Dental Insurance: To Have Or Not To Have
And like so many other questions in modern world, you need to say, "Well ... the depends." The answer depends on whether you are expecting to face aching bills for your teeth.
Dental insurance comes in four varieties:
- The HMO, or health maintenance organization, option restricts coverage to dental professionals within a specified network.
- The most popular plans are PPOs, or preferred provider organization, policies. Some 70 percent of dental policies are PPOs. They are similar to HMOs but allow patients to see dentists outside the network.
- An indemnity plan which allows a patient to see any dentist and picks up a percentage of the costs. The advantage of PPOs over indemnity plans is that here's a negotiated discount for services. Dentists within the PPO network typically agree to accept lower fees and can't bill you for the difference.
- Discount plan which charges an annual fee in exchange for discounted services from network providers. Enrollment fees often run between about $80 and $120 a year. Providers' discounts can range from 10 to 60 percent. Before buying in, be sure to take a careful look at what the plan covers. There is often a lot of restrictive fine print. Although these plans typically cost less than HMOs and PPOs, most often they won't save you as much money in the long run.
Dental policies vary widely, and choosing the right one can be difficult. People with dental insurance commonly have what's described as "100-80-50" coverage, meaning it pays 100 percent of the cost of routine preventive and diagnostic care, such as checkups and cleanings; 80 percent for fillings, root canals and other basic procedures; and 50 percent for crowns, bridges and major procedures.
The vast majority of coverage is provided through employee and group policies, with annual premiums of between $235 and $435 per person. The cost to buy an individual policy averages about $360 a year. Paying out of your own pocket for two exams and cleanings and a set of X-rays would cost about $370, on average, according to the American Dental Association.
Most plans cap coverage at $1,500 a year, although higher annual limits can be had by paying a higher premium.