You’ve got to have dental insurance, right? Otherwise you’ll be left footing the bill for expensive dental work that could have been covered by insurance.
Well, sort of.
Dental insurance doesn’t work in exactly the same way as health, auto or homeowners insurance. Those policies protect you against catastrophic injuries and losses. Sure, you’ll probably have to pay some out of pocket in the form of a deductible and there may be an out-of-pocket maximum you have to reach. But theses policies usually provide a good deal of financial protection if the worst should occur.
It’s not the same scenario with dental coverage. These policies usually have maximum annual payouts and they don’t cover everything you may want or need to be done. That’s not to say they’re a bad thing or not a good investment.
So when it comes to dental insurance, it’s important to learn how these policies work before deciding on the right course of action for you. Read on to learn more.
There are Caps
Many dental insurance plans only pay up to a certain amount for dental work, including your routine exams and cleanings. So if you have a costly restorative service like a root canal, you can exhaust your benefit in one office visit. Many plans allow maximum annual charges of between $1,000 and $2,000. So while dental insurance would provide relief if you have one expensive restoration per year, if you require more, you could be on the hook for not only the cost of the service, but the dental insurance premiums, too.
Your dental plan will limit which dentists you can see. Your favorite dentist (Dr. Bonham, of course!) may not participate in your dental plan. That means you can continue to see him, but will have to pay out of pocket for routine cleanings, exams and x-rays. And did you know that some dentists don’t accept insurance plans at all! Some dentists will work with you if they aren’t in network with your plan. It doesn’t hurt to ask, especially if you’ve found a dentist you really like and trust.
Some Services Aren’t Covered
Your dental plan won’t pay for any cosmetic services. That include teeth whitening, veneers, bonding or sometime even tooth-colored composite fillings aren’t covered. Many dental insurance plans don’t pay for orthodontics either. You sometimes have the option to add orthodontic coverage for an additional premium.
Additionally, some services aren’t covered at 100 percent. Your policy may only pay half of a root canal or crown. That means you’ll still pay some out of pocket along with your premiums.
How Much Does Dental Insurance Cost?
According to the National Association of Dental Plans, the majority of Americans have dental insurance that’s sponsored by an employer. Sixty-four percent of Americans have dental insurance and for most, it’s provided at work. The NADP says premiums for group dental plans ranged from $19 to $32 per month or $228 to $384 annually.
When deciding if the cost is worth it, do some math.
While fees vary by location and dentist, there are some average costs to go by. Here is the average cost for some common procedures, according to the ADA Health Policy Institute’s 2013 Survey of Dental Fees:
- Adult teeth cleaning: $85
- White dental filling: $149
- Silver filling: $125
- Porcelain crown: $1,003
- Intra-oral X-rays: $124
It’s a Great Preventative Tool
Dental insurance usually pays for preventative services at 100 percent so it’s a great way to ensure your teeth are staying in good shape. And if a problem is identified, dental insurance could help pay a portion of the fee.
As with any financial decision, you should base your decision on your family’s specific circumstances. But it pays to look at the price you would pay in premiums compared to what you would pay out of pocket. This is especially important if you maintain good oral hygiene and don’t routinely need lots of dental work.
If you have questions about your dental plan, it’s probably best to contact the company directly. However, we’re happy to help you navigate the sometimes confusing world of dental insurance. Please feel free to contact our office if we can help you understand how your policy works.