Is dental insurance worth it?

As my heart rate starts to climb and my palms get sweaty, it can only mean one thing.  I have a dentist appointment today!  I seriously despise going to the dentist.  I can think of 100 pain inducing things I would rather do than go to the dentist.  (For example, getting punched really hard in the stomach).  It’s not the cleaning and lying with your mouth open for an hour that I dread, it is the fear of the unknown that kills me.  Will the dentist find a cavity?  Is there something wrong?  That fear causes me to lose sleep at night!

This brings me to the insurance point.  I get asked all the time, “Is dental insurance worth it?”  “Should I just pay out of pocket or buy an insurance plan?”

If your views of the dentist are like mine, I think dental coverage serves a purpose greater than the dollars and cents….  It actually forces me to go to the dentist.  I know that I am paying my premiums each month and to get some value out of it, I better go.  In my experience with thousands of clients, I find that most of them fall into 3 categories:

– People who avoid the dentist all together

– People on the fence that go annually because they know it is the right thing to do

– People who have great teeth and don’t mind going to the dentist

I think most people fall in the middle category (myself included) and that is where dental insurance can help “nudge” you to see the dentist.  

Now let’s look at the financial side:

Dental insurance for an individual is around $30/month for a good policy.  I would avoid “discount” plans like the first group of people avoid the dentist, they aren’t worth the time.

Annually you pay:

$30 x 12 = $360/year in premiums per person

In exchange for the $360, you get 2 cleanings, 2 exams, and 1 set of x rays covered every year at 100%.  You can also get the panoramic (full head) x-ray covered in full every 5 years.  Here is what my dentist charges:

Cleaning $94.00

Bitewing X rays – $67.00

Evaluation – $52.00

$213 every 6 months + $94 + $52 = $359/year in fixed costs. (x rays taken 1 time per year)

What I have found is that dental coverage is kind of a break even in a normal year.  If you go every 6 months as suggested, you will get in what you pay in premiums.  

Now lets imagine that you have a cavity (like I did today…).  My dentist gave me an estimate of $214 to fix the cavity.  With dental insurance, it will pay 80% of a cavity ($171.20) leaving me with a balance of $42.80 to pay.

Most dental plans have a calendar maximum of $1,000 that they pay (your cleanings, x rays, and exam costs do NOT count towards this $1,000).  This $1,000 can come in handy when an unanticipated problem pops up.

I think some people have a limited viewpoint of dental insurance because it caps the amount it will pay annually.  However, if you look at what you actually pay out of pocket, without any insurance, I think it becomes a little easier to justify the premium.  I know from personal experience that if you are like most people, who prefer to do anything other than going to the dentist, dental insurance can provide the gentle “nudge” needed to go and see your dentist on a regular basis.  

P.S. Don’t forget to floss!