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Dental Insurance is a Rip Off

 

paying for dental care

One of the worst things about self employment is insurance or lack thereof. After taking my daughter for her back to school dental visit and coming home with $125 less in my pocket, I decided to look into dental insurance. Maybe with all the recent changes in health care, there was a new affordable plan that might save money? Unfortunately, I came to the same verdict as I did after checking a few years ago, dental insurance is a rip off.

If you are self employed or if your work doesn’t offer dental coverage, you can pick up an individual plan. I did not check every plan known to man and the cost varies by area, but I bet they are pretty similar wherever you live.

Cost of Dental Insurance

Looking at ehealthinsurance.com, Humana offers the cheapest plan at $37.98 per month or $455.76 a year for one adult and one child, non tobacco users. So what does this plan give us as far as benefits?

Well, we get up to two free cleanings and one set of bitewing x-rays per year. Sweet! We already do that anyway. That sounds great to get it free, until you look at our annual dental out of pocket expenses without insurance, which are around $371 per year. By having insurance, I would be in the hole $84 for routine dental care.

Coverage for Dental Problems

Am I right that nobody buys insurance for the preventative care but for things that go wrong? I bet dental coverage would be a smart move if I had a cavity. Let’s take a look.

The classic plan covers fillings at 50% after a $150 deductible. I’ve never paid more than $150 for a filling, so I guess I’d need lots of cavities to come out ahead.

I’m sure I’d be glad for my dental insurance if I needed something major, right? Not exactly.

For crowns (prefabricated stainless steel only), the plan pays 50% after the $150 deductible is met. That sounds pretty good because I know crowns can run around $1,200 each. But wait, stainless steel crowns are generally only used for children’s primary teeth or as a temporary measure until a permanent crown can be made from porcelain or other metals. Prefabricated crowns are not custom made and do not hold up in adults over time. So I would still be out $1,200 for my permanent crown or I would have a temporary one that would need to be replaced several times.

Enhanced Dental Plans

An enhanced plan can be purchased for $82 per month. The enhanced version only has a $50 deductible and they pay half on crowns, fillings, and other common dental procedures. It also looks like I can get coverage for a high quality crown, with one big exception.

The most important part of the fine print for both the classic and enhanced plans should be in big bold letters. No matter which dental plan, the annual benefit maximum is $1000!

For that Cadillac plan, I will be paying $984 per year in premiums plus my $50 deductible while the insurance pays out $1000 total. Do they market these plans for people who flunked 8th grade math?

No Buying and Cancelling After Dental Work is Done

A couple of other notable rules:

  • You have to buy the plan for a year.
  • There is a six to 12 month waiting period for major procedures like root canals or crowns.
  • There is a limit of two crowns or root canals the first year and one per year after that.

Forget signing up for and then cancelling a policy after getting a tooth fixed!

What’s a smart person to do?

Take Care of Your Teeth

There are people who have genetically crappy teeth or suffer from accidents, but the need for major dental work is most often caused by lack of cleaning and routine dental care. Brush, floss, don’t crunch on ice, avoid cigarettes like the plague. Seems simple, but from having a sister who is a dentist, I am amazed at how many people don’t brush their teeth regularly!

Get Routine Dental Care

If you catch a cavity early and have it filled, there is no need for root canals and crowns. When something is wrong, get it fixed. Denial is almost always more expensive over the long run.

Self Insure

I probably hear a couple of people a month say that they can’t go to the doctor, optometrist, or dentist because they have no insurance. Insurance is not a requirement. Doctors love self pay patients and might even give a cash discount for not having to fool with filing an insurance claim.

Instead of paying $30, $60, $90 a month to a dental  insurance company, put that money into a savings account. Use a HSA if you have one for extra tax savings. By the end of the year, you’ll be able to afford paying for dental visits.

Look for Coupons or Discounts

I often get coupons in the mail urging me to try out a new dentist for a big percentage off. Groupon is also a great place to look for discount dental rates. I like the dentist I have now and hope I don’t have to change, but if money was tight, you can bet I’d switch if it meant significant savings. Another option is to ask your dentist if she will match a competitor’s ad. It’s easier to keep established patients than find new ones, so there is a good chance your provider will offer the same discount as the office across town.

