Is Dental Insurance Worth It?

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 your teeth and flossing diligently. “The cheapest cavity is the one you never get,” Cleveland dentist Matt Messina tells U.S. News & World Report.

The Price of Insurance

About 61% of Americans have dental insurance. Nearly all of them have coverage through work or a group plan like AARP’s, Medicaid, Tricare (for military families) and the federal Children’s Health Insurance Program, wrote Evelyn Ireland, executive director of the National Association of Dental Plans, in an email interview.

Most dental preferred provider organization and regular insurance (indemnity) plans have an average deductible of $50 and a maximum yearly benefit of $1,000, Ireland says. Only 2% to 4% 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 of choice, 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.

Annual premiums for dental insurance run, on average, according to Ireland at the NADP:

  • $166 to $326 per person yearly for an employee only.
  • $325 to $667 a year for an employee and family.

Is Insurance Worth It?

The National Association of Dental Plans describes coverage in a typical plan:

  • Preventive care (periodic exams, X-rays and, for some age groups, sealants) — 100%.
  • Basic procedures (office visits, extractions, fillings, root canals (sometimes), and periodontal treatment) — 80%.
  • Major procedures (crowns, bridges, inlays, dentures and sometimes implants and root canals) — 50% or less.

Orthodontics coverage usually can be purchased as a rider, says the NADP. Cosmetic care is not covered.

In deciding if insurance is worthwhile for you, consider:

  • The annual price of premiums.
  • The cost of the dental care you need.
  • Your policy’s limit on how much it pays out in benefits. Some plans let you 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,” explains Angie’s List.

Help From the Affordable Care Act

The Affordable Care Act requires insurance 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,” says 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:

10 Alternatives

Dental insurance isn’t the only way to cut dental bills. In fact, 39% of Americans have no dental insurance. Here are 10 other ways to cut your costs:

1. Self-Insure

It may be less expensive to pay out of pocket than buy a plan. Fees vary by dentist office and by geographic region. Here are average costs in the U.S. for several common procedures, from the American Dental Association Health Policy Institute’s 2013 Survey of Dental Fees:

  • Teeth cleaning (prophylaxis) adult — $85.
  • White dental filling (one surface, anterior) — $149.
  • Silver filling (one surface, primary or permanent) — $125.
  • Porcelain crown fused to noble metal — $1,003.
  • Complete series of intra-oral X-rays — $124.

2. Preventive Care

In many cases, the best way to save on dentistry is to take excellent 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 away your tooth enamel?

The American Dental Association tells how to brush correctly, how to floss effectively and offers more information on dental health.

3. Cut Back to One Cleaning a Year

If you don’t have serious dental issues, you can probably get by with one cleaning annually, not two. “Several studies have indicated that visiting the dentist twice a year has no notable benefits when compared with a single visit annually,” writes U.S. News & World Report.

Just don’t skip that 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 buying in, be sure to look at a list of covered procedures.

Enrollment fees often run between about $80 and $120 a year. Providers’ discounts commonly are 10% to 60%, says NerdWallet.

But note: “These plans typically cost less than HMOs and PPOs, but they won’t save you as much money in the long run,” Angie’s List says.

5. Request 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 discount for cash.

If your dentist doesn’t provide a discount, ask for one. A respectful and polite request has the best chance of success. Or shop around for a dentist, gathering recommendations from friends and then phoning those offices to find out if they offer a discount.

6. Charitable Clinics

Look for low-cost or free dental clinics offered in your community by local dentist volunteers.

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 nonprofit organization (727-849-2002). Or ask your state’s dental association (find it online) about low-cost care.

7. Dental Schools

Dental schools, at many colleges and universities around the U.S., often offer free or reduced-cost care. Accredited programs are listed at the American Dental Association website.

8. Federally Qualified Health Centers

Private health centers offering dental services are in cities and counties across the country. They receive some government funding and charge according to what you can afford. Use the clinic locator at the federal Health Resources and Services Administration website.

9. Look into Dental Tourism

Cost savings can be had by traveling to other countries for dental care. “Dental patients who live close to an international border form the majority of dental health travelers,” according to Patients Beyond Borders, which publishes a site and books with information about medical and dental tourism.

Josef Woodman, CEO of Patients Beyond Borders, told Fox News that an estimated 400,000 Americans crossed international borders for dental care in 2012.

Do plenty of research to ensure you are getting safe and high-quality care. Some resources:

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. The use of fresh gloves, sterile instruments and safe water are not standard practice in all countries. Without these precautions, patients could be infected with diseases such as hepatitis B.

10. Broaden Your Reach

Dentist fees in rural counties typically are lower than in urban areas, the ADA’s 2011 survey of fees found. Comparison shop for the procedure you need by phoning offices of American Dental Association member dentists outside your metro area and asking about fees.

This post originally appeared on Money Talks News.

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Image: iStock

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