You need medical insurance, if only to protect against the cost of an accident or illness so expensive that you could be ruined financially. But do you really need dental insurance?
It’s an interesting question, because you can avoid the most likely causes and expenses of dental problems, decay and gum disease, by brushing and flossing your teeth diligently. But some teeth are more prone to problems, and when they have a problem, the costs can mount quickly.
The price of insurance
About 64 percent of Americans have dental insurance. Nearly all of them 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 dental preferred provider organizations and regular insurance (indemnity) plans have an average deductible of $50 and a maximum yearly benefit of $1,000, Ireland says. Only 2 percent to 4 percent of Americans with dental insurance use up their yearly maximum allowance.
Dental plans offered through a workplace typically are one of three types:
- Indemnity plan: You choose your provider, and your plan pays a percentage of the fees.
- PPO: Preferred provider organization plans have groups of practitioners who agree to reduced fees for patients within the network. Your costs are lower with network dentists. You may see out-of-network dentists, but it’ll cost you more.
- HMO: Health maintenance organizations cut costs by requiring members to use only providers within the network.
Premiums for group dental plans in 2014 (the latest information available) averaged from $19 to $32 a month ($228 to $384 annually), said the NADP.
Is insurance worth it?
The NADP describes these elements of coverage in a typical plan:
- Preventive care: periodic exams, X-rays and, for some age groups, sealants -- 100 percent.
- Basic procedures: office visits, extractions, fillings, root canals (sometimes) and periodontal treatment -- 70 percent to 80 percent.
- Major procedures: crowns, bridges, inlays, dentures and sometimes implants and root canals -- 50 percent or less.
Orthodontics coverage usually can be purchased as a rider, said the NADP. Cosmetic care isn’t covered.
Dental insurance isn’t always worth the cost. It depends on your plan, your needs and the cost of the services available to you.
In deciding 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 how much it pays out in benefits and whether you can roll over unused benefits from the previous year
- Policy coverage
“While many dental policies focus on preventive measures by offering two annual visits, you’ll really start seeing the savings with more expensive treatments, like root canals and crowns,”
Help from the Affordable Care Act
The ACA requires providers to offer dental insurance for children younger than 18. “Although the new act does not require dental coverage for adults, most state marketplaces will also offer dental coverage for adults,” said the American Dental Association. Adult dental coverage may be offered as part of a comprehensive health plan or as stand-alone dental insurance. Here’s more about the ACA and dental coverage:
- The ADA tells how to compare and assess dental plans.
- Use this Healthcare.gov plan locator to find ACA dental plans locally and compare costs.
Dental insurance isn’t the only way to cut dental bills. In fact, 36 percent of Americans have no dental insurance. Here are 10 other ways to cut your costs:
It may be less expensive to pay out of pocket than buy a plan. Fees vary by dentist’s office and by geographic region. Here are average costs in the U.S. for several common procedures, from the ADA Health Policy Institute’s 2013 Survey of Dental Fees (the latest data available):
2. Preventive Care
Did you know that fruit juices, carbonated drinks and acidic foods can help wear away your tooth enamel?
3. Cut back to one cleaning a year
Several studies have shown that visiting the dentist twice a year doesn’t deliver notable benefits compared with one exam a year. If you don’t have serious dental issues, you can probably get by with one cleaning annually.
But don’t skip that one annual cleaning and exam. It could save you from costly and serious problems.
4. Discount dental plans
Discount plans charge an annual fee in exchange for discounted services from network providers. Before you buy into a plan, look over its list of covered procedures to see if they’re ones you are likely to use.
A tip: The cheapest dental plans don’t offer much value, but don’t just go with an expensive plan -- do some careful research. “If you know you’re going to be spending some time in the dentist’s chair soon -- and especially if you require an expensive dental procedure immediately -- the right discount plan could save you hundreds of dollars,”
5. Request 10 percent off
Some dentists will take 10 percent off the cost of a visit or procedure if you pay at the time of the visit. Some offer a discount for cash.
6. Charitable clinics
Look for low-cost or free dental clinics in your community offered by local dentist volunteers.
7. Dental schools
Dental schools at many colleges and universities around the U.S. offer discounted care but can cost as much as going to a retail dentist if you are not careful.
8. Federally qualified health centers
Private health centers offering dental services exist in cities and counties across the country.
9. Consider dental tourism
Dental tourism -- traveling to other countries to get treatment, often at a fraction of the U.S. cost -- is a huge business. Among the top countries that have a thriving dental industry catering to foreigners are Mexico, Spain, Turkey, Poland, Philippines and Hungary.
Do plenty of research to ensure that you’re getting safe, high-quality care. Some resources:
- OSAP, the Organization for Safety and Asepsis Procedures, tells how to assess infection-control practices in a dentist’s office and gives a checklist for obtaining safe dental care abroad.
- Board Certified Mexico Dental Association has English speaking top specialist dentists in Mexico's most popular dental tourism locales. The Association offers free estimates and referrals.
“The decision to visit another country for dental care should go beyond simply comparing prices or even evaluating the dentists’ expertise. Countries differ in their standards for infection control and safety. And more importantly, many developing nations permit unqualified general dentists to learn advanced dentistry at the patients expense by trial and error.
Best to always insist on Board Certified Dentists when going abroad for your important dental procedures such as crowns, root canals, dental implants, oral rehabilitation etc. They have the years of advanced dental training and certification most dental tourists need.
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