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March 13, 2016

Is it worth the cost to get dental insurance?

This is the most common question I get every day from my patients. My answer is no, but I will explain in this blog why you don’t need dental insurance.

Here are 7 main reasons:

Reason 1

Most of dental insurances cover only 50% of major procedures like crowns and bridges, which doesn't make any sense considering the insurance premiums.

Reason 2

The majority of dental insurances are provided by employers, but the employee must pay into the plan too. It can cost about $400/ year. But it covers for only two cleanings and exams, which would cost the same paying out of pocket at any dentist. Unlike health insurance, there is no need to get dental insurance because the cost of the premiums is higher than paying out of pocket for exams and cleanings and other preventive services.

Reason 3

Most of the dental insurances have pre-existing clauses which will help them to prevent paying for implants and bridge work. So it doesn't help to have dental insurance if you have a missing tooth and want to get it replaced. And of course cosmetic dental work is not covered by any dental insurance.

Reason 4

If you are planning to buy dental insurance individually (outside your work), be sure to find what the waiting period is. A waiting period is the time you have to wait before you can get any treatment. Most dental insurance companies have a year to year-and-half waiting period for major treatments. The waiting period is generally required by dental insurance companies so that you don’t buy insurance, get a crown and then drop it.

Reason 5

Ok, we have made the case so far that dental insurance is not worth the cost. But there is one (and only one) advantage of dental insurance: it provides a negotiated discount with dentists who accept it. But even that advantage is useless if you go to a dentist who offers an in-house dental savings plan.

Reason 6

Almost all the dental insurances has annual limitation of about $1000-$1500, which is not enough for an implant or two root canals and crowns. So really dental insurance doesn’t help you in a major situation like trauma or undiagnosed dental health conditions. Also, if you need braces, which typically cost around $5000, insurance will only cover $1000 and the remaining cost is your out-of-pocket expense.

Reason 7

To get insurance to pay for the service done in a dental office, a claim needs to be submitted. This is a big paperwork hassle, as they might not accept the first submission, it might require additional verification and communication, and it’s a time-consuming task. They might downgrade a service recommended by the dentist, like paying only for silver fillings instead of white fillings, or downgrading from a bridge to a partial denture.

So if you are looking to buy dental insurance, take some time and find a local dentist who gives discounts for their services. It's worth forgoing traditional dental insurance and look for discount dental plans.

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about the author

Dr. Kenneth Bunn, DMD.

I value my relationship with each and every one of my patients and hope we develop lifelong bonds.
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