Over the years it has been common for us to be asked about the value of private individual dental insurance plans. Patients who have no dental insurance think about this as an option to paying for all the fees on their own. These plans tend to be a compromise to the group plans often offered by employers. The decision on purchasing one of these plans is an individual one; however, as indicated, these are a compromise.
For the lower premium plans, patients may have the option to pursue their own dentist even out of network. These plans may also pay quite a bit for preventive services. However, the compromise may be that these plans may cover considerably less than 80% of the fees for x-rays. Another compromise is that these plans may contribute a small amount for basic services like fillings and extractions. Moreover, these plans may not contribute payment towards major procedures like crowns and implants for a few years.
Another example can be a more moderately priced plan. In these plans deductibles may be lower, all preventive services may be covered at about 80% of the fee or better, and both basic and major services may be better covered. These plans may steer patients towards selecting an in-network dentist for richer benefits. These in-network dentists obtain marketing and referrals to their practices from the insurance companies in exchange for accepting considerably lower than market fees. While this may seem “fine”, these dentists in accepting lower fees must make business decisions in order to squeeze out more of a profit. These decisions may decrease the quality of care or the accessibility to care. Patients must understand there may indeed be compromises when accepting care from in-network dentists.
Another alternative is a richer more expensive dental plan. These plans may offer even lower deductibles and perhaps may eliminate or severely decrease co-payments. All services may be covered to a degree. These plans are somewhat vague when describing the discounts actually available. These plans may also require patients to select an in-network dentist for all services. Again, the quality of care and accessibility to care may well be compromised by selecting an in-network dentist due to their accepting generally significantly lower fees for services.
So should people consider obtaining one of these plans? Again, this is a personal choice. My recommendations are to find the details to what is offered by the plans, obtain information about individual in-network dentists from online reviews, calculate how much your annual premiums are and how much you think you would spend with deductibles and co-payments and compare that to how much you spend without any dental insurance at all. From there you can determine if there are adequate amounts of savings with the dental plan you are looking to purchase. Is the cost savings worth the potential compromises?
If you need help with terminology or coverage we invite you to contact us. If you are interested in experiencing our unique delivery of dental care at a value, we invite you to contact us at (972) 250-2580, or you may contact us in any manner you see available within this web page.