Most people would agree about the need for medical insurance, even if only as protection against the cost of an illness or accident so expensive that it could ruin them financially. However, does the need to carry dental insurance equal the importance of having medical coverage? Your West Linn family dentist understands that many patients face this uncertainty.
A difficult question to answer, as you can successfully lower your risk of the most likely causes of expensive dental problems – gum disease and dental decay – by regularly flossing and brushing. Some individuals have a higher likelihood of developing oral problems – whether due to genetics or lifestyle choices – and when problem develops, the costs can quickly escalate.
The Cost of Dental Insurance
Roughly 64 percent of Americans have dental insurance. Nearly all of them have their coverage thanks to their work or a group plan like Medicaid, AARP and the federal Children’s Health Insurance Program, according to the National Association of Dental Plans.
Most dental plans carry an average deductible of $50 and a maximum yearly benefit of $1,000, reports the NADP. Yet only between 2 to 4 percent of Americans with dental insurance actually exhaust their yearly maximum.
Most workplace offered dental plans fall into one of three categories:
- Indemnity plan: You choose your provider, and your plan pays a percentage of the total fees you’re charged.
- Preferred provider organization plans have many types of practitioners that have previously agreed to lower their rates for patients within the network. You enjoy a lower cost when visiting an in-network dentist, and need to pay more when visiting an out-of-network dentist.
- Health maintenance organizations reduce costs by requiring members to only visit in-network practitioners.
Premiums for group dental plans in 2013 averaged between $19 to $32 a month ($228 to $384 annually), reports the NADP.
So is Dental Insurance Worth the Cost?
While dental plans vary, the NADP lists the following elements of coverage in a typical plan:
- Preventive care: dental exams and cleanings, X-rays, and dental sealants for younger patients – 100 percent covered by insurance.
- Basic dental care procedure: office visits, tooth extractions, dental fillings, periodontal treatment and (occasionally) root canals – 70 to 80 percent covered by insurance.
- Major procedures: crowns, inlays, dentures, bridges, and, depending on coverage, root canals and implants – 50 percent or less covered by insurance.
Orthodontics coverage can usually be added to a dental plan for an additional cost, while cosmetic dental care is not covered.
Understanding whether dental insurance is worth the cost depends on your individual needs, your plan and the cost of the services it provides.
When deciding if a dental insurance plans is right for you, consider:
- The annual premium
- The average cost of the care you require
- The policy’s limit on how much it pays out in yearly benefits and whether you can roll over unused benefits
- Policy coverage
If you enjoy quality oral health and only require visiting the dentist for biannual cleanings, then dental insurance may not be right for you. However, you never know when a significant issue may come up that requires expensive treatments that you’ll need to pay out-of-pocket. As is usually the case with insurance, protection against the unexpected can offer a lot of peace of mind if you can afford to pay the premiums.