Think Outside the Box

If you don’t mind spending extra time in the chair, dental schools can be a cheap place to get extensive dental work done. You will be treated by a student or resident who is supervised by an on staff dentist. My sister did all kinds of difficult cases when she was a dental resident. It was a win win for students and patients.

If you have a particular skill that might be of value, ask your dentist to barter. Maybe the office needs a new website or a new coat of paint. You never know until you ask. Just make sure you are actually skilled in what you’re offering for trade.

Another option that I’ve seen recommended is going across the border to Mexico. I don’t know if I would have the nerve, but I see all kinds of signs for cheap dental work when we drive to San Diego. Just remember that even if the dentist is well trained, other countries don’t have the same strict rules as the US regarding malpractice and standard of care. This can be good or bad.

I guess dental insurance won’t be in the cards for my family. Even with Jim’s group plan, the rates and coverage are very similar to what I found online. That doesn’t mean we won’t get great dental care, it just means we won’t get ripped off by buying dental insurance.

Do you believe dental insurance is worth the money? How much do you pay for dental care, with insurance or not?

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About Kim Parr

Kim Parr is a private practice optometrist, freelance writer, and personal financial blogger. You can follow her journey to 20/20 financial vision at Eyes on the Dollar.

23 comments

  1. I think you know my answer to this. 🙂 It was great when I had it when my old company paid for it, but it’s a little like pet insurance…it’s just better to have a savings bucket with money allotted to that particular care because then you’re not paying a premium, and you’d still have out of pocket expenses anyway so why bother?

    • Pet insurance is another one I consider a huge rip off. I wonder if there are more providers in larger areas. No one even takes it where we live.

  2. We’re in the same boat Kim. I thought when I left my job we’d be able to get dental insurance for not much at all and boy was I wrong. We go the self-insuring route ourselves and use our HSA when we need to go. Thankfully we have a really good dentist that we’ve gone to for years that gives us a discount if we pay upfront and will discount other things for us slightly. Every little bit helps!

    • We get cash discounts fairly often, especially for when we need x-rays. As a provider, I know it’s usually worth 10%-20% for not having to file a claim and wait for payment.

  3. We didn’t have dental insurance all through grad school. I think there was a supplementary plan offered, but as you laid out, it wasn’t worth it for routine care. We also found out that our health insurance offered a dental discount plan, so that is something else to check for. Basically, by giving our health insurance information to our dentist, all the procedures became 40-50% off the listed price! We started saving up cash for our twice-yearly visits and just paying out of pocket. After the discount, I’m sure that was far less expensive than having a dental plan.

  4. Given that this is my field, I SO get this. People do not understand that by having your exams/cleanings every 4-12 months (depending on a few factors) you can save thousands via prevention. And you’re right, pay the $$ out of pocket for these things, eat a good diet to prevent needing restorative work done to begin with. If you’re only needing cleanings and the odd filling or whatever then yeah its a waste of money but if you’re prone to needing heavy work done (My patient with Sjrogens syndrome comes to mind) then it’s probably worth it…but a much better plan. Also..this plan does suck, just for comparison out dental is covered under hubbys work ins and it covers 100% basic stuff (cleanings/fillings/extractions) and 80% major (crowns/bridges etc) no deductible to a combined max of $2.000 per calendar year.

    • I think in some situations, there probably are plans that make sense, but for most of us who get cleanings and x-rays plus the occasional cavity, self insuring just makes more sense. I view my six month dental visits as an investment in my long term health.

  5. This is a helpful post! We’d imagined that we’d look into dental when we retire and no longer have employer-paid dental coverage, but didn’t imagine the answer would be: No way, Jose! What a lousy deal!

  6. I have never run the analysis, but I always feel like we lose on dental insurance. I honestly have no idea what our coverage pays for since we always seem to have dental bills. We just make it a point to use our HSA to coverage dental bills including the big ones we will have soon now that we found out our son needs braces. 🙁

    • We are going to need braces too! It’s a bummer, but I’m glad to be able to do it while she’s young. Growing up with crooked teeth can be a real self esteem killer.

