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You need to have insurance for protection in the case of a car accident or if you have expensive medical costs due to an illness, which could wipe out your bank account.  But is it really necessary to have dental insurance? Making sure you have good oral hygiene habits will help reduce your dental bill.  But there are some teeth that are prone to more complicated medical issues which will lead to higher costs quickly.

How much does dental insurance cost?

About 64 percent of Americans buy dental insurance either through their employer or a group plan like Tricare (for military families), Medicaid or through the federal Children’s Health Insurance Protection (CHIP). Most preferred provider organizations (PPOs) and indemnity plans have an average deductible of $50 and a maximum yearly benefit of $1,000 to $2,000 according to the National Association of Dental Plans (NADP).  Once this annual limit is reached you are responsible to pay for full coverage of dental care. Only 2 to 4 percent of Americans exhaust their dental insurance coverage each year.

What types of dental insurance plans are available?

In the workplace there are typically three types of plans to choose from.  Premiums range from $228 to $384 annually according to NADP for the following group dental plans:

  • Indemnity plan: You may choose your provider and your plan pays a percentage of the provider’s fee.
  • PPO: These plans have groups of practitioners who agree to reduced fees within a network. If you use a dentist outside this network you will pay more.
  • HMO: These plans only allow you to use the practitioners in their network to help keep costs in check.

What elements does a dental premium cover in a typical plan?

  • Preventive care: Full coverage is provided and includes periodic exams, X-rays and for some age groups sealants
  • Basic procedures: Plans typically cover 70 to 80 percent of office visits, extractions, fillings, root canals (sometimes) and periodontal treatment.
  • Major procedures: Plans usually cover 50 percent or less of costs for crowns, bridges, inlays, dentures, and sometimes implants and root canals.

Orthodontic care is provided if you add coverage.  Cosmetic work is not usually covered in dental insurance plans.

Does the Affordable Care Act (ACA) provide plans with dental coverage?

The ACA will provide coverage for children under the age of 18, and in some state’s marketplaces dental coverage for adults, either as a stand-alone policy or part of a comprehensive health plan (Healthcare.gov).


SOURCE: MoneyTalksNews, “Is dental insurance worth the cost?” by Marilyn Lewis

Dr. Ted Melchers and his staff are here to help address any of your dental health issues and decide the best course of treatment for their patients.  Contact us today to see how we can best meet your dental care needs.