Is Dental Insurance Worth It?

Is dental insurance worth it? Let’s take a look.

Major dental work is expensive. As if the procedure itself isn’t already painful enough, a typical root canal will cost you somewhere around $1,200. And an extraction and single-tooth implant can run upwards of $6,000!

With such exorbitant costs, dental insurance should be a no-brainer, right? Well, dental insurance works a bit different than medical insurance. Let us explain.

Unlike medical insurance, which covers costs after your deductible is met, dental insurance has a cap on the amount it will cover in a year. You pay any costs accrued during the year that exceed the plan’s yearly limit.

That maximum annual benefit coverage limit varies by plan, but most usually fall somewhere between $1,000 and $2,000.

So, what is typically covered within the plan’s limit? Most dental plans provide coverage known as 100/80/50. This means preventative care like X-rays, exams and cleanings are covered at 100 percent. Basic procedures like fillings, extractions and periodontal work are typically—although not always—covered at 80 percent. And major procedures like crowns, root canals, dentures, bridges or implants are covered at 50 percent.

So, for major dental expenses, you will likely still be responsible for half of the bill up front—as well as any remaining costs after you exceed the plan’s annual coverage limit.

Now, before you go and cancel your dental plan, know that major dental expenses are only half of the story.

According to a survey by the American Dental Association, approximately 22.9 percent of adults indicated they are either unsure or definitely do not plan to visit a dentist within the year. Among these respondents, most attributed this to either a lack of dental insurance or other financial concerns.

But forgoing preventative care really is a bad idea. Those exams, X-rays and cleanings are crucial to preventing severe dental problems—and will actually save money in the long run. According to a study by The Guardian Life Insurance Company of America, employer groups with high preventative care utilization spent 86 percent less on major dental services over a six-year period than those with low preventative care utilization. Moreover, they actually reported 16 percent less combined preventative and major dental claims costs.

Preventative care is important to both reduce overall claims costs and improve dental health. And that’s why the typical plan covers 100 percent of preventative care. Employees are more likely to visit the dentist for regular exams and cleanings when they don’t have a financial obligation to worry about.

If you’ve ever had painful dental problems, like an abscessed or broken tooth, you probably know the importance of maintaining good oral health. In other words, regular preventative care to avoid excruciatingly painful major dental issues isn’t likely debatable in your mind.

You may still be asking, “So, is dental insurance worth it?” All things considered, and given our many years of professional background, we say yes, it is. Some argue that paying out of pocket for bi-annual exams is less expensive than paying the yearly premium for dental insurance. But, as research suggests, people are more likely to put off visiting the dentist when they don’t have insurance, even if paying for it isn’t a problem. But going without regular checkups and cleanings only leads to problems. And with preventative care covered at 100 percent with most plans, it makes taking those much-needed trips to the dentist for exams and cleanings a no-brainer.

Fringe Benefit Analysts simplifies benefits management, reduces costs and saves time through progressive solutions and our devoted team of experts. Contact us for all of you and your employees’ benefits needs. From employer-sponsored to individual plans, we can help you find plans, including dental, health, vision and more, that fit any budget. Click here to contact one of our offices.