If it’s been a while since you’ve been to the dentist, you’re not alone. According to the Centers for Disease Control, approximately one-third of Americans have not seen a dentist in the past year. Although most people are aware of the importance of regular exams and cleanings, many people struggle to afford to pay for an exam. Dental insurance is offered by many employers, however, you’re not out of luck if yours doesn’t or if you’re self-employed because individual plans are readily available.
According to the National Association of Dental Plans, approximately 74 million Americans had no dental coverage in 2016. Around 77 percent, or 249.1 million people, had private dental insurance, with around 90 percent receiving it from their employers. Roughly 83.9 million people receive dental coverage through public programs like CHIP and Medicaid while around 7.1 percent of people have purchased individual coverage for themselves.
Without dental coverage, making it to the dentist regularly is easier said than done. If you lack coverage, you may be surprised by just how affordable it can be. Read on to learn more about the benefits of having dental insurance.
The Benefits of Having Dental Insurance
Going without dental insurance can negatively affect your health by making you reluctant to visit the dentist on a regular basis, which is a crucial part of maintaining proper dental health and hygiene. The savings that it provides makes undergoing routine exams and cleanings more affordable, and it also makes it easier to know what to expect for budgeting purposes.
The average price of a typical individual policy cost around $350 a year. Dental plans have deductibles, which is the amount that you must pay out of pocket before the plan starts to pay. Other out-of-pocket costs may include co-payments, co-insurance, and any expense that exceeds your plan’s annual maximum.
The vast majority of dental insurance plans follow the ‘100-80-50’ billing model. Preventative care and cleaning services are covered at 100 percent after the annual deductible has been met; fillings and other non-routine care services are covered at 80 percent; major work like bridges and crowns are covered at 50 percent.
Examples of the types of routine care that are usually covered at 100 percent include:
- Exams
- Cleanings
- Fluoride Treatments
- X-rays
- Sealants
Examples of non-routine care services, which are typically covered at 50 to 80 percent:
- Cavity Fillings
- Tooth Extractions
- Periodontal treatments
- Bridges
- Dentures
- Root Canals
- Emergency Services and Anesthesia
Dental plans often vary in the frequency at which they will cover certain services. For example, most plans cover cleanings and exams every six months, but some cover them three times per year or only one time per year. Many plans cover full-mouth X-rays once per year, but some only allow them every three years or so.
It is also important to understand what is not usually covered by dental insurance plans. These types of plans don’t usually offer any coverage for cosmetic services like teeth whitening. They also usually exclude services that are typically covered by medical insurance plans; oral surgery is a common example. Many providers offer multiple plans, and some more comprehensive plans may include coverage for orthodontia. However, such plans tend to cost more on average.
Dental Insurance Options
It’s important to do research before enrolling in a dental insurance plan. Compare and contrast various aspects of top plans on your list, including how many dentists are included in the plan’s network; whether you are allowed to see out-of-network dentists; whether there is a waiting period for certain services; and the annual maximum that the plan will pay.
For your convenience, here’s a rundown of five of today’s most popular dental insurance plans:
Delta Dental: With plans averaging between $16 and $27 per month per person, Delta Dental is an affordable option to consider. The plan imposes no waiting periods, and there are more than 140,000 dentists in its network. Some advantages of this plan include the fact that maximum prices are set for many procedures, so there’s no guesswork; there are several policies to choose from, and orthodontic services are covered on some of the policies.
One of the biggest drawbacks of this dental insurance plan is that it is not offered in several states or in Puerto Rico. If it is available where you live, however, this may be the best option in terms of coverage and price.
Cigna: Dental insurance plans from Cigna average between $31 and $35 per month, so their plans are a bit on the pricier side. However, your premium covers the entire cost of exams, cleanings, and X-rays two times per year. There are only around 87,000 dentists in its network, but the plan does provide coverage for many out-of-network dentists. There is a waiting period, but it can be waived for many reasons. You can take your pick from three plans, including one that offers limited coverage for orthodontia.
Perhaps the biggest drawback of this plan is that it is not available to residents of New York or Washington State.
AARP: Regular dental cleanings and exams are of particular importance to the elderly, so it is convenient that AARP, the organization that is available to Americans aged 50 and over, offers dental coverage. The AARP dental plan is a standout in that it covers three cleanings per year, which is great for seniors.
However, it is also among the most expensive dental plans around, with premiums averaging between $42 and $67 per person per month. Administered by Delta Dental, the plan’s network includes more than 140,000 dentists, and you can use out-of-network dentists as well. However, coverage for out-of-network dentists may not be as comprehensive, so you may be responsible for paying the difference out of pocket.
Aetna: Aetna primarily offers its dental coverage through group plans, which you can only join through participating employers. However, it also offers individual plans in five states: Alaska, Arizona, Delaware, Illinois, and Pennsylvania. If you live in one of those states, you should agree that the monthly premiums, which average between $25 and $33, are quite affordable. Another advantage of Aetna is that its Premium plan covers the entire cost of preventive cleanings, exams, and X-rays, which makes it easy to budget for annual dental expenses.
There is no enrollment fee, but a six-month waiting period may apply for some services. Typically, these are pricier services, and the waiting period is designed to prevent people from buying a plan and dropping it quickly after receiving necessary services. With 205,000 dentists in its network, Aetna offers unparalleled coverage—and the plan will even cover up to 80 percent of the cost of denture repair.
MetLife: For as little as $23 per month, you can purchase an individual dental insurance plan from MetLife. The plan allows you to choose from a network of thousands of dentists, and it also allows you to visit any licensed dentist that you want. Orthodontia coverage is included with the comprehensive plan, which costs closer to $40 per month but is still an affordable option for families with kids who will need braces. After the $50 annual deductible per person has been met, the plan pays for cleanings and exams every six months and for full-mouth X-rays every 36 months. For some services, a waiting period of six to 12 months may apply.
When it comes to caring for your dental health, brushing and flossing twice per day isn’t enough. Regular visits to the dentist are a must, and the right dental insurance coverage can help to make them more accessible and affordable. Do your own research to learn more about today’s most popular plans to identify one that suits your family’s needs the best.