Dental Insurance

            Dental insurance, what to make of it? The thought of paying in advance for a product sounds good especially when the product arrives and no payment is required. It feels almost like a gift. However, dental insurance does not always pay off the way people hope. If you are employed and your employer provides health insurance, congratulations! You are among an ever decreasing number of people who receive such benefits. Also, you probably received a dental insurance rider. Double congratulations! You will get assistance in paying for dental care for you and your family.

            If you notice I did not say you get insurance but assistance. That is really what dental insurance is. Let me explain. When you hurt yourself, say you break your leg playing soccer, you expect your health insurance to pay to have your leg repaired. There may be deductibles and co-pays but the insurance will pick up whatever costs there are and rarely questions how the physician intends to fix your leg. In dental care, it can be quite different. Say, for example, you broke a tooth and your dentist determined that the best way to fix it would be with a crown with a cost of around $1200. Okay, you figure the dentist will do the crown and your insurance will pay for it excluding deductibles and co-pays. Not so fast. Insurance companies routinely ask the dentist for pre-operative Xrays and a narrative explaining the need for a crown. Then, they have the right to deny it if they do not feel it is necessary. Why, you wonder, would my dentist do something I did not need especially after he or she showed me the fracture and I could see the need for the crown? The truth is that it’s just a ploy by the insurance company to delay payment. Even after the crown is approved and paid for, most insurance companies only pay 50% of the cost so you are stuck with a big bill.

            If dental insurance is included in your employee benefits, it’s worth it to have it. However, for retirees it almost does not pay to carry dental insurance. The premiums, deductibles, co-pays and yearly maximums (the amount the insurance company will pay in a year), make the cost of insurance very expensive and most people are better off going without dental insurance. Also, those plans have strict limits on what is covered. So, why do we have dental insurance? It was originally a low cost add-on to health insurance and provided a benefit to employees and their families. Employers could provide their employees with an extra benefit that would help pay for dental care. As time went on, it became a profit center for insurance companies and the benefits were reduced year by year while premiums increased.

            The truth is that many seniors will need quite a bit of dental work after they retire. As we age, our general health declines and with it dental health declines too. For them, dental insurance is a false promise. The restrictions especially on retiree dental plans are so severe that most people are usually disappointed with the poor coverage they have. So, my advice is to save the premium dollars, put the money into an separate account and use those funds as needed to pay for dental care.