Health insurance has been a hot topic in the United States for some time. And while Americans are increasingly getting medical coverage, dental coverage is often left on the back burner.
But some people don’t realize how crucial dental health is to overall health. According to the Mayo Clinic, poor dental health can lead to bloodstream infections that cause heart valve damage.
But is it better to get dental insurance or pay for your dental services out of pocket? I recently struggled with the same question, and the result of my research shocked me.
Is Dental Insurance Worth It? – 7 Important Factors to Consider
With monthly premiums, waiting periods, and limitations, it’s easy to wonder if dental insurance is really worth it. To make that decision, there are several factors you should consider.
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1. How Much Dental Insurance Costs
Compared to medical benefits, dental benefits are relatively inexpensive. You can get dental insurance for between $15 and $60 per month for a basic plan, depending on factors like your state and coverage aims. That’s peanuts compared to health insurance, which can cost several hundred to $1,000 or more per month.
Nonetheless, it’s still quite a bit of money on an annual basis. Is it worth spending several hundred dollars per year on a dental plan? That depends on whether you can afford to pay dental costs out of pocket without it.
2. How Much Dental Services Cost Without Insurance
If you need dental work, your jaw is likely to drop when you see the prices of some procedures.
Preventative Care
Preventative care is an annual or biannual occurrence and helps ensure your long-term overall health.
- Oral Exams: Between $50 and $150 or more
- Cleanings: Between $75 and $200
- Full Set of Dental X-Rays: Between $75 and $250
Basic Procedures
You’re likely to need other basic procedures from time to time, and those costs can add up quickly.
- Composite Fillings: Between $90 and $250 for up to two surfaces and between $150 and $450 for three or more surfaces
- Simple Extractions: Between $65 and $450 per tooth
- Recementing Crowns: Between $70 and $135
- Additional X-Rays (Beyond Routine): Between $25 and $750
- Teeth Whitening: Between $300 and $1,000 or more
Major Procedures
You may need a major procedure from time to time, and those can become very expensive.
- Impacted Extractions: Between $300 and $4,000
- Root Canals: Between $200 and $2,000 or more
- Orthodontics (Braces): Between $1,500 and $10,000, but the cost can vary wildly
- Dental Implants: Between $2,400 to $10,000, including the post, abutment, and crown
3. Your Dental Care Needs
Whether or not dental insurance is worth it for you depends heavily on your dental care needs. While everyone should take part in routine preventative care, annual cleanings will only set you back between $75 and $400, though your dentist may recommend two yearly cleanings. Also, many dentists offer free oral exams and X-rays for first-time visitors.
So if all you need is general preventative care, shelling out over $300 per year for insurance isn’t worth it unless you live in an area where they charge on the high side. And even then, it may not save you much.
On the other hand, if you have other dental needs, having a dental plan may be worth the money. For example, if you have tooth pain and think you need a root canal and a couple of fillings, dental insurance will likely save you plenty of money.
4. Your Age
A 21-year-old and 70-year-old likely have very different needs in terms of dental work, even if they both have solid oral hygiene. As we age, our teeth tend to degrade over years of crunching on our favorite foods.
Older people are more likely to need dentures and periodontal services that can get quite expensive. As such, most older consumers should have a dental plan. But younger consumers with no oral issues may be better off paying for preventative care out of pocket. Put the money you would pay for dental insurance in a separate bank account to ensure you’ve got it when you need it for dental care.
5. Types of Dental Insurance Plans
As is the case with health insurance, there are different types of dental insurance plans, and the one you choose makes a big difference. The types of plans available include PPOs, HMOs, and dental discount plans.
Preferred Provider Organization (PPO)
PPO plans allow patients to choose the dentist of their choice rather than having to stick to in-network providers. However, even on PPO dental plans, staying in the provider network leads to discounts on out-of-pocket expenses, reducing your overall cost.
Health Maintenance Organization (HMO)
If you sign up for an HMO plan, you must go to in-network providers for your benefits. Of course, you can always go to an out-of-network provider and pay cash, but then there’s no point in having insurance.
Dental Discount Plans
While discount dental plans like Careington and DentalPlans.com aren’t a form of insurance, many dental providers accept them. These plans don’t pay anything on the patient’s behalf but offer one big perk. When patients visit partner providers, they pay a lower negotiated rate for services rather than the full cost.
