A diary at the Great Orange Satan has a great primer on dental insurance. You should read it if you need to know more about how dental insurance works as I don’t have that knowledge base to give this subject justice. Below are a few key take-aways:
First and foremost: Stop thinking about dental insurance as “Insurance”. It’s not. It’s really a gift card that can be used for certain purchases for certain amounts. The trick, as a consumer, is to figure out if you are going to spend more money on the gift card than you will actually use.
Dental plans break out services by category. In general, these are:
- Preventative and diagnostic : Preventative cleanings, fluoride, sealents, exams, x-rays, sometimes periodontal maintenance cleanings
- Basic: Fillings, root canals, extractions, periodontal treatment
- Major: Crowns, bridges, dentures, implants
“Is purchasing insurance right for me?” Here’s what you need to do to figure it out. Call up your dental office. Ask what a year’s worth of maintenance visit’s cost. Do you have any work that’s needed? What is it, and what is the cost. Does your dental office offer any cost savings for patients paying cash (more offices are offering “in house” dental plans)? Add up the costs of yearly maintenance, then factor in what the treatment cost is, and subtract any savings you might be offered by your dentist. THEN, look at the plan that you are considering purchasing. What is the yearly premium? Is your dentist in the network? If yes, ask the dental office what the fees are if you are going to be in that network. What will your out of pocket cost be on work that needed, making sure to take into account what you will pay in deductibles and the maximum plan payment (provided, of course, the work can wait until any waiting periods are met….that may not be advisable). Add that up. Compare the two.
Just go and read an excellent explainer on yet another part of the arcane field of medical insurance.
Presidential Statement and Press Conference
Central Planning
For me, my company’s dental insurance family plan is a no brainer. I have 5 kids and the price doesn’t change based on the size of the family. I think the rate averages $6/week or something close to that. The preventative care is covered which is huge with 12 appointments every year. Also, braces for some of the kids is also a huge expense, and while expensive, the dental insurance covers 50% of the cost.
beltane
@Central Planning: Same for me. The coverage for preventative care alone makes it worth it. The nice thing about teeth is that if you take meticulous care of them, you are not terribly likely to require anything beyond preventative care. It’s been almost fifteen years since I’ve needed a filling.
Shygetz
Richard, perhaps you can explain why, in the American health care system, insurance for dental and vision preventative and corrective services are not covered as “health care” under standard health insurance.
Fair Economist
The reason everybody needs insurance is that your dentist, like your doctor, will rip you off if you don’t have an insurance company negotiating for you. Every bill I ever get from my dentist is for two to three times what my insurance company allows. It probably also provides some protection against overtreatment – they can’t generally tell if a dentist overtreated a given case, but a dentist who chronically caps too many teeth can be identified statistically at the insurer’s office. No individual patient could ever figure that out.
Richard Mayhew
@Shygetz: Path dependency.
Dentists (and surgeons) came out of the barber field (people with sharp tools) while docs where highly educated gentlemen discussing humors and optometry came out glass grinders. The initial American health insurers were hospitals that were attempting to stabilize their revenue streams so the initial plans were medical/surgical focused while the dental/vision things were seen as buy-ups.
http://io9.com/5965741/how-barbers-became-surgeons
different-church-lady
Haven’t had a chance to read the article yet, but is the “gift card” concept a sign I shouldn’t feel guilty about being a jumper-and-dumper, at least when it comes to dental “insurance”?
The Gray Adder
@beltane: Even if you take “reasonable” care of them, the level of care you’re likely to need will probably not rise above what you might be able to pay for out of a flex spending account funded by pretax dollars. The trick then becomes figuring out how much the “usual” amount of dental work is going to cost you next year. If you’re lucky, that root canal or crown or whatever can be pushed to the next calendar year, when you can plan for it.
You’re absolutely right; you can exercise a measure of control over dental expenses by keeping up with hygiene, not using tobacco (which will mess up your teeth – I’ve seen it), staying away from sugary crap, etc.
rikyrah
Dental costs are prohibitive. they are shutting themselves off from a large pool of customers.
The Gray Adder
@Fair Economist: Not to the extent your MD does. I have an out-of-plan dentist who makes me pay up front and is nice enough to submit my insurance paperwork for me. I end up paying around 50% out of pocket. As long as I can afford it, he’s the guy I’ll be seeing because he’s far and away better than the McDentists at the local dental mill (and doesn’t try to upsell me every time I’m in the chair shot up full of Novocaine), which is why he can get away with it. That doesn’t add up to the kind of money I’d be on the hook for if I went to an MD for anything at all. Not even close.
Gindy51
Daughter’s dental is $22/month, she’s very meticulous about her teeth and has had one cavity in 26 years. She’s keeping it because two cleanings is over $300 plus who knows if she might need a filling (another $150 plus each time). Most vision insurance is a total rip off.
As for me, I have a mouth full of gold like Fort Knox used to be, helps to date a dental student who needs a guinea pig for crowns). Yeah I got them on the cheap but to replace them would break my bank account. Our Tricare Dental is $53/month for two old farts and well worth it.
Scout211
We chose to keep the dental plan with my husband’s employee-sponsored plan after he retired. Our dentist actually recommended paying out of pocket. But our premiums are reasonable and the preventative care is worth it to us.
The question for most people is: if all your visits are out-of-pocket, how often would you go for the preventative visits?
We didn’t have the option to stay on the vision care plan and I know we have put off those visits and new glasses due to the costs.
USAA now offers vision (and I think) dental insurance but the costs didn’t add up for us. We now have to work into our budget new glasses.
Scout211
@Gindy51:
Tricare does offer several affordable plans but we found that their network was very narrow and most dentists in our area won’t accept it.
Matt McIrvin
@beltane: There are a lot of delayed effects. Dental science and I take much better care of my teeth than we used to, and I basically never need new fillings, but my old ones from the bad old days are sporadically crapping out and requiring escalating interventions, to the point of the occasional root canal or implant surgery.
Regular checkups and professional cleanings are absolutely key. We could probably accomplish a lot just by having a national program that funded those, and maybe basic drill-and-fill on cavities.
Rafer Janders
Jesus — only about 20% of Americans, at best, are actually able to competently accomplish all of the above tasks, and even then only at the cost of losing about a day of work chasing down all that information and making all those calls. I find it difficult, and I’m a Wall Street professional with two Ivy League degrees. What’s everyone else supposed to do? You simply can’t run a health care system this way….
goblue72
Doesn’t the math change if your employer is covering all or a significant portion of the annual dental premium?
Calouste
@Rafer Janders: I even wonder of 20% of the dentist offices would be able to give you a quote.
Richard Mayhew
@goblue72: yep, gets a lot easier to take dental insurance at 3.72/week for the entire family than at 22.50/week
Chris T.
@Shygetz: It’s simple: teeth and eyes are not body parts. :-)
(Alas, RM already spoiled this with his factual historical answer)
GHayduke (formerly lojasmo)
Wife has free dental through her work. I have some kind of dental/vision reimbursement given to me by work $1500/year, IIRC.