Is Dental Insurance Worth It?

Posted: July 19, 2023

Your oral health is crucial to your overall health and well-being, and a dental insurance plan can help you save significantly on dental services. Every plan is different, so determining if dental insurance is worth it depends on the right level of coverage for you.

Let’s dive into dental insurance, including what it covers, how much it might save you and how to find the right plan for your needs.

What Does Dental Insurance Cover?

Dental insurance coverage usually spans three primary categories:

1. Preventative services, which fully cover elements like cleanings, exams, X-rays, and children’s fluoride treatments.
2. Basic services, encompassing common treatments like fillings, simple extractions, and root canals. The majority of plans cater to roughly 80% of the costs of these services, but some might offer full coverage.
3. Major restorative services. These include intricate treatments such as crowns, bridges, dentures, and inlays or onlays, which your insurance may cover between 50%-80%.

However, dental insurance generally excludes cosmetic procedures such as teeth whitening, orthodontics, and non-medically necessary dentistry. Other typically non-covered services are higher levels of sedation, 3D X-rays, and sleep dentistry.

How Much Does Dental Insurance Cost?

The average preventative plan costs about $26 a month, while a typical comprehensive plan costs about $47 a month. The price of these premiums is affected by several factors, including:

• Deductibles: You’ll need to pay your deductible before your plan will cover services. In-network care typically has a deductible of $0, $50 or $100. You may have deductibles that apply to the whole family, and you may have a higher deductible for out-of-network care.
• Copays and coinsurance: Copays and coinsurance reflect how much you’ll pay out-of-pocket for your care. These can vary by service and how long you’ve had the plan. Most preventative services won’t have any coinsurance or copay, but other services will charge you a percentage of the cost, such as 20% or 50%.
• Annual maximums: Many plans have a dollar amount at which they won’t cover any more services for the year. Most start at around $1,000 of coverage, but they may go up with successive years, and you might have different amounts for different types of services. Some plans offer unlimited coverage.

Pros and Cons of Dental Insurance

Dental insurance offers valuable benefits for many people. The advantages of dental coverage include:

• Preventative care: Many oral health problems can’t be reversed. Dental insurance can help you pay for preventative care to prevent them from appearing in the first place. It can also offer peace of mind and support for maintaining your oral health.
• Lower costs: Simply being part of a dental plan usually gets you lower rates for services. Even if you have costs to meet before your deductible or you exceed your annual limit, your payments might be lower than they would be without insurance.
• Incentivizing visits: If you tend to put off your semi-annual cleanings, dental coverage can help motivate you to get your regular checkups completed. These services are usually 100% covered, so going to your appointments helps you get your money’s worth.
• Quick return on investment: Two cleanings and yearly exams can exceed $400 a year. A plan that costs $35 a month would equal $420 a year, providing lots of coverage for an extra $20. For many people, the preventative benefits alone pay for the plan quickly.

Although dental insurance can help cover the costs of oral health care, it does come with some caveats to be aware of. Here are some cons of dental insurance plans:

• Annual limits: Some dental plans have low annual limits, which might not cover the entire cost of more expensive treatments.
• Waiting periods: While most preventative coverage kicks in right away, you may need to wait several months or a year for basic or major services. Waiting periods prevent you from buying coverage only when you need it, which can pose a challenge when you require treatment quickly.
• Coinsurance amounts: Most plans offer the typical coinsurance coverage. Some will charge you more than others, so you’ll need to pay attention to these values when choosing a plan to ensure fair coverage.
• Network coverage: Some insurance companies have limited networks of providers, so it might be harder to find one that’s covered.

Should I Get Dental Insurance?

Deciding whether you should get dental coverage often comes down to whether you’ll use the services. If you at least get your regular cleanings, a basic plan will likely pay for itself. If you have more demanding oral health needs, such as missing teeth, good dental insurance is an especially good investment.

Factors to Consider When Choosing Dental Health Insurance

As with other types of insurance, picking a dental plan is all about finding the one that’s right for you. If you just want a safety net for the basics, you can likely find one with a low premium. If you think you’ll need more complex treatments, a plan with more coverage may be appropriate.

Keep these five factors in mind when choosing a dental insurance plan:

1. Annual Limits

Make sure your plan has a reasonable annual limit. Dental implants, for instance, can cost several thousand dollars, so an annual limit of $500 won’t be very helpful.

2. Waiting Periods

Check the waiting periods associated with your coverage. If you anticipate using your benefits in the coming months, try looking for a plan with shorter waiting periods.

3. Network Coverage

Check your insurance company’s network before signing up for a plan. You can make sure you have options in your area or see if your favorite dentist is in-network. If your plan covers out-of-network providers, you may not need to worry about this step.

4. Coinsurance Amounts

Some plans will charge high coinsurance amounts in exchange for low premiums, so always look at these dental insurance costs to make sure you’re okay with them.

5. Your Needs

Consider how likely you are to use benefits in higher service tiers. If you go to your regular cleanings and haven’t had a cavity for a while, you might not need to pay more for better coverage on major restorative services. Alternatively, if you haven’t been to the dentist in years and have some concerns, better coverage might pay off.

Find the Right Dental Plan at Health for California

The best dental insurance plan is one that matches your needs and budget. Finding the right plan can be tricky, especially with so many different options out there. With Health for California, you can access a fast, easy online application to help you identify the best plan for you. Plus, our agents are always available to answer any questions about dental health insurance and beyond.

Reach out to us today to talk about your insurance options and protect your oral health.