Do I Need Dental Insurance? | Mira Health
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.
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
| Pros | Cons |
|---|---|
| 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.
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.
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 |
| Restorative crown | $1,634 |
| Non-surgical extraction or pulling of a tooth | $295 |
| Extraction or pulling of a tooth that requires removal of bone | $465 |
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 that has a low annual maximum, it may make sense to purchase your own dental insurance or pay for services out-of-pocket.
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.
- Secondly, many community health centers, which are federally qualified, offer dental care in addition to other health services.
- Lastly, if you have a high deductible, you can set up a Health Saving Account (HSA).
Dental Insurance Frequently Asked Questions (FAQs)
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.
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.
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.
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.