Insurance is almost always a good idea. In exchange for a monthly premium, you shield yourself from some of life’s worst financial catastrophes — a flood that destroys your house, an accident that totals your car, a surgery that costs thousands. But with its annual limits and many exclusions, dental insurance (a misnomer, really) is in a class of its own. To find out whether dental insurance is worth the cost, we spoke to experts and combed through patients’ experiences online.
What is Dental Insurance?
For a monthly fee of around $20 to $50, a typical insurance plan will cover preventive services alongside some dental work. But unlike health insurance, dental insurers often cap how much they’re willing to cover, with most offering annual maximums between $1,000 and $1,500 a year.
“Do not expect dental insurance to pay for a large, unexpected event like health insurance covers,” Dr. Elizabeth C. Robinson told Cheapism. “Think of dental insurance as a coupon that can be applied to $1,000 to $2,000 of your dental treatment, depending on the plan.”
What Does Dental Insurance Cover?
Preventive Care: Insurance companies often completely cover annual exams, cleanings, x-rays, and other common preventive procedures.
Basic Procedures: Policies will usually cover 80% of basic procedures such as fillings and extractions.
Major Procedures: Most plans will only cover 50% of the cost of crowns, root canals, bridges, and other major services.
Orthodontic Procedures: Insurance plans usually offer some dental coverage for a child’s orthodontia, though there are often lifetime maximums.
Cosmetic Procedures: Cosmetic procedures and teeth whitening are excluded from most plans.
Gallery: 5 Cheapest Ways To See a Doctor Without Insurance
Photo credit: megaflopp/istockphotoHow Does Dental Insurance Work?
Dental insurance is less about covering the costs of major procedures and more about encouraging regular preventive care. It’s like a AAA policy for your mouth, as one dentist put it. You pay a relatively modest monthly fee, you receive some benefits like free check-ups, and you have around $1,500 to put toward procedures (despite inflation, that number hasn't changed since the 1980s, according to dental hygienist Whitney DiFoggio). We know it’s a drag, but to really understand all the nitty gritty (and boring) details of your policy, you’ll need to know the following terms.
Premiums: A premium is the amount you pay for dental insurance each month, typically $20 to $50.
Copays: A copay is a fixed amount you pay for a covered service such as a filling, usually $20 to $30.
Deductibles: A deductible is the amount of money you have to pay before your insurance starts to pay.
Coinsurance: Coinsurance, usually a percentage, is the portion patients pay for covered procedures.
Annual Maximums: An annual maximum is the most that an insurance policy will pay out for the year, usually between $1,000 and $1,500.
Waiting Periods: When you sign up for dental insurance, there will often be a waiting period — a few months to a full year — before you receive full coverage.
What Types of Dental Insurance Exist?
| Plan Type | What It Is | Pros | Cons |
|---|---|---|---|
| PPO | Patients have access to a network of dentists who have discounted rates for covered procedures. | Patients can choose from a large network of dentists, including out-of-network providers. | PPO premiums are usually more expensive. |
| HMO | Patients only have access to in-network providers and out-of-network costs aren't usually covered. | Patients will pay lower premiums and often receive free preventive care. | Patients don't have access to as many dentists as they would with a PPO. |
| Indemnity | Patients have access to a wide range of dentists, with the insurance company paying a fixed percentage of a procedure's cost. | Patients can choose any provider. | Reimbursements are tied to what the insurance company determines are "usual, customary, and reasonable" fees, not what the dentist actually charges. |
What Do Patients Think About Dental Insurance?
On budget-conscious subreddits like r/Frugal and r/PersonalFinance, many Redditors argue that insurance is worth it, especially if your employer is footing at least some of the bill.
"Like with health insurance, the real benefit of dental insurance isn't coverage for a once-a-year checkup, it's the care required if something goes wrong," one Redditor writes.
The commenter adds that if you opt out, you should put away the money you would be spending on premiums in a savings account.
"If your teeth are in good condition, you might consider dropping dental insurance, but I would strongly suggest that over the next few years, you put what you would have spent on the premium into a high-yield savings account — essentially self-insuring," they explain.
Photo credit: PeopleImages/istockphotoIs Dental Insurance Worth it?
So, should you get dental insurance? The answer entirely depends on your needs, experts say. "In many cases, people pay more per year on their policy than they would’ve paid out of pocket, even in situations where they’re visiting the dentist for preventive care," explains Dr. Guneet Alag.
If you have some idea of your typical yearly dental costs, you can use a simple formula to determine if insurance is worth it, Alag says. Add the cost of annual insurance premiums and money you'd pay out of pocket, then compare the amount with they how much you'd pay out of pocket without insurance. If you'd pay more out of pocket without coverage, then it makes sense to sign up with an insurance provider.
The bottom line is that you'll have to think about your dental health and financial situations to know if insurance will really save you money.
Frequently Asked Questions
Do I legally need dental insurance?
No, dental insurance is not required by law.
How much is dental insurance?
Dental insurance premiums vary, but most cost around $20 to $50 a month.
Are dental implants covered by dental insurance?
While some plans cover dental implants, many consider the procedure cosmetic and don't offer coverage.
Is dental insurance worth it?
That depends. Take a look at how much you typically pay without dental insurance and compare that amount with the cost of out-of-pocket bills and insurance premiums.
What are alternatives to dental insurance?
Discount plans provide lower rates on some dental services at select dentists and are typically cheaper than insurance plans, with annual costs of around $150. You can also ask if your dentist offers a membership plan, which offers patients discounts in exchange for a monthly fee. Uninsured patients in need of low-cost dental care can also visit community health clinics and dental schools.
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