Think Twice Before Buying Private Dental Insurance
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Consumer Reports has no financial relationship with advertisers on this site.
Thinking about buying dental insurance because you don't have an employer offering it as a benefit? It might not be worth the cost even if you need extensive dental work.
It’s a concern for a lot of people. One in 4 Americans doesn't have dental insurance, and of those over 65, half have no coverage, according to the National Association of Dental Plans (NADP).
About two-thirds of people who do have insurance get it through their job-. If it's offered to you, it almost always makes sense to take it because employers subsidize the monthly premiums and can negotiate lower rates for dentists in their network. The employee contribution toward the premium is generally pretty low.
Of course, getting regular dental checkups is important for your health. Untreated conditions can lead to serious health problems or indicate an underlying medical issue. Getting routine care can prevent more serious and costly treatment down the road, says Dave Preble, D.D.S., senior vice president of the American Dental Association's Practice Institute.
But when employer insurance isn't an option, there are other ways you can get dental care that can be more affordable than paying the premiums for insurance on your own.
How Dental Insurance Works
Employer-provided and stand-alone plans operate pretty much the same way. Although benefits vary, plans typically cover 100 percent of preventive care, such as regular check-ups and cleaning, 80 percent of basic services, like filling cavities and pulling teeth, and 50 percent of extensive work, such as root canals, bridges, and crowns.
Most plans have annual deductibles of $50 to $100 and usually limit annual coverage amounts, with a median cap of $1,500, according to the National Association of Dental Plans.
In other words, whether you have an employer-provided plan or a private one, you'll still pay a lot out of pocket if you need extensive work.
And if you buy dental insurance yourself and wind up needing only basic care, you could end up paying more in monthly premiums than if you paid for the individual services yourself.
Premiums for private plans vary widely, and you can opt for a low-cost plan. In a recent search on eHealth, an online insurance marketplace, individual coverage ranged from $20 to $80 a month for plans with $50 to $100 deductibles and an annual max of $1,000 to $2,000.
But the cheapest plans often don’t have a robust provider network, so it may be difficult finding a dentist who takes that insurance, says Preble.
Given the high cost of dentistry, it's easy to see how paying for a plan with a low annual max plus a monthly premium may not make sense. The cost of a cleaning for an adult is $73 to $130; fillings, $108 to $246; crowns, $959 to $1,650; implants, $1,200 to $2,500; and root canals, from $613 to $1,200, according to the American Dental Association Health Policy Institute’s 2018 Survey of Dental Fees.
Given all that, “it’s hard to make paying for private dental coverage seem worthwhile,” he says. “If you’re one of those people who doesn’t need a lot of dental work, you are likely to save money by paying out of pocket."
But there's an exception to that rule: If having coverage would make you more likely to go to the dentist, that's an important argument in favor of buying dental insurance, says Preble.
Forgoing dental insurance is also less risky than going without medical coverage. Unlike comprehensive health insurance, which can protect you financially from catastrophic health problems that can cost tens or hundreds of thousands of dollars, you’re not likely to rack up such enormous bills even if you have fairly significant dental needs.
Though limited, some major dental work may be covered by your health insurance, such as a serious dental procedure that requires hospitalization or treatment in an emergency room for a mouth injury because of an accident.
How to Save Money On Dental Care
With or without dental insurance, there are many ways to make dental care more affordable. Check out these strategies.
Get covered if you can. As mentioned above, employer-subsidized plans are the best way to get dental care covered for working adults. For seniors over 65, Medicare insurance doesn’t cover dental services, but you can buy a private Medicare Advantage plan with a supplemental plan for dental coverage.
Some Medicare Advantage plans charge additional premiums for dental, averaging $284 a year in 2016, according to a report by the Kaiser Family Foundation. Seniors can also look for plans through groups like AARP.
States are required by the Affordable Care Act to provide dental benefits to children covered by Medicaid and the Children’s Health Insurance Program (CHIP). Some states also provide a dental benefit to adults who have Medicaid.
If you’re a veteran and have a service-connected disability, you may be eligible for free comprehensive dental care from the Department of Veterans Affairs. Other veterans can buy dental insurance at a reduced rate.
Create a dental emergency fund. Put aside money you might have used for premiums. If you can, save the money in a tax-advantaged account. With a flexible spending account, which is available only with workplace healthcare plans, you can put away money pretax to pay for medical expenses, including dental, that your insurer doesn’t cover.
And if you have a high deductible health plan (HDHP), you can fund a Health Savings Account (HSA) with pre-tax money and use it on a range of healthcare costs including dental. Note, you can't use both an FSA and an HSA.
Go to a dental school. You could pay 30 percent to 40 percent less on dental services at university dental schools compared to a private practice. You’ll get care from students supervised by dentists but the downside is that it’s very time consuming.
“It’s much slower because the student is doing work under the supervision of an instructor," says Preble. Visits are longer and care that could be done in a few sessions in a dental office could take a few months to complete.
Check a community health center. Some offer dental care and charge on a sliding scale based on your income. But they may have limited services and, possibly, waiting lists. Call your local health department or state dental association, or go to Tooth Wisdom to find clinics near you.
Consider a dental savings plan. These are membership programs, where you pay $80 to $200 a year to get access to a network of dentists who offer discounts. Check the number of dentists locally that participate. You can search for a savings plan at DentalPlans.com.
Shop around. Whether or not you have insurance, you pay a lot for expensive procedures so you should compare prices for big ticket items. Use sites like Healthcare Bluebook and FAIR Health to research prices where you live.
Dentists are open to negotiating prices and often will offer a discount if you pay for a procedure when you get the service. Some dentists offer in-office dental plans for people without benefits. Patients pay a small monthly fee and get basic care for free and discounts on other services.
Spread out services. Many employer plans provide 100 percent coverage for getting a checkup twice a year. But if you’re paying on your own and in good dental health, once a year may be enough according to American Dental Association guidelines, says Preble.
The ADA also says that adults with generally healthy teeth only need bitewing x-rays every 18 to 36 months. There's no one-size-fits-all dental treatment though, says Preble. You can go to the ADA's MouthHealthy.org site for more information on paying for dental care, preventive care and recommended frequency of visits.
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