Dental Insurance...is it a benefit??

Yes and No!

When looking for dental insurance in the individual or family market (not group health insurance) there are limited  options.  Other than Aetna, all carriers require that dental insurance be purchased with your health insurance policy or added on as an additional benefit to current policies without.  The Health Insurance Shoppe only represents one stand-alone dental product and that is with Aetna.

Now...for myself, I have never had dental insurance.  I have always had a dentist in the family who took care of my cleanings or any cavities I may have had.  Any work such as wisdom teeth removal were covered by my parents, when I was young.

In the past three years I have gone without getting my teeth cleaned.  Unfortunately, this was not a good idea, since I love candy!  Long story short, I began noticing some sensitivity and then went to a local dentist who was referred through the family.  Since this was a new dentist, I had to pay an initial consultation fee which was around $150, which included x-rays, teeth inspection and photographs.  From this I was recommended for an extensive deep cleaning to be completed.  This cleaning happened over a two visit duration and ended up costing  $900.  After the cleaning, the sensitivity and any pain that was there prior, had gone away.

The above example cost me a total of $1,150.  Since I did  not have insurance, and was able to take care of this in 90 days, the dentist had lowered the cost to $900.

Three months later, I noticed a pain in my lower front incisor and ended up needing an emergency root canal for interior resportion, which is caused from braces or trauma to the head.  My dentist referred me to a top Endodontist, who performed the root canal.  After two visits, the total for the root canal was $1,200.  Once again, since I did not have insurance, the price was discounted to $950, over a 90 day payment plan.

For these visits I paid a total of $1,850 over 6 months, $308/month.  To me, that was affordable.  Now if I did have dental insurance, I most likely will be paying a premium of around $26-$45/month in premium for a dental plan with a $1,000 or $1,500 calendar year maximum in payouts.

I would be paying roughly $420 over the course of the year in premium.  With all the insurance carriers out there, neither my dentist or Endodontist accepted dental insurance.  Depending on the dental plan, I might have coverage at 50% or none for a dentist who does not accept insurance, and is considered "out-of-network".

With an exception of the plans, I would have to wait 6 months after being insured before I could receive a benefit for the extensive deep cleaning that was $900.  If it had been 6 months after being covered, I would have owed $450.

As for the root canal, I would have to been covered under the dental plan at least 12 months before there would be coverage for Major Services.  Depending on the plan, I could expect to see the dental insurance pay out $135-$400 (depending on plan) towards the root canal.

If I had dental insurance I could have expected to pay ($420+$450+$400) $1,270 compared to the $1,850 without having dental insurance.  This cost figure can only be true if I had exhausted the initial 6-12 month waiting periods.  


If I did not exhaust the waiting periods, than the above would have cost an additional $420 (premium) more than not having dental insurance.




Now, if I had not gone 3 years without a teeth cleaning and went at least once a year, then the above would not be an issue, other than the root canal.  If you have good teeth without decay, than you can expect to pay anywhere from $89-$129 for a teeth cleaning.  If you had dental insurance, than your teeth cleanings would be covered at 100% by insurance, only if the dentist is in network.

You would most likely be paying more in annual premium than what it would have cost if you did not have the dental insurance for regular teeth cleanings.

Please feel free to contact the shoppe with any questions!

-THIS