There you are, having a routine visit with your dentist. During the checkup, the dentist informs you that you’ve got a tooth that’s in big trouble. If you get a root canal and crown soon, you can rescue that troubled tooth and save a lot of money by avoiding a dental implant somewhere down the road. The procedure will cost you about $2,500. For most of us, that’s a lot of money to produce on short notice. But it’s okay because you got dental insurance a few months ago. So you’re covered, right?
Wrong. As a newly insured person, you will likely be paying for any restorative treatments out of your own pocket for 6-12 months. If you weren’t planning for this waiting period, it can really impact your budget.
(If you do need dental care ASAP, consider joining a dental savings plan. Unlike insurance, these plans provide savings right away – and no annual spending limit.)
See how much you can save with a dental savings plan.
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Understanding Dental Insurance
Dental insurance works differently from health insurance.
Your medical insurance covers costs after you have reached a specific amount known as the “deductible.” As an example, an Obamacare mid-range silver plan has an average deductible of $4,890. Once you spend that amount on healthcare, your insurance kicks in. The ACA prohibits insurance from setting spending limits, so there is no annual or lifetime cap on your coverage.
Dental insurance also has a deductible, typically $50 per person, but only pays up to a specific amount each year. Typically, that limit is $1,000-$1,500 annually. When your dental costs go over that limit, you are responsible for paying those costs out of pocket until the plan resets.
The spending caps on dental insurance have remained roughly the same for decades. Meanwhile, as you would expect, the costs of dental care have increased. Last year, the annual inflation rate for dental services was 4.7% – which was well below the overall US inflation rate of 8.2%, but insurance limits remain the same. A single root canal and crown can exhaust your dental insurance budget for an entire year.
Pros and Cons of Dental Insurance
Spending caps and waiting periods are two of the biggest concerns that people may have about dental insurance. Neither of these may be an issue for you if you only need basic dental care. Other pros and cons to consider include:
Pros:
- Increases likelihood of regular dentist visits
- Offers comprehensive coverage for preventive care
- Affordable premiums for most people
- Helps alleviate costs for some dental procedures
Cons:
- May not include all services, such as cosmetic
- Potentially not worth it if not frequently used
- Typically, waiting periods for accessing benefits
- Low annual maximums could limit service coverage
- Limited to in-network providers in some plans
Do I actually need dental insurance?
You do not need dental insurance to see a dentist. But without insurance – or an alternative option like a dental savings plan – you are responsible for paying the full cost of your dental care out-of-pocket, which can be a significant expense, especially for more complex treatments.
If your employer is covering the cost of the monthly premiums, or if you anticipate you won’t need much more than basic preventive care, insurance may be the right choice. You might also opt to “self-insure,” and simply bank what you would have spent on monthly premiums in a health savings account.
But if you need more than basic care, consider joining a dental savings plan.
Alternatives to Dental Insurance
Nearly 40% of U.S. adults avoid dental care, often due to financial constraints. Dental insurance can make dental care more accessible by covering preventive care and partially covering other dental work. However, its limitations, like not covering certain treatments and having low annual maximums, should be considered. Thoroughly researching and understanding the terms of your dental insurance, as well as exploring alternatives, is crucial in making an informed decision about whether dental insurance is the right choice for you.
Dental savings plans (also known as discount dental plans) are an affordable alternative to insurance. Plan members report saving an average of 50%* on their dental care. And, unlike dental insurance, dental savings plans have no annual limits, no restrictions on existing health conditions, and your savings start right away, even on restorative care such as root canals, crowns, dentures, and dental implants. Many plans even include cosmetic dental procedures such as teeth whitening and overlays. And since there are no open or closed enrollment periods, you can purchase a dental savings plan anytime of the year.
It’s simple to choose a plan at DentalPlans.com, the largest marketplace for dental savings plans and dental insurance. You can compare more than 25 plans from the most trusted brands in healthcare, and easily join your selected plan. Want a personalized plan recommendation? Give us a call at 1-833-735-0399 or use our calculator below.
*Discount Health Program consumer and provider surveys indicate average savings of 50%. Savings may vary by provider, location, and plan.