Do I Need Dental Insurance?
If you typically need a lot of dental care, you should consider purchasing dental insurance. However, if you do not visit the dentist often or do not need extensive dental care, dental insurance may not be necessary for you.
For cost-effective, comprehensive health coverage, dental benefit plans can be an excellent addition to a membership with Mira. Mira provides access to $99 urgent care visits, low-cost lab testing, and discounts on prescription medicines. A membership with Mira paired with a dental benefit plan can help you take care of all of your health needs.
You Might Need Dental Insurance
Dental insurance is not imperative for everyone, but it can help you save money at the dentist in some cases. You may benefit from dental insurance if:
- You go to the dentist often for regular checkups and or cleanings.
- You often need additional services, such as fillings, when you go to the dentist.
- You have a large family with many children who also go to the dentist regularly.
- You are unable to pay the cost of dental procedures out-of-pocket.
However, if you go to the dentist infrequently and do not tend to need any additional dental services, dental insurance may not be necessary. It is always a good idea to compare how much you would pay out-of-pocket at the dentist with the amount you would pay for insurance.
Pros and Cons of Dental Insurance
Deciding whether to get dental insurance can be overwhelming, so Dr. Thomas J McCarthy, DDS at SportingSmiles, has helped us identify the main pros and cons of purchasing a dental plan.
Pros and Cons of Dental Coverage
|Dental insurance is great for the person that goes in for regular checkups and cleanings.||Many policies have waiting periods for specific procedures before you can access care.|
|Dental insurance is great if you have a large family with several children.||Deductibles and copays have increased on most policies in the recent past, and the policy will typically have a yearly cap.|
|Dental insurance can protect you from medical debt if you cannot pay for services at the time of care.||Sometimes it's cheaper to pay out of pocket than use your insurance.|
What is Dental Insurance?
Dental insurance works differently than your typical medical insurance. Dental insurance is often referred to as “dental benefits” because it covers some procedures in full and only a percentage of the cost of other procedures. Dental benefits cover some costs but do not reimburse you for all charges incurred.
Many companies cut dental benefits from their health insurance plan offerings because dental care is not commonly viewed as essential to well-being. Now, these plans need to be purchased separately from health insurance.
Dental plans have coinsurance and annual maximum components to consider. Typically, PPO plans use a 100/80/50 coinsurance structure. You pay the percentage of the treatment that the insurance plan does not cover. Here is how that breaks down:
- Insurance covers 100% of preventive care, including cleanings, exams, and X-rays
- Insurance covers 80% of basic procedures, such as fillings
- Insurance covers 50% of major procedures, such as crowns and dentures
Additionally, dental insurance rarely covers expensive procedures that are considered elective, such as cosmetic dentistry and braces for appearance purposes. There is also an annual maximum amount your dental plan will cover, usually between $1,000 and $2,000. Once you have reached this limit, you are responsible for paying all additional dental care costs, but 95% of Americans never reach the annual limit.
Dental Insurance Costs
Most Americans pay between $15 and $50 a month for a dental plan, amounting to around $360 per year. Sometimes, this is less than the cost of dental care without insurance, but other times it is about equal to the price of care without dental insurance. If you do not need any complicated procedures, two annual teeth cleanings and one set of x-rays may cost you around $485.
Source: NADP 2019 Operations and Premiums Report
Below we outline the cost of some dental procedures if paying without insurance. Note that these prices will vary depending on your location, the complexity of care required, and what type of dentist you see.
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Estimated Dental Costs Without Insurance
|Description||Average Price Without Insurance|
|Comprehensive Dental Exam for a new or established patient||$130|
|X-rays - Full mouth||$187|
|Simple cleaning for adult||$139|
|White Filling - Back tooth - 1 surface||$250|
|White Filling - Back tooth - 2 surfaces||$315|
|White Filling - Back tooth - 3 surfaces||$385|
|Non-surgical extraction or pulling of a tooth||$295|
|Extraction or pulling of a tooth that requires removal of bone||$465|
Source: FAIR health consumer database
Considerations for Group Plans
Some employers may offer dental insurance for their employees and families. However, if your employer provides dental insurance, it does not automatically mean it is a good deal.
