Dental work can be expensive especially when you need major work done. This leads people to believe that if they are not covered by dental insurance through their employers they should buy a private plan. But is it worth it?
We tell our patients to remember that these plans generally have annual maximums that could leave you with high copayments and not all procedures are covered.
Individual Insurance
Here is how individual insurance works. The company will charge you a monthly premium. Usually around $50 per month or $600 a year. They will provide a maximum $1,000 worth of coverage. Not all procedures will be covered at 100%. Meaning you might have to spend additional money out of your pocket to reach your maximum. Most plans only cover checkups and cleanings at 100%.
On a year where you only have two cleanings and x-rays one a year, you will most likely not spend the $600 premium. On a bad year when you need major work, crowns, root canals, or implants you will still end up with major out of pocket expenses. This is because after the insurance company pays $1000 they have no further responsibility.
Some people think they can wait and buy insurance when they know they need it. This is also a problem. Many of the plans have a “ waiting period”. This means that the insurance company will not pay for major work for one year.
For these reason we recommend to our patients not to purchase traditional dental insurance. Instead we find they do much better buying preferred provider plans. These plans provide in network fees for a very low premium and no maximum. Typically if you have 2 cleanings and x-rays one a year you will spend less then $500 a year. And with no maximum now matter how much work you have done the in network fees apply.