral surgeries.

If you’re asking yourself, “Is it needed?”

it is best to understand that while you can make it without it, there are some consequences. Most of the time, it pays off to have some form of insurance coverage for dental work, but depending on your personal situation, you may not need the most comprehensive one. After all, it does not matter if you have dental insurance or not; any problems involving your mouth, teeth, or gums should not be ignored. A decrement in oral health can worsen the underlying issues and can escalate into other expensive health complications.

We will discuss the workings of dental insurance and how it can help you save more in future expenses.

To start with, here is what you should note regarding dental insurance.

Some policies, like car insurance, are intended to protect you from financial loss in case of an accident. Dental and health insurance, however, both have a more proactive approach which seeks to ensure that you remain as healthy as possible.

To put it simply, dental insurance enables you to pay a defined monthly amount (premium), and in return, your plan will cover a spending ceilling for your care in that year. Plans can vary based on the insurance carrier and their plan options. Nonetheless, most plans pay for preventative dental care, which consists of checkups and cleaning, in their entirety. Other more extensive services are often offered at varying degrees of coverage.

Lastly, take note of these further terms.

Premium: The fee one pays for monitoring coverage under a dental insurance plan.
Deductible: The threshold amount you will have to personally incur before receiving benefits for the year commences. For dental plans, this amount is usually between $25-$75, although, unlike many other insurance deductibles, preventive services are covered even before you reach your deductible.
Coinsurance – The coinsurance is the portion you need to pay for the dental service after easily meeting your deductible. An example is in the case of a root canal; your coinsurance could be 20% or 50% of the overall fee.
Annual maximum – The upper limit of the dental plan’s payment is the annual maximum, which is the total sum of money that can be spent in a single year’s period towards dental care. After hitting the annual maximum, the patient is responsible for all expenses.

65 per cent of adults in the United States have dental coverage through an employer, which begs the question, does dental insurance make sense? How does dental insurance pay for itself? Explain it as such.

If you do your preventive care appointments, dental insurance will fully reimburse your investment. And, if you need additional dental work, then you will surely appreciate the investment made in the plan.

Let’s look at an investment made with some calculated numbers – say, an example of the monthly premium, which in this case is $40 a month. That works out to be $480 in a year.

This investment typically comes with two covered checkups at 100%, which may vary by plan. Providers of dental services may also negotiate checkup charges with insurers which further reduces costs. However, without insurance, these two visits alone are usually out-of-pocket expenses that range from $400 to $500. That said, the value of dental insurance usually goes beyond that, as most plans offer partial coverage for fillings and root canals.

Besides, dental insurance can reduce the chances of a person needing more advanced dental treatment. Here’s the explanation: in the absence of dental insurance and with the rising costs of preventive care, many may choose to forgo it altogether. However, regular checkups are paramount in maintaining optimum oral hygiene and preventing emergent health conditions that can be painful and costly to treat. In addition to that, from the physician’s holistic view, the dentist can also be the first practitioner who will detect other health issues, for example, oral cancers or diabetes, considering that there’s a bigger picture of a person’s overall health.

The financial burden of dental care without insurance: Costs add up fast

Adults, on average, incur costs of $685 a year which was reported by the American Dental Association in 2013. The average figures reported tend to be much higher due to inflation shifting the costs upwards, bringing the average adult spend to around $1,000 a year. However, these figures are highly adaptive to different conditions, making them difficult to estimate with absolute precision. To simplify this assessment, let’s assume that dental costs for people with no insurance coverage average approximately $1,000/year without any added complexities like surgeries or adding really costly services onto their belt.

The amount shifts further north when you are considerate of root canals, crowns, or any other speciality service. Americans are spending more and more of their own money and less of their pocket towards dental care. Dental insurance plans being offered cater to those services, too, greatly reducing the expenditure spent on that service. All crowns would,, cost around $1200. With different dental plans there is a notable difference with negotiated deals with clinics where drastically shifts to around $900. Using the 50% coinsurance model, an individual pays $450, and the plan pays the same amount, meaning you are actually paying around $750 less from your pocket.

Cost of dental services without insurance

Routine dental checkup: In most places, you most likely will have to pay an out-of-pocket amount for your teeth cleaning and checkup, which can range from $80 to $400. Insurance covers this expense when it comes to basic checkups.
Dental fillings: The average cost of a filling can be anywhere between $140 and $200. The exact price will vary based on the size and location of the filling. In more extreme cases, where the teeth need a root canal, the filling cost may get up to $500. Insurance usually covers up to 80% of the cost.
Teeth removal (extraction): According to many statistics, routine tooth extraction can cost anywhere from $75 to $300 for a non-complicated removal. However, prices can steeply rise into the thousands if the extraction is more complicated (surgical extraction). Insurance may cover 50% to 80% of the cost.
Crowning: Depending on the area where you live, the price of a dental crown can greatly vary. In most regions, you can expect to pay around $1,100 to $1,500 for a standard crown. Insurance may cover 50% to 80% of the cost.
Root canals: Prices for a root canal can range between $700 and $2,100 – most likely depending on the tooth’s location, potential emergencies, and more. Insurance will usually reimburse 50 to 80 percent

Do I need dental coverage provided by my employer? Yes, in most cases, it is a good option.

Your employer decides the network, coverage, and premiums of the dental insurance, which, more often than not, is a great deal. If your employer has a dental plan, then more often than not it is a great value. The following are some of the benefits:

The employer has to pay a portion of the cost.
As this is provided through an employer, the premiums are lower because of group insurance.
The employer already had to work with the insurance company, so they are getting good value for money spent on coverage.
It also helps you save tax as the premiums can be deducted from your salary before tax is applied.

Are individual dental plans worth it? There are numerous affordable and flexible options available.

In the case where you are not a part of a company’s dental plan, obtaining individual or family plans makes sense. Self-employed individuals, retirees, or people without access to employer-funded dental coverage are able to purchase dental insurance directly from an insurance marketplace. These plans will allow you to get adequate coverage for you and your family members.

With an individual dental plan, it’s up to you to choose among different networks and plans that suit you the best. This helps sharpen your health and financial requirements. The specifics of a plan, for example, maximums, premiums, networks, and coverage specifications, will vary on your selection.

While enrolling in a dental plan, you can choose to cover your spouse and dependents as well. With the ability to cover the entire family, getting dental care becomes cost-effective when using an in-network dentist.

In selecting a plan, several factors should be considered, including:

The level of dental attention your family will require
If there is a covered dentist within reasonable proximity
What your financial capacity is

Finding reliable dental insurance for individuals and families is a challenge.

If dental coverage through an employer is unavailable, consider looking for individual or family dental coverage options. Everyone’s situation is different, but generally, if you have dental coverage, you are more inclined to utilize a dentist’s services, which is commendable. Whether for an emergency or preventive services, attending to your dental needs will maintain the health of your soft tissues. Later in life, the savings in pain, time, and finances will be well worth the effort.

Learn More