A great plan would cover your entire family with a generous annual maximum for a low monthly cost (for example, $20 per month). A mediocre plan would be more costly on a month-to-month basis (say $50 per month) with a low annual maximum. If your employer offers a costly plan and that has a low annual maximum, it may make sense to purchase your own dental insurance or pay for services out-of-pocket.
The only time when it definitely makes sense to buy the group dental insurance plan is if you cannot afford the total price of care at the time of service.
How to Save Money on Dental Care
Without insurance, dental care can be expensive, as the cost of a simple cleaning can be over $100. Fortunately, there are options to find affordable dental care.
- First, many dental schools accept Medicaid or charge a lower rate than a private office. The students are still trained and can provide safe and effective care.
- Secondly, many community health centers, which are federally qualified, offer dental care in addition to other health services. You can call ahead to see if any centers near you provide dental care before making an appointment.
- Lastly, if you have a high deductible, you can set up a Health Saving Account (HSA). Having an HSA allows you to use pre-tax money to pay for eligible dental vision expenses for yourself, your spouse, and eligible dependents like children, siblings, and parents.
Dental Insurance Frequently Asked Questions (FAQs)
Whether or not you should buy dental insurance is mainly dependent on your personal dental care needs. Each plan is a little different and can cover different services, so when shopping around, be sure to read the benefits information thoroughly. Below we answer a few questions regarding dental insurance with insight from Dr. Katrina Zhao, Principal Dentist and Managing Director at Midas Dental.
What should I consider before buying a dental plan?
The main thing you should consider before buying a dental plan is whether it will save you money or not. Even though dental plans will cover 100% of preventative care, the annual costs of dental insurance may be more expensive than paying out of pocket.
Furthermore, if you need extensive dental procedures, you will be paying 50% or more out of pocket anyway. So if the plan has a low annual maximum, a dental plan might not be a good investment. Below are some additional questions to consider when deciding if you should get dental insurance:
- What dental procedures might you need this year? How much would they cost out of pocket vs. with insurance?
- How much will I pay monthly and annually in premiums?
- How much will I pay for regular cleaning without insurance versus with insurance?
- What is the maximum annual payout for this insurance policy? Which procedures are covered?
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Who should buy dental insurance?
There are several reasons you may want to consider purchasing dental insurance. It can be an excellent way to protect yourself from the cost of future procedures for those with existing dental problems.
Dental coverage is also essential for patients with children who need braces or oral surgery, in which case you may be interested in having dental insurance that includes orthodontia. Some states require all dental insurers licensed in the state to provide coverage for children’s braces, but only if the braces are necessary to improve the child’s ability to chew food properly. These treatments often come with a high upfront cost that you may need coverage for.
It's important to remember that your personal needs will vary depending on your financial status and desired coverage amount. You should speak with an insurance broker or company before deciding what type of policy works best for you.
How much does dental insurance cost?
Most dental insurance plans cost up to $50 per month, but the cost of dental insurance can vary depending on the type of policy, your age, how often you visit the dentist, and your general health. Generally speaking, if you want more coverage, your plan will have higher premiums.
How much does visiting the dentist cost without insurance?
Visiting the dentist without insurance can be costly, depending on the treatment you need. A dental exam costs around $130, while a restorative crown can cost almost $1,700. Some dentists will offer discounted rates to those without insurance, as long as you have an income that meets specific requirements. The cost of dental procedures varies significantly depending on where you live, but some people end up paying hundreds or thousands of dollars out-of-pocket.
Forging dental care can lead to even greater costs in the long run. Preventative dental care is essential to long-term health. So if you foresee yourself needing expensive dental care in the near future, you should look into purchasing a dental benefit plan.
Health care is expensive regardless of if you have insurance or not. Sometimes it makes sense to pair care membership plans, like Mira, with your dental insurance. For a small monthly fee of $45, a membership with Mira can help you save on all kinds of health care services, including urgent care visits, prescriptions, and lab testing.
Alexis Bryan MPH, is a recent graduate of Columbia’s Mailman School of Public Health. She is passionate about increasing access to care to improve health outcomes. Outside of work, she loves to travel, read, and pay too much attention to her plants.