Just note that you may not be able to combine discount dental plans with insurance plans, and your dentist must accept the plan just like they need to take your insurance. However, if you need services not covered by your insurance, dental discount plans can reduce the sting.
6. Supplemental Plans
Supplemental insurance providers like Aflac and Mutual of Omaha help cover out-of-pocket expenses insurance doesn’t cover. While these plans are usually an addition to bolster general insurance plans, you can also use them by themselves to assist with high-cost procedures like braces, even if you don’t have a dental insurance plan.
7. Specific Plan Details
Whether you’re interested in a PPO or HMO insurance policy, there are several options to choose from. When comparing plans, pay close attention to these plan details:
- Price. Plan prices vary wildly. Choose an affordable plan that meets your needs.
- Deductible. As with other forms of insurance, some dental plans come with a deductible, and your benefits may not kick in until you meet it.
- Coinsurance and Copays. Coinsurance is the percentage your insurance provider covers versus what you cover. For example, an 80% coinsurance clause means you pay 20% of the cost of care. Copays are set fees you pay for visits and specific procedures. Your insurance may have only one or both.
- Annual Maximums. Each plan has different maximum annual benefits, both overall and for specific services. That’s the maximum amount the insurer will pay for covered service.
- Waiting Periods. Many insurance plans require patients to wait a few months before the benefits kick in. If you need dental services right now, find a plan with no waiting period. These plans often have minimal coverage early on, but it may be better than nothing.
- What’s Covered. Some plans don’t cover certain procedures. For example, we recently learned our plan would only cover my son’s braces if they were medically necessary, leading to $7,000 in out-of-pocket expenses. Know what’s covered to avoid surprises.
It’s also important to note that dental plans are generally much more limited than health care plans. They have a maximum annual benefit, usually only a few thousand dollars.
These plans also limit things like the number of fillings you can get per year and set time frames like five years on crowns or implants. If you’re anticipating needing specific dental work, it’s vital to know the plan’s limitations before signing up.
Should You Buy Dental Insurance?
Consider dental coverage carefully. There’s no one-size-fits-all answer. However, you should strongly consider dental insurance if:
- You Have Dental Pain. If tooth pain is a constant issue, chances are you’ll need a procedure or two to alleviate it. In that case, dental insurance will likely save you money.
- You Have Sensitive Teeth. Sensitive teeth can be a sign of dental issues that may become serious if left unchecked.
- You’re 35 or Older. Younger consumers have fewer dental issues. However, as your teeth age, the chance of having significant dental problems increases. So those 35 and older should consider signing up for a plan.
- You Know Dental Work Is Coming. If you’re interested in teeth whitening services or your child needs braces, it may be best to dive into the dental insurance arena. If this is the case, ensure the plan you choose covers the procedure you want or need.
How to Afford Dental Care Without Insurance
Dental care is expensive, but it’s something many people can afford, though covering it may require some lifestyle changes. Some things you can do to make dental care affordable without insurance include:
- Asking for a Payment Plan. Some dentists offer in-house payment plans, spreading the cost of dental services over a few years. Many that don’t offer these plans take CareCredit, a revolving line of credit that does the same thing.
- Working With a Free Dental Provider. There are several free and low-cost dental service providers, often working as nonprofits. Do some research to see if you can find one in your area.
- Searching for Deals. You might be surprised what an online search for teeth whitening or braces coupons will yield.
- Going to a Dental School. Dental students need real-life experience, so many dental schools provide discount services for those willing to let students handle their procedures. Instructors carefully monitor students, and it’s far less expensive than a traditional dentist.
- Cutting Costs. Think about your monthly expenses and consider where you can trim a thing or two. You might be surprised at how much cutting the cord or bringing lunch to work will save you.
- Getting a Side Gig. If you don’t have enough money, there’s likely an opportunity for you to get more. Think of things you’re good at that others will pay for or take on a side gig.
Final Word
If you’re in pain, go to the dentist now, then worry about insurance. Most plans come with waiting periods, and your dentist may be able to do something to alleviate the pain temporarily while saving more expensive procedures for after your insurance kicks in. That’s why it’s important to consider dental insurance before you have a problem.
However, for younger consumers with great dental health, paying the premium might not make sense. Consider the cost of dental plans and the services you need before deciding.
If you decide you need dental insurance, compare your options carefully. You’ll likely be surprised at just how different plans can be.