Dental Insurance: Can You Afford Not to Have It?
We all have a list of things we know we should have but don't. Too often, dental insurance makes that list. Why is it so easy to file dental health insurance in the same "save for later" pile where apartment insurance and pet insurance live? Because when you do that, you're treating your oral health as a want and not a need. And as you know, that's a no-no.
One reason why such ill-logic flies is because of the excuses we make. Think about it. Some of those excuses — "I can't afford it" or "I don't know what kind to get" — seem to stack up, right? But when you break them down, they don't make much sense. Because, ultimately, when your mouth is healthy, you can speak, smile, eat, chew, drink and sing with ease and without pain. And that's something no excuse can justify.
So let's address some of the common reasons why we avoid getting dental insurance — HMO dental insurance, PPO dental insurance or even cosmetic dental insurance — and figure out how to turn bad excuses into good examples.
Excuse: Dental health insurance is too expensive.
Actually, you'd be surprised at how affordable dental insurance is, especially if it's part of a group plan provided by your employer. If you're purchasing dental health insurance independently, coming to terms with the costs might require a change in mindset. We think the easiest way to give the "I can't afford it" excuse the boot is to arm yourself with the facts. Numbers, specifically. Let's start with a break down of the average cost of dental insurance and compare it to the average cost of basic dental care services.
Here's an example.
Let's say it costs $96 a year to purchase independently an individual dental insurance plan. That's just $8 a month - the equivalent of two triple lattes. This plan covers part of your preventive dentistry costs (dental exams, full-mouth X-rays and teeth cleanings) as well as fees for fillings, dental crowns, root canals and even root planing and scaling treatments (for gum disease). Now let's break down some of these costs to see how dental health insurance can save you money.
Average Cost* Amount Covered** Your Cost
Dental Exam $57 $57 $0
Full X-rays $96 $96 $0
Teeth Cleaning $101 $81 $21
1-Surface White Filling $1146 $1121 $25
*Based on data from DentalPlans.com.
** Based on a SafeGuard HMO Plan.
Under a plan like this, you can save $1355 for preventive care and a basic dental restoration; you've already gotten more than your money's worth! Naturally, as the costs get higher for more intensive treatments, the more your savings will increase, if you have dental health insurance.
Keep in mind that preventive dentistry -- when combined with good oral hygiene practices (brushing teeth, flossing and eating a well-balanced diet) -- is its own form of "insurance." With regular exams and dental cleanings, your dentist can monitor the health of your teeth and gums, address problems as they crop up and prevent them from escalating. When dental problems are nipped in the bud early on, the less you'll have to worry about paying for more intensive, more costly treatments in the future.
Excuse: I don’t know what kind of dental insurance to get.
This is a common dental health insurance dilemma for individuals and families alike. Should you choose HMO dental insurance or PPO dental insurance? The answer is different for everyone, depending on your budget, your needs, whether you want the freedom to go to any dentist or feel fine choosing from a smaller pool of dentists. Let's see where you might fit.
Are you single? - When it comes to dental insurance, singles have it good. With no dependents, you can easily narrow down your choices. HMO dental insurance might be the safest bet for singles in need of a comprehensive dental insurance plan at a reasonable cost.
With HMO dental insurance, you're limited to picking a dentist from a specific network of dentists. If you don't have a particular dentist you'd like to see or have been seeing, HMO dental insurance makes sense. With HMO dental insurance, you typically have a low co-pay ($15+) for preventive dental care services; some plans fully cover yearly exams, X-rays and cleanings. Co-pays are typically higher for restorative care (fillings, crowns, bridges), oral surgery (tooth extractions, root canals), gum treatment (scaling and root planing [SRP]) and other types of dental care. Be sure to check the fee schedule that comes with your HMO dental insurance plan or contact your dental insurance provider for details.
On the other hand, if you're the type who likes a wide net of options, PPO dental insurance might be a better fit. With PPO dental insurance, you can choose from a larger pool of dentists; some PPO dental insurance plans even allow you to see any dentist who accepts your form of insurance. So if a friend recommends a great dentist, as long as she or he is a provider for your insurance and your PPO dental insurance allows you to pick any dentist, you're golden.
Keep in mind that some PPO dental insurance plans may require that you meet a certain deductible amount before coverage kicks in; after that, you'll pay a co-pay for dental services. This sounds worse than it is. All it means is that you'll have to pay the first $250 worth of dental treatment that you receive from your PPO provider. After that, your co-pay will depend on the dental treatment you receive. Again, ask your PPO dental insurance provider for details.
