Dental insurance can be very confusing and difficult to understand. So we thought we would help shed some light on this subject and help you determine if dental insurance is really for you! Amy Fontinelle wrote a great article about dental insurance on Investopedia that is worth the read! In this article she helps grasp the idea of dental insurance and how it can help you. Check out Amy Fontinelle's article titled "Should You Bit On Dental Insurance?" below! Let us know if this helped further your knowledge, it sure helped us!
Should You Bite on Dental Insurance?
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Should You Bite on Dental Insurance?
Read more: Should You Bite On Dental Insurance? http://www.investopedia.com/articles/pf/07/dental-insurance.asp#ixzz4xJuZj7j1
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There's no question that dental work is expensive – especially
when you need to have major work done. If you're not covered through your job,
you may have to purchase it on your own. However, purchased privately, dental insurance can be a huge waste of money if
your plan doesn't match your needs. In this article we'll show you how to drill
through these plans to find out if dental insurance is right for you.
Overview of the System
First, here's a breakdown of how private dental insurance works.
You select a plan based on the providers (dentists) you want to be able to
choose from and what you can afford to pay:
- If you already have a dentist you
like and he or she's in the insurance company's network, you'll be able to
opt for one of the less expensive plans.
- If you don't have a dentist at
all, great! You can choose from any of the dentists who are in-network,
and again have the option of a less expensive plan.
- If your existing dentist is not in
the network, you can still get insurance, but you'll pay significantly
more to see an out-of-network provider – so much more that you may not
have any chance at coming out ahead by being insured.
The monthly premiums will
depend on the insurance company, your location and the plan you choose. For
many people, the monthly premium will be around $50 a month. This means that
you're spending $600 on dental costs each year even if you don't get any work
done.
Things to Consider
Now, you may be thinking that most people don't come out ahead
with most kinds of insurance, and you may be right. After all, if insurance
companies didn't make a profit, they would all go out of business. Insurance is
designed to protect you in a worst-case scenario. Dental insurance is
significantly different from most other kinds of insurance, however. With
policies like health insurance or homeowners insurance, the potential downside
is so high that almost no one can afford the risk of not being insured. With
dental insurance, the potential downside is fairly low – and so is the potential
upside.
In a good year when you only need the standard cleanings, exams
and x-rays, you are likely to lose about $200 by having dental insurance. While
these services will generally be completely covered by your insurance because
they are considered preventive care. If you paid out of pocket for them you would probably
only spend around $400 for the year instead of the $600 you're spending on insurance premiums.
Will It Be There When You
Need It?
What about when you need some work done? In a really bad year,
your dentist may inform you that you need a couple of fillings, a root canal
and a crown. On top of that, you'll still have to pay for your usual cleanings,
exams and x-rays. This is the time to be insured, right? Unfortunately, your
insurance may not be as helpful as you'd expect. Many dental insurance plans
have very low annual maximums of around $1,000 (this will vary by plan and by
provider, of course). This means that once your dental bills exceed $1,000 in
any given year, you're stuck paying the rest of the bills in full.
You may still pay a lower negotiated fee for the work you need as
a benefit of having insurance, but even the negotiated fees are quite high. For
example, if the dentist's regular fee for a filling is $150, the negotiated fee
might be $100. In this situation, your regular oral maintenance and fillings
will use up most or all of your annual maximum, so only a fraction of your
large dental work bill will actually be covered. You're likely to still pay
$1,000 to $2,000 out of pocket, plus your annual $600 in premiums. On top of
that, while you may pay 0-10% in co-pays on
preventive maintenance and 20% in co-pays on fillings, the co-pay on expensive
procedures like root canals tends to be a whopping 50%. Even if you haven't
used up your annual maximum by the time you need the expensive procedure,
you'll still have to pay several hundred dollars for it.
Dental insurance also rarely covers expensive procedures like
orthodontics and cosmetic dentistry, even if you try to argue that you need a
procedure to alleviate emotional pain and suffering. When insurance does cover
them, the annual maximums still often prevent you from saving very much, if
anything, after you factor in your biannual cleanings and exams.
Waiting Could Be Worse
If you're thinking that you'll just hold out and then purchase
dental insurance when you need it, think again. Because of what's called a
waiting or probationary period, this strategy won't work (you didn't really
think you'd found a way to outsmart the insurance companies, did you?). Waiting periods mean that, for example,
one year after you first become insured, your insurance will not cover any
major work (like crowns or root canals) and for three months after you first
become insured, they won't pay for any minor work (like fillings). Insurance
companies know that when you need a filling or a crown, you need it now – you
won't be able to find out you need a crown, buy insurance, wait 12 months, and
then get it taken care of. If you tried to do that, you'd probably suffer from
a lot of discomfort and ultimately lose your tooth (and you'd have to pay full
price for that extraction, too).
Considerations for Group
Plans
Surprisingly, even if your employer offers dental insurance, you
might be better off skipping it. Many people assume that employer-sponsored benefits are
automatically a good deal because you're receiving a group rate, but this isn't
necessarily true. When evaluating your employer's dental plan, make sure to
really look at the monthly payments, the annual maximum and the co-payments.
Your employer may offer you a great plan that's only $20 a month to cover your
entire family with a generous annual maximum, or a mediocre plan that's $40 a
month with a $1,000 annual maximum. With the former, you can really benefit,
but with the latter, you're probably wasting your money. Do the math for your
own situation to determine whether you're likely to come out ahead.
There is one situation where it can make sense to get dental insurance
regardless of whether it seems like a good deal in the long run, and that is if
you are someone who is currently living from paycheck to paycheck with little or no
money saved. When you don't have dental insurance, you have to be able to pay a
$1,600 bill when you have the work done (if not in full, then in prompt
installments). If you can't do it and your options are to overpay for dental
insurance, neglect your only set of teeth or put dental work on a credit card that you'll have trouble
paying off, your best bet is to get the insurance. You'll probably waste less
money on insurance than you would paying interest on a credit card, not to
mention that you wouldn't want to ruin your credit scoreover a few fillings.
Parting Thoughts
If you can't participate in a quality group plan – either a preferred provider plan (PPO) or a Dental
Health Maintenance Organization (DHMO) – the best way for most people to come
out ahead on dental expenses is to pay for everything out of pocket. Brushing
and flossing regularly, switching to an inexpensive electric toothbrush,
getting professional cleanings every six months and going to a dentist who does
high quality work that lasts for years can be the most effective ways to save
money in the long run.
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