Did you know that of all the types of health care, Americans are most likely to skip dental care?
In fact, 13% of working Americans admit to foregoing needed dental procedures. Why? Because of the costs.
But wait, you might be thinking. Isn’t that what dental insurance is for? That way, if I need a root canal or another major procedure, everything is covered, right?
Not so fast. While dental insurance may appear to function the same way as medical insurance, it’s actually very different.
So here’s the million-dollar question: Is dental insurance worth it?
The answer depends on your circumstances. In this post, we’ll outline the pros and cons of dental insurance and help you decide if it’s the right step for you.
How Much Is Dental Insurance?
Dental insurance plans vary by state, city, and insurance provider.
In general, most people pay between $15 and $50 a month–or $180 to $600 a year–for dental insurance. The national average falls right around $300 per year.
Compared to the soaring costs of healthcare coverage, $300 a year might seem like a steal. But before you get too excited, there are a few important things to note.
In most cases, your dental insurance plan comes with a maximum coverage benefit or annual limit. This is generally around $1,000 to $2,000 per year.
Unlike healthcare coverage, which kicks in after you meet your deductible, dental coverage is the opposite. Your dental insurance provider will cover your care up to the maximum amount ($1,000-$2,000 each year).
After that, you’re responsible for 100% of the costs out of your own pocket.
Considering the average cost of a root canal is $1,000-$1,200 and implants start around $1,500, you can exhaust your dental benefits very quickly!
What Does Dental Insurance Cover?
Again, plans vary, but most follow a structure of 100-80-50 coverage.
- 100% coverage for routine cleanings, exams, and X-rays
- 80% coverage for basic procedures like fillings or extractions
- 50% coverage for major procedures like crowns, root canals, or implants
This means you get 1-2 free exams and cleanings every calendar year. The idea behind dental insurance is to encourage preventative care and avoid more serious dental work down the road.
Be sure to read the fine print of any plan you’re considering, as coverage varies. One company may consider a root canal to be a basic procedure, while others classify it as a major one.
Orthodontic work, such as braces or Invisalign, generally isn’t covered under a dental insurance plan. The same goes for cosmetic procedures such a teeth whitening or veneers.
Different Types of Dental Insurance Plans
Dental insurance plans fall into three main categories: DHMO, DPPO, and Indemnity.
Let’s take a brief look at each type of coverage.
DHMO Insurance Plan
A dental HMO plan offers low premiums and 100% coverage for preventative services. Basic procedures will come with a co-pay, while major procedures will only be partially covered (or not covered at all).
An HMO plan requires you to use a dentist within their network, so your options may be limited depending on where you live. If you’re not picky about which dentist you visit and your teeth are in good condition, this could be the best plan for you.
DPPO Insurance Plan
A dental PPO plan offers you the option of using dentists within their network or outside of it. The plan provides more coverage if you use an in-network dentist.
Most PPO plans have a maximum coverage allowance each year. Some major procedures may not be covered or may have a pre-set waiting period before coverage kicks in.
This is the middle ground of dental insurance plans. It’s best for those who don’t need any major dental work right away–but want to be prepared in case they need some in the future.
Indemnity Insurance Plan
An indemnity (or fee-for-service) plan offers the most flexibility. You’re free to choose your dentist, your deductibles will be lower, and your coverage limit will be higher.
Of course, with those perks comes a higher premium. Indemnity insurance plans are the most expensive type because they provide the most coverage and flexibility.
If there’a particular dentist you wish to use and you need a major procedure(s) done, this is probably the best choice for dental insurance.
Pros and Cons of Dental Insurance
Like other types of insurance, there are benefits and drawbacks to dental insurance.
Even if you only use it for your annual checkups and cleanings, you’re more likely to stick to a good routine if you’ve already paid for it. That in itself is a huge benefit–especially if those preventative treatments keep your teeth healthier.
It can also give you peace of mind in case you develop an unexpected dental problem. The procedure may not be fully covered, but your insurance plan can help to ease the financial burden.
The vast majority of people, however, don’t end up utilizing the full benefits of their plan. In fact, 97% of Americans don’t use up their allotted coverage amount in any given year.
If your teeth are in good condition and you don’t foresee any major dental work, you may be able to get by just paying out-of-pocket for your annual cleanings. One or two cleanings per year will cost less than even the cheapest insurance premiums.
But what if you need a little–or a lot–of dental work in the near future? What if you just want the peace of mind that comes with knowing you’ve got at least partial coverage?
Keep in mind that even with the best dental insurance plan, you will still pay for some procedures out of your own pocket. Whether the premiums are worth paying on top of the work you need to be done is up to you.
Is Dental Insurance Worth It?
So, is dental insurance worth it? The answer depends on your financial situation and what type of dental work you need to be done.
We can’t make the decision for you, but we can offer solid financial advice for other aspects of your personal life.
Click here to read our latest blog posts about how to wisely manage your finances.