  7. Dental insurance is not a rip off – it simply is not a handout. It is an insurance plan like any other. The majority of healthy participants subsidize the minority needing the benefits. The waiting periods prevent adverse selection (people buying the plan, soaking the company for benefits, and then canceling).

    The annual benefit maximum is per person, so my 8th grade math supports the numbers for people who need dental work – especially if they can pay the premiums with pretax deductions at work. A Flexible Spending Account is another option for people with predictable routine dental care needs.

    • A flex plan or HSA is an excellent way to take care of dental care. The plans I studied were $1000 max. I’m sure there are some wonderful group plans and if your employer picks up part of the premiums, it could be a good deal. For self employed people, I still think it’s a rip off.

  8. I just changed jobs and didn’t buy dental insurance. My usual plan is to schedule my routine cleanings right before open enrollment and if I have some huge issue (I never have), then I’ll get dental insurance starting in January. Like you, if I just need some cleanings, x-Rays, and a cavity filled every couple of years, I don’t need to pay for insurance.
    That said, I learned that you may get what you pay for with those cheap chain dentists. I went to one and ended up needing a couple fillings (two teeth but the cavities were facing each other so I guess I missed something in my brushing /flossing. Anyhow, the tooth below the fillings hurt so badly a day afterwards that I thought maybe I had a cracked tooth. Apparently she didn’t shave the filling down enough. The dentist took x-Rays of the area and the fillings were huge for what was described as a very small set of cavities. That will cost me in 20 years when they need to be replaced and that’s a bummer. Next time I’m going to find a dentist who has good reviews and may not be just out of dental school.

    • I think there are good providers and bad ones, usually irrelevant of how long they have been out of school. That being said, it’s pretty easy to get hired at a chain anything, although I’m sure there are some excellent dentists who work there as well. You do have to be worth your weight to work in a private office or specialty practice, so even if it’s more expensive, I guess there is less risk of something like that happening.

  9. If you are fortunate enough to live near a dental school, you can have work done (supervised) by dental students at very discounted rates. I am a San Francisco native, and UCSF has one of the best dental schools in the world. People who can well afford to pay full price for regular dental work go here to get the latest and greatest done to their teeth by final year students, carefully supervised by faculty.

    When I was 15, my dentist noticed that my gums were receding. He wanted a friend of his, a man who is a world renowned periodontist and who was on faculty at UCSF, to examine me. I saw Dr. Superstar, and he informed my parents that I did indeed need gum graft surgery, and that because my case was a bit odd, he wanted to do the procedure himself as a teaching exercise for his students. It would all be done at no charge whatsoever. I got my gums operated on by Dr. Greatest in the World, and my parents were saved somewhere in the neighborhood of $10,000. A very good situation for everyone!

    • That is very cool. As I said in the post, my sister was a dental resident at one time and did all kinds of difficult stuff on patients for cheap. She was always as good as an experienced dentist but still had the experienced dentist right there if there was a problem.

  10. Good tips on dental care insurance and coverages. I always seem to cringe before spending big bucks on dental care, as long as no pain or major issue is there you can always wait a bit. Insurances are every day getting people to get less and pay more.

  11. When I got my first job, I signed up for dental insurance. While the out of pocket of the insurance wasn’t too bad, it was a complete waste of money. After I visited the dentist for my checkup, my insurance only covered about half the cost.

    Sounds OK but when I did the math, my premiums totaled more than they covered for my treatment! During open enrollment the following year, I canceled the coverage.

  12. I have reached the same conclusion many times! Most dental policies in my area seem to have low payout limits too. So they really wouldn’t cover you in the event of an emergency.

  13. Dental insurance is pretty cheap through my employer–even still, I only started carrying it this year. Lucky for us, though, because my husband and I both got cavities for the first time ever in our lives this year. The copays were still a little high, but I was glad to have the coverage.

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