Why Isn’t Dental Insurance Included in Medical Insurance?
Posted: November 16, 2022
Medical insurance is a crucial benefit that helps millions of Americans pay for health care — according to the Centers for Disease Control (CDC), 66.6% of adults aged 18-64 have private medical coverage. Another survey found that only 50.2% of that population has dental care coverage because most medical insurance plans don’t include dental care.
If you’re wondering why your regular health coverage doesn’t provide dental insurance, you probably aren’t the only one. Under the Affordable Care Act (ACA) of 2010, most insurance plans must cover 10 essential health benefits, including prescription drug costs, mental health services and more. Offering dental insurance for adults is optional.
While your medical insurance plan may not offer dental care, there are many good reasons to get this coverage for you and your family. Learn more about supplemental dental insurance and how you can benefit from having it.
3 Reasons Why Dental Is Separate From Medical Insurance
Insurance companies don’t consider dental coverage to be an essential health benefit. Most health plans offer dental coverage separately, though some employers or group programs include it. Here are a few reasons why you most likely won’t find dental insurance included with your health care:
1. The Dental and Medical Fields Are Separated
The medical and dental fields are separate professions, though this hasn’t always been the case. Physicians founded the first dental school in the United States in the 1840s. Yet these schools divided dental students from education in other medical fields. This separate educational path was one of the first factors that led to the divide between the medical and dental fields.
Another factor that influenced the separation was the creation of a largely employer-sponsored health insurance industry that excluded dental care. While health insurance in the U.S. developed in the late 1800s, dental insurance wasn’t introduced until the 1950s, making it a relatively new service. These elements combined to sever dental practice from the broader field of medicine.
The early differences between the dental and medical fields have led to vast differences in practice that persist to this day. Although poor oral health contributes to diseases like oral cancer and diabetes, many in the medical community view health insurance as more essential.
2. Dental Insurance Is Specific to Dental Carriers
The insurance industry is highly specialized, and insurance companies aim to offer cost-effective coverage. Your insurance provider has already formed relationships with physicians, hospitals, clinics, specialists and other health care providers. These professional relationships in your insurance network make it possible for your provider to offer coverage at lower rates.
Dental insurance providers do the same thing, creating relationships with dentists, orthodontists and other oral health professionals to form a network. Dental carriers negotiate and bargain with dentists with these professionals, who agree to provide their services for a lower rate in exchange for being part of the insurance network.
Overhauling these insurance networks would require a significant amount of work. Computer systems and policies have been set for years, making change difficult. Many insurance companies would rather have the separation between medical and dental care than attempt to redo the system.
3. Insurance Companies View Dental Insurance as Supplemental
Because dental insurance isn’t one of the 10 essential health benefits under the ACA, insurance companies also view it as supplemental. Medical insurance must provide these 10 benefits to treat common health needs, from preventative services to emergency services and hospitalization. In contrast, dentists offer a smaller range of services that center around preventative care and rarely deal with life-threatening health issues.
The cost of care is another factor influencing how insurance providers treat dental coverage. Medical issues vary in seriousness and cost. A patient may need lab work, which is often relatively inexpensive, and then require major surgery. This variability makes medical coverage more costly for insurance providers. Dental care has a lower cost of care in comparison, with most services limited to x-rays and teeth cleanings.
Benefits of Getting Dental Insurance
Although medical insurance and dental insurance are separated on most policies, both are vital for helping people maintain overall health and well-being. Regular dental visits and tooth cleanings can help people prevent oral and gum disease, while dental insurance lowers the cost of visits and makes better health more affordable.
Consider a few of the benefits dental coverage offers:
1. Dental Visits Spot Problems Early
Access to regular dental care can keep poor oral hygiene from developing, as dentists are able to spot potential issues during an exam and help their patients take preventative measures to maintain their health. The CDC recommends that adults visit their dentist at least once a year and practice good oral hygiene at home, like brushing their teeth and flossing. Regular visits to the dentist can catch potential cavities and other oral health issues before they become serious.
Some of the diseases and other health issues dental care can prevent include:
- Gum disease
- Oral cancer
- Untreated cavities
- Tooth loss
2. Dental Insurance Makes People More Likely to Receive Care
High dental care costs may discourage many people from receiving the care they need. Even yearly dentist visits can add up and motivate people to put off making an appointment. Yet people enroll in dental insurance because it significantly reduces the cost of dental care. Insurance allows people to proactively manage their oral health while reducing expenses. Dental insurance also reduces the cost of emergency oral care like toothaches, chips and more. For instance, dental insurance may help with the cost of:
- Teeth cleanings
- X-rays
- Mouth exams
- Treatments
3. Oral Health and Overall Health Are Linked
Your dentist may also be able to determine some things about your overall health during an oral exam or teeth cleaning — or help you improve your overall health. For example, if left untreated, certain oral diseases like gum disease may increase a person’s chance of having a heart attack or other cardiovascular event. Poor oral health is also linked to other issues like:
- Diabetes
- Heart disease
- Arthritis
- Stroke
- Immune conditions
Choose Dental Insurance Through the Health for California Insurance Center
It can be challenging to determine the insurance you and your family need. At Health for California, we help California residents access the supplemental insurance plans they need to make their health care more affordable. We offer a fast, accurate and easy online application process to make applying for insurance simpler. We also provide free guidance from our knowledgeable team, who can help you select the right California dental insurance plan for you.
Request a free quote for dental insurance or fill out a no-obligation application today.