By Marilyn Lewis/MoneyTalksNews
You need medical insurance, if only to protect you against the cost of an accident or illness so costly that you could be financially ruined. But do you really need dental insurance?
It’s an interesting question, because you can avoid the most likely causes and expense of dental problems, cavities, and gum disease by brushing and flossing your teeth diligently. But some teeth are more prone to problems, and when they do have a problem, the costs can quickly mount.
The price of insurance
About 64% of Americans have dental insurance. Almost all have coverage through work or a group plan like AARP, Medicaid, Tricare (for military families) and the federal Children’s Health Insurance Program, according to Evelyn Ireland, executive director of the National Association of Dental Plans, in an email interview. .
Most preferred dental provider organizations and regular insurance (compensation) plans have an average deductible of $50 and a maximum annual benefit of $1,000, Ireland says. Only 2-4% of Americans with dental insurance use their maximum annual benefit.
Dental plans offered through a workplace are usually one of three types:
- Compensation Plan: You choose your provider and your plan pays a percentage of the fees.
- PPO: Preferred provider organization plans have groups of practitioners who accept reduced fees for patients within the network. Your costs are lower with network dentists. You can see out-of-network dentists, but it will cost you more.
- HMOs: Health maintenance organizations reduce costs by requiring members to only use providers within the network.
Premiums for group dental plans in 2014 (the latest information available) averaged between $19 and $32 per month ($228 to $384 per year), the NADP said.
Is the insurance worth it?
The PNDA describes these hedging elements in a typical plan:
- Preventive care: periodic examinations, X-rays and, for certain age groups, sealants – 100%.
- Basic procedures: office visits, extractions, fillings, root canal (sometimes) and periodontal treatment – 70% to 80%.
- Major procedures: crowns, bridges, inlays, dentures and sometimes implants and root canals – 50% or less.
Orthodontic coverage can usually be purchased as an endorsement, the NADP said. Cosmetic treatments are not covered.
Dental insurance is not always worth the cost. It depends on your plan, your needs and the cost of the services available to you.
To decide if an insurance plan is right for you, weigh:
- The annual premium
- The cost of the dental care you need
- Your policy’s limit on the amount of benefits paid and whether you can carry forward unused benefits from the previous year
- Policy coverage
“While many dental policies focus on preventative measures by offering two annual visits, you’ll really start to see the savings with more expensive treatments, like root canals and crowns,” according to Angie’s List.
Affordable Care Act Help
The ACA requires providers to offer dental insurance to children under 18. “Although the new law does not require adult dental coverage, most state markets will also offer adult dental coverage,” the American Dental Association said. Adult dental insurance can be offered as part of a comprehensive health insurance plan or as stand-alone dental insurance. Learn more about ACA and dental coverage:
Dental insurance isn’t the only way to reduce dental bills. In fact, 36% of Americans do not have dental insurance. Here are 10 more ways to cut your costs:
It may be cheaper to pay out of pocket than to buy a plan. Fees vary by dentist’s office and by geographic region. Here are the average costs in the United States for several common procedures, taken from the ADA Health Policy Institute’s 2013 Dental Costs Survey (latest data available):
- Teeth cleaning (prophylaxis) adult: $85
- White dental filling (one surface, anterior): $149
- Silver fill (one surface, primary or permanent): $125
- Porcelain crown fused to a noble metal: $1,003
- Complete series of intraoral x-rays: $124
2. Preventive care
In many cases, the best way to save on dentistry is to take great care of your teeth and gums and teach children healthy dental routines. For example, did you know that fruit juices, carbonated drinks and acidic foods can help wear down your tooth enamel?
The ADA tells you how to brush your teeth properly, how to floss effectively, and offers more information on dental health.
Delta Dental, an insurer, has more tips on preventative care.
3. Reduce to one cleaning per year
Several studies have shown that a visit to the dentist twice a year does not bring noticeable advantages compared to a check-up a year. If you don’t have any serious dental issues, you can probably get by with just one cleaning a year.
But don’t skip that annual cleaning and review. This could save you from costly and serious problems.
4. Discounted Dental Plans
Discount plans charge annual fees in exchange for discounted services from network providers. Before buying a plan, check its list of procedures covered to see if those are the ones you’re likely to use.
PolicyGenius, an independent insurance broker, compared five dental insurance and dental discount plans. Costs vary a lot depending on where you live and because the state insurance marketplaces created under the ACA offer different plans. It’s hard to compare dental plans: Companies don’t readily share cost and coverage information until you sign up, PolicyGenius found. Even so, “all five plans we reviewed offered better value than paying cash outright.”
Word of advice: The cheapest dental plans don’t offer much value, but don’t just go for an expensive plan – do your research thoroughly. “If you know you’ll be spending time at the dentist soon — and especially if you need an expensive dental procedure right away — the right discount plan could save you hundreds of dollars,” writes PolicyGenius.
5. Ask for 10% off
Some dentists will take 10% off the cost of a visit or procedure if you pay at the time of the visit. Some offer a cash rebate.
If your dentist doesn’t offer a discount, ask (politely, of course) if they can. Or shop around for a dentist, get recommendations from friends, then call those offices to see if they offer a discount.
6. Charity clinics
Look for low cost or free dental clinics in your community offered by local volunteer dentists.
Find opportunities in your area through America’s Dentists Care Foundation. Another charitable organization with volunteer dental professionals is Dentistry From the Heart, a global non-profit organization. Or ask your state’s dental association for low-cost care.
7. Dental schools
Dental schools at many colleges and universities in the United States often offer free or discounted care. Accredited programs are listed on the ADA website.
8. Federally Licensed Health Centers
Private health centers offering dental services exist in cities and counties across the country. They receive government funding and charge based on what you can afford. Use the clinic locator on the federal Health Resources and Services Administration website.
9. Consider dental tourism
Dental tourism – traveling to other countries for treatment, often at a fraction of the US cost – is big business. Some of the top countries that have a thriving dental industry catering to foreigners include Mexico, Thailand, Spain, Turkey, Czech Republic, Costa Rica, Poland, Philippines, and Hungary.
“Dental tourism companies and corporate dental chains are increasingly advertising ‘all-inclusive’ travel packages that include dental procedures, hotel room reservations, trips to tourist attractions and airline tickets to attract international customers,” said an article in the International Journal of Contemporary. Dental and medical examinations.
Do plenty of research to make sure you’re getting safe, high-quality care. Some resources:
“The decision to visit another country for dental care should go beyond simply comparing prices or even evaluating the expertise of dentists. Countries differ in their infection control and safety standards. The use of new gloves, sterile instruments and potable water is not standard practice in all countries. Without these precautions, patients could be infected with diseases like hepatitis B.”
10. Get out of town
Dentist fees in rural counties are generally lower than in urban areas. Compare the procedure you need by calling the offices of ADA member dentists outside your metropolitan area and asking about fees. Here’s how to locate an ADA member dentist.