Not having insurance can possibly bankrupt you. One bad car accident or illness could easily result in tens of thousands of dollars in bills. So, we buy insurance. I buy auto and health insurance because I don’t want to go bankrupt.
But what about dental insurance? Can the average person save money by forgoing it and just paying for care as needed? With certain types of insurance, you should take a deep dive into the numbers to see whether the coverage is worth it for you. Dental insurance fits that category. So let’s take a look.
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How Most People Purchase Insurance
Many who have dental insurance receive it through their employee benefits at work. Some employers offer such insurance to help attract and retain employees.
Since dental insurance isn’t outrageously expensive, some companies will pay for it in full. However, other companies will pay just a portion. If you will be partially responsible for the cost of this insurance, your payment will be deducted from your paycheck.
Not everyone has access to dental insurance as an employee benefit, though. So what should you in that situation?
Some people buy dental insurance on their own. If you go this route, expect to pay more because the cost of the plan isn’t subsidized by your employer.
As a freelancer, I could purchase dental insurance through my wife’s employee benefits package or on the open market. Here’s how I made my decision about whether dental insurance is worth it for me.
How Much Will Dental Insurance Cost Me?
The first thing I did was determine how much dental insurance would cost through my wife’s employer and how much it would cost on the open market.
My wife’s employer has an unusual dental insurance offering: Basic services such as routine cleanings, X-rays, and exams are free for her only. But if you want additional insurance to cover fillings and other dental work or to cover other family members, there is a fee for each.
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The additional dental insurance for her would cost $322 per year. If she wants to add me, there will be an additional cost of $368 per year. That brings the total cost to $690. Plus, there’s an annual maximum payout of $2,000 per person.
Dental insurance purchased independently for an individual would cost about $366 per year for reasonable coverage, based on quotes from eHealth, a site that allows you to compare and review the most affordable insurance plans in one click.
Costs With Insurance vs. Without It
Even considering the cost of dental insurance, healthy teeth are a blessing, and anything can happen in life at any inopportune time. The financial pain may be alleviated by having a plan in place.
“When people think about the cost of two visits per year for regular cleaning, they are thinking about the cost they pay out of pocket, not necessarily the sticker cost charged by the dental office,” says Lou Haverty, a financial analyst at Financial Analyst Insider. “When you use insurance, you benefit from the group negotiating power of your insurance plan, which represents a 40 percent to 50 percent discount from the gross fee charged by the dentist.”
To put it simply, if you need major work done, you’ll end up paying less for it if you have insurance than if you don’t have it.
For basic services with and without insurance, Haverty estimates, “If two cleanings a year with X-rays is an estimated $275 per visit or $550 per year [without insurance], with insurance those visits only cost $156 per visit ($312 per year).”
If your insurance covers 80 percent, you would only pay 20 percent of the $156 per visit charge, or $31.20 per visit plus your monthly insurance fee.”
The average cost of dental services over the course of a year was $685 in 2013, according to a report by the American Dental Association. For people who only saw a general practitioner, the average annual costs came out to just $514. Meanwhile, for those who required a specialist's services, it came out to $1,755. That’s a decent chunk of change if you don’t get a discount through your insurance or are uninsured altogether.
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Is Dental Insurance Worth It?
After examining my options, I looked back at my previous dental costs. Last year, I went to the dentist twice. The first time was for an annual exam, a cleaning, and X-rays, which cost $163. The second time for another cleaning, which ran $77. My total dental costs for the year were $240.
For dental insurance to be worth it for me, I would need to get a fair amount of work done.
So for someone like me who is on top of my dental hygiene, is genetically lucky to have good teeth, and does not visit as frequently as is recommended, paying per visit is an easy choice.
But is this the approach everyone else should take? Is it worth about $1,755 for specialist or emergency work to skip dental insurance completely?
Should You Get Dental Insurance?
While my current analysis says that I personally shouldn’t carry dental insurance, I didn’t always run the numbers. I had a plan for three years at my last company and used the insurance just once. I probably paid hundreds of dollars in premiums for at most $200 of services.
If you’re not going to go to the dentist that often, you might consider dropping the insurance. That said, many experts would say that for such a small price, why not keep it in case you run into unexpected dental issues?
If you have routine dental issues such as needing crowns or root canals, or if you follow a doctor-recommended frequency of checkups and cleanings, dental insurance can be worth it.
Haverty suggests that the dental insurance’s real worth lies not in the twice-a-year visits, but in those emergencies that come around every couple of years in which you need a serious issue fixed immediately and the gross out-of-pocket costs lie somewhere in the thousands.
Additional reporting by Jazmin Rosa and Evan Sachs.
