How Does Dental Insurance Work?

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The Basics

  • While health insurance is generally considered a necessity, you have more leeway when it comes to dental insurance. That's because major dental emergencies, like getting your teeth knocked out in a bicycle accident, should already be covered by your health insurance policy. Other problems, like needing a filling or a crown, can be covered by dental insurance. However, the things that can go wrong with your teeth are not nearly as expensive to fix as the things that can go wrong with your body, making dental insurance less important. Dental bills, unlike medical bills, are not likely to be high enough to send anyone into bankruptcy, and dentists will commonly work with clients who need time to pay for the work. That being said, dental work can still be expensive, and for this reason, some people choose to purchase dental insurance.
    Consider who you want to be your dentist (also known as your provider), how much you're willing to pay monthly for your insurance coverage (also known as your premium) and how much coverage you want. If you already have a dentist, you'll need to choose an insurance plan that lets you use their coverage with your existing dentist. Also, if you already have health insurance, you may be able to add dental coverage through the same insurance company for a reduced fee.

What Dental Insurance Covers

  • It is common for dental insurance to cover routine cleanings, X-rays and checkups. Particularly with employer-sponsored plans, these services may be free under your policy. This benefit alone can save you $200 to $400 a year, depending on what your dentist charges. Dental insurance will also cover fillings, root canals, crowns and the like. However, it usually does not cover services like orthodontics, whitening or veneers, all of which are considered cosmetic.
    Also, there is usually a waiting period before dental insurance will cover anything beyond the basics. This is to protect insurers from people who might wait to sign up for insurance until they have a problem in order to save on monthly premiums. If insurance companies allowed people to use the system this way, the companies would not be able to stay in business. The waiting period will depend on your insurer, but it might be 3 months for fillings and 6 months to a year for more expensive procedures.

Will Dental Insurance Help You?

  • Dental insurance does not make financial sense for everyone. It really depends on the amount of coverage you can obtain, the monthly premiums, the annual maximums, and the amount of dental work you typically need each year. If you typically only need basic cleanings and no major work, you are not likely to come out ahead with dental insurance. If you typically need lots of work, you may come out ahead, but only if your policy's annual maximum is sufficiently high to cover all the work you need and/or your monthly premiums are sufficiently low. Also, even with insurance, coverage on expensive procedures is usually only 50 percent. For all of these reasons, many people will be better off if they set aside a portion of savings to cover both regular and unexpected dental work--in effect, insuring themselves--rather than purchasing dental insurance.
    However, even if you exceed your annual maximum, as a benefit of being insured you may get a discount on your dentist's usual prices because of what's called a "negotiated fee." This discount is not as significant as the discount you get when a procedure is covered by the insurer, but it can still help.

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