Without a doubt, proper dental care and oral hygiene is an essential part of overall wellness. Not only is it an important aspect of your health, it can help you maintain a beautiful smile and prevent major dental problems down the road. Interestingly, a lot of people who have dental insurance are often surprised by the out-of-pocket costs for certain services.
Dental insurance is unlike medical insurance in that it tends to be less comprehensive as it relates to the procedures covered. In fact, that’s one of the reasons why it’s often referred to as dental “benefits” instead of dental “coverage.” For example, healthcare insurance usually requires you to pay a deductible, after which any costs incurred are covered by the health insurance company. It’s a different story with dental insurance in that there is usually an annual limit that’s covered by the insurance company and you pay for any amount beyond that limit, which tends to average around $1,250.
If you require a procedure that costs $2,000, you might find yourself in a financial bind. Not to mention the fact that you’ll have to pay for any other dental procedures for the balance of that year. While the cost of dental insurance services has risen by more than 5% annually, the limits have not increased much for many years. If you’re someone who doesn’t have any major dental problems, then there’s a good chance that you’ll remain within the annual limit.
What happens if there’s an unexpected problem that requires a root canal or a crown? After all, you really can’t predict when you’ll have a dental emergency. You could essentially exhaust the annual limit in one visit, and still have a significant bill to pay. Despite the low limits and rising costs, less than 5% of dental insurance plan subscribers use their annual maximum – many believe it’s because of preventative care.
Studies have show that approximately $50 is saved for every $1 spent on preventative dental care. Most plans pay for the full cost of preventative care, which includes diagnostic services. A typical dental insurance plan will cover two annual cleanings. When considering whether or not to buy dental insurance, a key factor will be whether you intend to get your teeth cleaned twice each year in order to prevent major issues down the road.
When it comes to major procedures like braces and bridges, dental insurance plans usually cover about 50%. The percentage is higher for root canals, fillings and other basic services. Beyond those amounts, you are usually responsible for the balance in the form of a “co-pay.” This means that you might have to pay out-of-pocket even when you have not reached the maximum amount for the year. In the event that your dental insurance has a deductible, you’ll have to pay that amount before the insurance company pays for anything.
If you’re still on the fence about buying dental insurance, you should consider whether there’s a chance that you will need significant work in the future. If so, then you can probably find a policy that has a high maximum to cover those services. You’ll probably have to work out the numbers, but if you plan on getting a lot of work done, it’s worth having a higher premium if the cap is high. Keep in mind that a pre-existing condition could pose a problem, but it depends on the issue and the insurance company.
If you want another option, then you might consider getting a dental savings plan. It’s an alternative to dental insurance that a lot of people prefer because there are no maximums or restrictions if you have a pre-existing condition. Ultimately, your decision will depend on your unique needs.