You have been happy with your dental health. Then, one day, you develop a painful toothache. It hurts to sip a glass of water, and you have a tough time focusing because of the pain. You know it will not get better on its own. You need a dentist, and you wonder about the cost.
The answer varies depending on whether you have dental insurance and what is covered. Some dental insurance plans might just cover preventive care, but others will cover treatments like crowns and oral surgery.
You question whether you need dental insurance. You can get by without it, but this comes with some risk. It is usually worth it to have dental insurance. Depending on your specific needs, you might not need a plan with comprehensive coverage. Dental insurance aside, you should not ignore problems with your mouth, teeth, and gums. Oral health issues will get worse without treatment and can lead to more costly medical problems.
What You Should Know About Dental Insurance
Some types of insurance, like car insurance, are there in the event something bad happens. But dental insurance is also designed to keep the worst from happening.
Here is how dental insurance works. You pay a monthly amount, a premium, and your plan covers a portion of the cost of your care for the year. Plans vary based on the insurance carrier and plan options. But dental insurance usually covers all preventive care, such as checkups, screenings, and cleanings. Other elective services can have various levels of coverage.
Here are the Terms You Should Know
- Premium- Your monthly payment to be enrolled in a dental insurance plan.
- Deductible- The dollar amount you need to pay towards your dental care before your benefits begin for the year. For dental plans, this is usually between $25-$75. Preventive services are covered before you reach your deductible.
- Coinsurance- The percentage of the service cost you pay after you have met your deductible. Your coinsurance for a root canal may be 20% or 50% of the cost.
- The annual maximum- The most your dental plan will pay for in a single year. After this point, you are responsible for 100% of your dental expenses.
How Dental Insurance Pays for Itself
If you maintain your preventive care appointments, dental insurance pays for itself. If you need additional dental care, you will see the value of having a plan.
To understand, let us start with a monthly premium. If you pay $40 each month, that equals $480 per year.
With this, you usually get two checkups covered at 100% each year. Without insurance, these two visits alone can cost between $400 and $500 out of pocket. But the value of dental insurance does not stop there, since most plans cover a portion of the cost of other dental procedures.
Dental insurance can prevent advanced dental care. Regular preventive checkups help keep your teeth and gums healthy, decreasing the risk of developing serious problems that can be expensive to treat. Your oral health is tied to your overall health, so your dentist may be the first to identify other health conditions.
United Healthcare Copays, Deductibles, and Coinsurance Definitions