Is Dental Insurance Worth It, and Do You Need It? Sep 2024

Dental Insurance and Your Wallet

Low maximum limits and high costs for deductibles, copays and coinsurance are easy answers to the question many people have: why is dental insurance so bad? But while you may be able to forgo carrying dental insurance, depending on your situation, doing so comes with risks.

Take a closer look at dental insurance and how you can determine whether it’s right for you.

Why You May Need Dental Insurance

Dental insurance has shown it can help you keep a healthier mouth and avoid the need for more extensive treatments, procedures and surgeries. People with dental insurance visit the dentist and maintain better dental health.

Those without dental benefits are more likely to need teeth pulled and dentures and less likely to have their teeth repaired or replaced or receive treatment for gum disease, according to the National Association of Dental Plans (NADP).

Fewer people have dental insurance than people who have health insurance in the U.S. The NADP also reports people without dental benefits report a higher incidence of other health problems:

• Heart Disease: 67%

• Osteoporosis: 50%

• Diabetes: 29%

Still, some argue that dental insurance isn’t really insurance at all because it pays for preventive services 100%, but has a diminishing scale for more serious and more expensive dental services and a max limit. This could leave you paying for more expensive services or choosing to delay those services, which many people do.

Understanding Dental Insurance

So is dental insurance worth it? It can depend on your dental needs, the plan you buy and your financial situation. Here’s a look at how dental insurance works.

Premium

The premium is your monthly costs for your dental insurance. Premiums for dental insurance typically run less than $50, depending on your dental plan and who is covered.

Deductible

The amount you pay before your dental insurance kicks in is your deductible. Dental insurance deductibles can run between $50 and $100, far below the average deductible for health insurance. Many dental plans can cover preventive dental care at 100% without the deductible.

Copay

You may have to pay for certain services when they are rendered. This copay usually is a flat fee or percentage of the cost of the service.

Coinsurance

After you meet your deductible, you still may have to pitch in to cover the cost of a dental service. This is called coinsurance.

Maximum

Your maximum is the dollar amount your insurer will cover each year for the dental services you need. Dental insurance maximums typically are low, ranging from $1,000 to $2,000.

You may be attracted to the premium for dental insurance—a fraction of the percentage of people’s income that goes to health insurance—but looking at the other costs and the services can help you determine whether dental insurance is right for you.

How Much Does Dental Insurance Usually Cover?

Many people wonder, “Is it cheaper to pay out of pocket for dental care?” Keep in mind that dental insurance companies typically operate on a 100-80-50 cost-sharing model.

This is what that means for your dental services:

• Preventive Services: Check-ups, cleanings and X-rays are covered 100%.

• Basic Procedures: Fillings, extractions and root canals are covered at 80%.

• Major Procedures: Bridges, dentures and implants are covered at 50%.

In the six years leading up to 2021, just 5% of people enrolled in a dental preferred provider organization (PPO), the type of plan covering nearly two-thirds of people with insurance, reached their maximum for in-network services.

Types of Dental Insurance Plans

There are four common types of dental plans.

Dental Preferred Provider Organization (DPPO)

You receive dental services at a reduced cost from in-network dentists with a DPPO plan. While you can go outside the network, coverage may be reduced.

Dental Health Maintenance Organization (DHMO)

Dental care is provided by a network of dentists at a reduced cost with a DHMO plan. You have to seek service from a network provider, and the insurer pays the provider.

Dental Indemnity

With dental indemnity, an insurer pays claims based on the dental service performed. There are no discounted fees offered under a contract.

Discount Dental Plan

A discount dental plan is not an insurance plan. A group of dentists agree to offer discounted services, and you pay a fee to join the program. When you receive a service, you pay the dentist directly.

Most people get a DPPO through their employer. Several other types of dental plans are available. Is marketplace dental insurance worth it, though? Plans on the marketplace are similar to those offered by an employer but at a higher price.

Pros and Cons of Dental Insurance

Dental insurance can help you cover some of your dental care needs. But it has its advantages and disadvantages.

With insurance, you are more likely to visit a dentist. Premiums are typically low, and preventive care is covered 100%. Having insurance can also cut the cost of other procedures.

However, dental insurance may not cover the services you need or expensive medications. Additionally, it often comes with low maximums and waiting periods.

Learn More About Dental Insurance From ConsumerShield

So who should buy dental insurance? Buying dental insurance is a personal choice. When is dental insurance worth it can only be answered by you. At ConsumerShield, insurance professionals can guide you in exploring whether dental insurance might be right for you. Get in touch with us to get started today.