Dental Insurance: 3 Things To "Chew On"

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.

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 helpme@freshbenies.com!

Reid Headshot

About the author: Raised & trained in Health Administration in Canada, he spent the past 21 years working in the US health insurance system.  Reid works to empower Americans to take care of their health, because he knows no government or insurance company will ever take care of it all.  He owns two companies that provide concierge non-insurance benefits to Americans.  Speaker, writer, health reform advisor.  Oh, and he's now a proud American.

About freshbenies: freshbenies (www.freshbenies.com) helps employers and employees take the headache out of healthcare with telehealth, doctors online, advocacy, Rx savings (and more)…all in one easy-to-use card. 

Blog Categories: Saving on Healthcare