On average, PPO dental insurance premiums cost more than HMO dental insurance premiums, whether provided through your employer or purchased independently. Why? Basically, it's the price you pay for freedom.
Do you have a family? - Because you have more than yourself to account for, deciding what type of dental health insurance to get might be tricky. Let's say you have little ones who currently see a pediatric dentist they love and you'd prefer not to switch them to someone new. In this case, you might consider a PPO dental insurance plan with the option to pick any dentist who accepts your dental health insurance. The downside here might boil down to your budget. A family PPO dental insurance plan might be too costly, considering all other expenses you probably have.
Conversely, if your kids don't mind switching dentists or you prefer to have just one dentist for the whole family, HMO dental insurance is a cost-effective way to go. The premiums are generally lower than PPO plans and the coverage just as comprehensive. One last thing to keep in mind about both HMO and PPO plans: There's a limit to coverage. Once you exceed that limit, you're responsible for paying the total cost of dental care services. However, when a new coverage year begins, your benefits renew.
Excuse: My teeth are healthy; I don't need dental insurance.
Here's a mental minefield you can't afford to cross. No matter how smart you are, you're simply not qualified to diagnose the health of teeth — only a dentist can do that. So even if you don't feel any pain or discomfort, that doesn't mean your teeth are in good shape and you don't need dental health insurance. Secondly, dental insurance helps offset the costs for dental emergencies such as broken teeth, missing teeth, knocked-out teeth, lost dental crowns and broken dental braces. Without dental health insurance, the costs for repairing such damage could very well burst your budget.
Excuse: My health insurance covers dental care.
You may be able to purchase both health and dental insurance from the same provider, but they're two different things. Health insurance covers, in part, physical treatments for your body and, in some cases, therapy for your mind. Things like yearly physicals, OB/GYN services and surgery for broken limbs fall under health insurance. In some cases, however, medical and treatment treatments may overlap; for example, cleft palate and cleft lip repair requires a multidisciplinary team of both dental and medical professionals. In any case, it's best to have both so that you're covered from head to toe.
Cosmetic Dental Insurance
Let's be real. If you're thinking about getting cosmetic dental insurance, it's probably because you want to improve the look, not the health, of your smile. We don't blame you! Especially because fixing dental imperfections like crooked teeth, broken teeth and even gapped teeth are actually better for your dental health. You should know, however, that most dental insurance plans don't cover cosmetic dental treatments such as teeth whitening or porcelain veneers (though veneers may be partly covered if they're considered necessary for health reasons). So if you want a red carpet smile, your options are to pay for it yourself, finance it through a health financing company like CareCredit® or look for cosmetic dental insurance.
But let's clear something up. Cosmetic dental insurance is actually a misnomer. It doesn't exist. Aside from dental financing and payment plans made directly with a dental office, you can also get what's called a dental discount plan to help offset cosmetic dentistry costs. It works like a discount card: Basically, you pay a premium for the plan and then get a membership card that entitles you to 15-50 percent off dental services (including cosmetic dentistry) at participating dental offices. Unlike dental health insurance, there's no paperwork involved - you pay as you go. The drawback here is that your current dentist or a dentist you'd like to see may not accept it.
Alternatives to Dental Insurance
Dental indemnity plans are fee-for-service plans that work similarly to PPO insurance. With a dental indemnity plan, you have the flexibility to visit any dentist who accepts your plan (there are no "networks" to consider). In some cases, a preauthorization form may be required to see a dental specialist. Like PPO insurance, dental indemnity plans usually have deductibles; after you pay your deductible, the plan typically covers a percentage of services rendered.
Low-income patients who can't afford dental health insurance may be eligible for State Aid. In the state of California, Medi-Cal recipients under the age of 21 receive Denti-Cal benefits. Adult dental care may also be covered, under certain circumstances (e.g., if you're pregnant or need a medical procedure that requires dental treatment first). State Aid benefits vary from state to state, however. The only way to find out if you qualify and what you qualify for is to contact your State Aid office for details.
Where to Get Dental Insurance
If your current employer doesn't offer dental health insurance, it's easy to get your own plan going. All the major dental health insurance providers (Aetna, Delta Dental, CIGNA) have their own websites where you can review different types of plans and, in some cases, sign up right online. Other sites aggregate dental plan information so that you can compare different types of plans from different providers and purchase a plan online.
Give your teeth a chance by protecting them with dental insurance. Call us and we'll help you find a dentist who accepts your plan. Even if you don't have dental health insurance, we can help you find a dentist who can work with you. Many of our dentists offer payment and financing plans or accept credit cards and cash. Call today! 1-866-970-0441.