Using data on plan features and out-of-pocket costs, this article will explore:
A question often directed at dental insurance is "Is it worth it?" Unlike Affordable Care Act medical insurance as well as large group health plans, dental coverage typically has a cap on the plan’s spending for covered benefits and the coverage also lacks a limit on annual out-of-pocket costs. So what’s the point in having coverage?
Assuming a person lacks dental insurance and cannot obtain such coverage through his or her job or a government program, dental benefits are normally obtained using one of the following alternatives:
Three of the above options (PPO, HMO, Discount Plan) are associated with networks of dentists who accept a negotiated rate for dental service. The advantage of negotiated rates is the promise of dental fees below market rates. Moreover, in the case HMOs and discount plans, the annual limits on service payments by the dental plan are absent.
HMO and PPO plans often have no copayments for annual dental check-ups.
When debating the value of dental coverage, it is important to know what the average plan costs. In the case of dental plans, benefits are not standardized and, as a consequence, there is considerable variation among premiums. On the low side, you may find a discount dental plan for around $9 a month while on the high side you may find a more comprehensive dental plan (with a $3,000 annual limit on benefits spending) that costs around $70 a month.
As mentioned in the prior section, the discounted or negotiated rates on dental services provided by networked dental plans can save consumers money compared to paying full retail rates. Dental plans also save money for enrollees when they waive copayments for preventive care such as annual oral exams and teeth cleanings. HMO dental plans may also deliver some dental services with little-to-no copayment and have no annual cap on dental service spending by the HMO plan.
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Without some form of coverage, a consumer should expect to pay full price for dental care. Below are a few examples of average dental fees in 2020 collected from the Rochester, MN, metro area by Advanced Practice Management, LLC.:
As the costs above illustrate, a few major dental procedures can quickly transform into considerable financial responsibilities for the patient. An amalgam filling, a root canal, and a crown in the same year adds up to $2,398.
A dental discount plan provides reduced price services from a network of participating dentists. Assuming the network is in the consumer’s region, he or she may save up to 20 percent of dental costs regardless of how frequently the dental services are used.
Our knowledgeable customer service team will assist you with any questions you may have prior to enrolling in a dental plan. They can guide you through the process of choosing coverage that matches your needs as well as your budget.
