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Sep, 26 2012

Let’s admit – it might be less painful to have a root canal than wade through a dental insurance decision!

For those who get insurance through an employer, it’s open enrollment time. You’re being handed the health insurance menu of options. For those who purchase your own insurance – you have more options, but fewer good ones. 

Whichever scenario fits you, the key is to evaluate value. In other words, consider what you’re getting versus what you’re paying. Americans are paying more than ever before for medical insurance and healthcare. It’s worth considering whether you’re getting the bang for your buck with dental insurance. We know you still need to keep your pearly-whites pearly (and white). But, you can be smart about how you're spending your hard-earned money.

Here are 3 questions to help you figure it out!

1. What are my options?

If you have dental insurance options through your employer, it’s usually better coverage at a better price than you’ll find if you’re purchasing as an individual. Pricing is better through an employer because of volume and it might be subsidized by the employer. If you are a high dental-user family, this might be a good value for you.

If you purchase individual insurance or don’t have an offering from your employer, options are limited. Individual insurance tends to be very expensive with less coverage. It may also require you to be on the plan for a year before covering major dental work. These are usually only worthwhile if you’re planning on some major work in the future and are willing to wait. Do the math to understand the pricing of your major work versus the cost of a dental insurance plan for multiple years.And look at some unique options such as an indemnity style plan or consider a dental savings plan.


Dental Savings

2. What are my family’s dental needs in a year? 

Think over the past couple years – are you getting your standard two cleanings a year and an X-ray every other year? Or maybe you’re having more “work” done: multiple fillings, reconstruction, braces, etc. Then, consider the next couple of years. Is there a risk of big expenses or needs coming your way?

If you foresee just needing the basics, look at the monthly insurance premium. You might be paying more for dental insurance than you actually get out of it. For instance, a family of 3 might pay $100 a month for dental insurance ($1200 a year), but only use it for the basics at about $600 a year. If your family is in constant need of fillings, crowns, root canals, etc., then you’ll get the most use out of an insurance plan.

If braces, teeth whitening or caps are on the list, they often aren’t covered by Individual insurance. Read your policy or ask your broker. If you need these, the best thing might be a dental savings plan which can translate to big savings on these expensive treatments.

Under the Affordable Care Act, most health insurance plans will include some amount of dental coverage for kids under the age of 19. So, if you're buying a dental plan for your family, you might only need it for mom and dad. 

3. What's the worst-case scenario? 

By definition, insurance is meant to protect us from the chance of something very bad or very expensive. This makes sense with home and auto insurance. But how bad a situation do we face with dental care? A root canal, a cavity, a crown, braces? Sure, these things might cost hundreds or even thousands of dollars. But, you aren’t likely to lose your home to pay for it. Another thing to remember is that all dental insurance plans have a maximum payout each year (maybe $1,000 to $2,000), so all charges over that amount are paid by you.  

Bottom line: compare dental insurance premium costs to the expected work to be done and ask “is the benefit worth the cost and risk for my family?”

If you want more help evaluating, talk to your Benefits Department, insurance broker, or feel free to contact me at!


Reid has a passion for helping brokers & employers strategize fresh approaches to benefit plans that contain costs and increase access to care - helping employers & employees control their healthcare dime, time, and peace of mind. He writes & speaks around the country and is the Co-Founder & CEO of freshbenies.

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Tanya Boyd
Tanya Boyd
President of Tanya Boyd & Associates

I didn’t want to go to urgent care or the ER. Using Doctors Online in my freshbenies membership, I went online to ask a doctor. The doctor responded and said to check my blood pressure. He followed up with the next day to make sure my numbers were OK. By then, the feeling was starting to go away. He told me if it persists to contact my doctor. It was great that I didn’t have to go somewhere and wait forever, and it was free.” - Kelli from Texas

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Anna from Texas
Anna from TX

I went to the eye doctor for my regular eye exam. I needed to get contacts and they were going to cost $80 so I pulled up my Vision Savings through freshbenies and found I could get them for $22!