Dental Insurance: Why It Matters

Most people recognize the importance of maintaining good physical health, and having regular physical examinations, but we rarely extend the same consideration to our teeth. The truth is that good dental care is a crucial part of your overall physical health because other systems can be affected by your oral health. For example, taking proper care of your gums can actually help prevent heart disease.

The condition of your mouth, teeth, and gums can also indicate other health problems. For example, acid erosion on the tooth enamel could indicate gastro-esophageal reflux disease (GERD), whereas frequent mouth infections and gum disease might indicate diabetes. Frequent dry mouth can make you more susceptible to tooth decay, and it can also indicate an underlying illness, like Sjogren’s syndrome.

Because dental health is so important, dental insurance is also important because it provides you a means to pay for both preventative and acute care.

Types of Dental Insurance

Dental insurance falls under two categories: traditional and managed care.

  • Traditional policies are also called indemnity policies. Under this type of plan you would be treated by any dentist then submit a claim to the insurance company for payment. In some cases, you would pay for the services up front, and the insurance company would reimburse you. In others, you might pay a small amount up front, called a co-pay, and the dental office would bill the insurance company for the remainder.
  • Managed care policies are also called PPOs or HMOs. Under these types of plans you are required to see a dentist that participates in your PPO or HMO plan. You might be required to pay a co-pay and the insurance company covers the rest.

Like health insurance plans, dental plans also have different levels of coverage.

  • Basic dental plans only cover routine care like periodic dental cleanings, X-Rays, and basic examinations. These plans might also cover a portion of the cost of common dental procedures, like fillings. If you have good basic dental hygiene and relatively healthy teeth, a basic plan could be all you need.
  • Major dental plans cover all the basic services as well as more expensive services, such as orthodontics and prosthetics, or false, teeth. People with known dental health issues would probably benefit most from a major plan. Teenagers and children would also benefit since they are more likely to need orthodontia or other dental appliances as they develop.

Frequency of Dental Care

The American Dental Association recommends that you have preventative checkups once every six months. These checkups include a basic examination, dental x-Rays, and a dental cleaning -- dental insurance should cover preventative checkups.

If you are returning to the dentist after a long absence, you might have a lot of plaque and staining on your teeth, which could require more frequent cleanings to remove. If you do need more frequent cleanings, dental insurance could cover the first two, and determine that you are financially responsible for the remaining cleanings.

Cost of Dental Care

According to a 2007 national survey, the average out-of-pocket dental cost per person was $873 per year. Additionally, when the survey factored in the cost of insurance premiums, those with insurance and those without spent approximately the same amount on basic dental care.

However, where dental insurance is crucial is in helping cover the cost of major dental care. Those without dental insurance usually experienced a greater variability in dental costs than those with insurance. That is, those with insurance tended to have more consistent pricing on dental care, while those without did not and were more likely to have higher costs.

Additionally, individuals with dental insurance have been found to be more likely to go to the dentist for preventative care, and are more likely to seek medical attention for acute dental issues. Those without dental insurance tend to wait until the last minute, which can also result in more health issues and more expensive care.

Cost of Dental Insurance

The costs of dental insurance vary by plan.

Basic plans tend to be less expensive, and you can often find individual coverage for as little as $15 per month.

Major plans tend to be more expensive, but you can still find affordable individual plans for less than $50 per month.

The costs for dental insurance tend to be about the same whether you are buying your own insurance, or getting insurance through your employer.

Some Final Thoughts about Dental Insurance

Dental insurance makes preventative care more accessible, and can lower the costs of acute dental care. For these reasons alone, it’s worth it to include a good dental plan in your overall health insurance package.

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