Do you need to purchase a dental insurance plan, or would you save overall if you pay for everything out of pocket?
Dental work can get expensive, so if your job doesn’t provide coverage, you may want to consider buying dental insurance privately. No matter how you obtain the coverage, however, selecting the proper plan is essential. Rates depend on the type of plan you choose, your location, and the insurance provider. A typical monthly premium might reach $50. If you manage to avoid the need for dental care- you may be spending around $600 a year on dental insurance.
What’s Covered and What Isn’t
Most dental plans cover the expenses that are broken down as follows:
- Routine preventive and diagnostic care (cleanings, checkups): 100%
- Basic procedures like fillings and root canals: 80%
- Major procedures like bridges and dental crowns: 50%
While dental insurance usually covers cleanings, exams, and X-rays that are part of a comprehensive exam, anything considered cosmetic (implants, veneers) might not be covered at all. Adult cosmetic orthodontics also fits in with this category.
When Insurance Might Not Be Worth It
When deciding whether to obtain dental insurance, you must consider that dental insurance differs from most types of insurance because potential upsides and downsides are low, compared to, say, homeowners insurance, or health insurance. Should something happen to your house or general health, being caught without insurance can be devastating. With dental insurance, provided you’re in good health, you might end up paying more in monthly premiums than annually out of pocket to cover the bare minimum you’d need in one year — exams, X-rays, your bi-annual standard teeth cleanings, and fluoride treatments (for children).
When You Could Benefit From Having Insurance
However, if you end up needing more work done, many dental plans won’t exceed $1,000-$1,500 annual maximum, so it’s worth having insurance to cover more expensive needs (crowns, fillings, root canals, etc.). This will minimize out-of-pocket expenses and might take the sting out of having to weather the burden of co-pays. Co-pays can run up to 10% on preventative procedures, up to 20% on the basic ones like fillings, and up to 50% on more expensive treatments. Another serious consideration is if you can anticipate some dental expenses but have no money saved to pay out of pocket. In this case, it’s better to get insurance than pay thousands of dollars — possibly with high interest, if you’re putting it on your credit card — and risk ruining your credit.
What Type of Insurance Works Best for You?
When you’re considering which plan to get, look at the value, flexibility, and ease of managing your claims and payments:
- Co-payments
- Annual maximum
- Monthly premium
- Your own needs and dental health
- Estimated yearly savings
- Terms and conditions (waiting period, cleaning frequency, deductibles for family members, is there’s orthodontics coverage, up to what age sealants are covered)
- Customer service (online portal, claims tracker, mobile app)
While paying out of your own pocket for routine checkups and cleanings may be less expensive than paying monthly premiums, whether you need dental insurance really depends on your health, your finances, and your unique dental needs. After all, you only have one set of teeth, and it’s worth preserving, maintaining, and taking the best overall care you possibly can of your valuable asset.
We accept all PPO insurance plans as well as DentaQuest, MCNA, and CHIP. If you are not sure if your health plan covers the procedure you need, our staff would be happy to contact your provider to confirm your benefits. We also have payment plans available for certain procedures. Please contact us anytime with questions or to schedule an appointment.