Are you taking care of your insurance shopping? It’s easy to just knock it all out at the same time, isn’t it? You’ve got your health insurance, life insurance, long-term disability insurance, pet insurance (can’t forget about Fido!)...
What’s that? You didn’t buy dental insurance because you thought it was included in your health insurance?
Average annual expenditures for dental services were $685 in 2013. Your dental care probably isn’t included in your health insurance. Would you be able to foot that bill all on your own?
When it comes to dental care options, your two main choices are dental insurance or dental discount plans. Let’s look at how you can get covered with dental insurance, as well as what a dental discount plan is and how you can find the best ones.
Health insurance does not equal dental insurance
It’s important, so we’ll say it one more time: your health insurance probably doesn’t cover dental care.
It seems logical that it would be included, but unfortunately that’s not the case. It usually wasn’t that big of a deal, since dental procedures used to be relatively cheap. But as they’ve gotten more expensive, dental coverage has been scaled back. Only 64% of people had dental benefits as of 2014 - which means 1 out of 3 adults are either foregoing dental care or paying out of pocket for it.
Even when health insurance became mandatory thanks to the Affordable Care Act (ACA), aka Obamacare, dental (and vision) coverage was only required for children. Adults were still on their own. Some people speculate that because the ACA took a lot of its cues from Medicare, and Medicare doesn’t cover dental care, Obamacare doesn’t, either.
Regardless of why health insurance doesn’t require dental care, the fact is that it doesn’t. You can find dental plans on marketplaces like Healthcare.gov, but you won’t necessarily get the consumer protections that Obamacare put in place, like guaranteed coverage and out-of-pocket maximums. That’s why it’s important to look closely at your other options and make sure you’re getting a good deal.
As mentioned, you can shop for dental insurance on insurance marketplaces like Healthcare.gov as either a standalone policy or as part of a health insurance policy. In 2014 less than 1% of Healthcare.gov plans were estimated to include dental benefits for adults, so you’ll likely have more luck paying for a separate plan.
Most dental plans offer "100-80-50" coverage. That means that the plan covers 100% of the cost of routine care (like your regular cleanings), 80% of the cost of basic dental work like root canals and fillings, and 50% of the cost for advanced procedures like crowns.
Because you don’t get consumer protections like you do with health insurance, make sure you know what your plan covers. For example, Humana notes that "full coverage" might mean just the basic services, or it could mean covering everything mentioned in the previous paragraph.
Also, where health insurance cannot cap benefits paid out for covered healthcare services, dental insurance may max out at a specific amount. You’ll be covered for, say, $1,000 over the course of the year, but after that you’re on the hook for costs.
If you’re not shopping for dental insurance on the government marketplace, you can look for it directly from insurers, just like you can with health insurance. For instance, you can go straight to UnitedHealthcare’s site and find their dental insurance offerings there.
Dental discount plans
An alternative to dental insurance is a dental discount plan. Rather than the limitations that come with dental insurance, a dental discount plan allows you to pay a membership fee to receive a discount on various dental procedures. It’s like Amazon Prime for your teeth.
Discount plans are mostly worth it if you’re willing to pay a little extra to make the discounts worthwhile (as we found in our deep dive into dental discount plans, the cheapest plans don’t provide very good discounts) and if you’re using them on more expensive procedures. For basic dental upkeep, you’ll probably get a better value out of dental insurance.
What’s the best discount plan? It’s sort of a cop-out to say it depends, but it really does depend on what you’re looking for as far as coverage. If you know you’ll need a certain procedure, or there’s something in particular you want protection against just in case, look for a discount plan that’s within your budget that provides the best discount for those procedures.
Luckily, though, if you’re looking for dental discount plans, you won’t be wanting for options. AVS Dental, Solstice Benefits, Reassurance Dental, and MetroCare are just a few of the dental discount plans you can find out there. Heck, even CVS offers dental discount plans as part of its iSave offering. Sites like DentalPlans.com can help you sort through all of your options to find the plan that works for you.
Dental discount plans vs dental insurance
When it comes down to it, it’s hard to compare dental discount plans and insurance on cost alone. You really have to compare them on what they cover.
For example, on DentalPlans.com, you can find an Aetna Vital Savings dental plan for $144.95 per year. The most affordable dental insurance plan on New York’s health insurance exchange for King’s County, with Dentacare, is $11 a month. But if you look at the plan brochure, you’ll see that "Adult molar root canals have very limited coverage."
However, the plan has an in-network cost share of $36 for "major dental care," but the dental discount plan starts at $29 for a routine checkup, and the cost only goes up from there. A root canal surgery starts at over $500 with the dental discount plan, but you’d have to do some digging to find out what it would cost with insurance.
If you want to learn about dental insurance and dental discount plans, check out our explainer here. We go into more detail and even some real-life pricing examples so you can see how both plan types affect your care.
The important thing to remember is that you do need to think about dental care. It probably won’t be included in the health insurance plan you bought, and it’s just as important to compare plans and shop around for dental insurance as it is with every other insurance type. Your pearly whites will thank you.