The average cost of a routine exam is about $80 for adults. Since most dental insurance plans cover just 2 exams every year, most people who pay more than $160 for dental insurance per year are spending more than they’re getting. Naturally, this is the case for most people with dental insurance – you pay more for insurance than it saves you.
The true value of dental insurance comes into focus when patients require dental work beyond standard cleanings. Though the exact amount depends on the details of the plan, dental insurance usually saves patients several thousand dollars on treatments like root canals, crowns, and fillings. The average cost of a root canal, for example, is usually around $800-1100, depending on the tooth and other factors. With insurance, most people only pay a copay to get a root canal.
Most insurance companies offer a variety of benefit plans with different features. You may have co-workers or friends who are also covered but their coverage could differ from yours.
Also, your dentist may not “participate” in the network for your dental plan. If your dentist does, he or she will submit your claim. If not, you may be responsible for paying your dentist and submitting your claim yourself.
If you are entitled to benefits from more than one group dental plan, the amounts paid by the combined plans will not exceed 100 percent of your dental expenses. Benefits for dependents vary from plan to plan. Pay particular attention to special clauses and to language about dependents.
Dental benefits are calculated within a “benefit period”, which is typically for one year but not always a calendar year. Check your benefits information so that you know when you might be approaching your deductible payments or plan maximums.
So the question to most people considering out-of-pocket dental insurance is centered around how likely they are to need dental work outside of regular cleanings and exams. If you have a family history of cavities or root canals, or you regularly engage in potentially dangerous activities like sports or motorcycling, you should consider getting dental insurance as it could save you money in the long run.
If you opt out of dental insurance, don’t use it as an excuse to skip your regular checkups. Dental insurance is only meant to supplement your income, it does not work the same way as medical insurance. Nothing saves you more money on dental work than regular cleanings at the dentist, since they’re often the best line of defense against cavities and gingivitis.
About the Author
Dr. Harris has been a practicing dentist and oral surgeon since 2005. In 2012, he received his Master’s of Science in Dentistry and a certificate in Endodontics. He founded East Coast Endodontics shortly after receiving his master’s degree. He also currently holds a part-time position as a Clinical Assistant Professor for the Endodontics department at Virginia Commonwealth University. View his full bio.