Often I am asked the question, “Should I buy individual dental insurance?” The answer is simple.
YOU SHOULD GET INDIVIDUAL DENTAL INSURANCE IF YOUR DENTIST IS IN THE NETWORK AND YOU GET REGULAR CLEANINGS!
Let me further explain this answer. If your dentist is in the network, then your cleanings and x-rays will be generally be covered in full, and you will have no balance! When you use an out-of-network dentist, the insurance company pays your dentist what they consider to be the cost of the cleanings and x-rays, and your dentist bills you for the difference. Here is a great example:
I use an out-of-network dentist and I have an individual dental plan. I went to my dentist and got a routine dental cleaning. After the insurance company processed my claim, they paid my dentist $40. The dentist actually charged $90! I had to pay an additional $50 to my dentist for the cleaning! This was an incredible disappointment as I pay $25/month for the dental insurance! (I know that I am using a lot of exclamation points here). Had I used an in-network dentist, they would have accepted the $40 and I would have no balance from the dental office.
The second condition for deciding if you should buy an individual dental insurance policy is, “if you get regular cleanings.” Dental policies will allow you to have cleanings and x-rays covered once every 6 months. They will pay 100% of these preventive services when using an in-network provider! This is also what most dentists recommend, so getting your preventive services twice a year is key. Since cleanings and x-rays cost about $150 per visit and visiting your dentist twice a year is recommended, then you can easily have $300 in preventive services in a year. If you buy an individual dental policy for about $25/month, you break even by just getting regular cleanings! With most policies paying 80% on basic restorative service and 50% on major restorative services, you actually come out ahead if you have any dental work outside of your normal cleanings and x-rays!
There are a few other things to know about an individual dental policy other that what I just posted above, but if you follow this principal, then you can’t go wrong in your decision on whether to buy individual dental or not. Remember, YOU SHOULD GET INDIVIDUAL DENTAL INSURANCE IF YOUR DENTIST IS IN THE NETWORK AND YOU GET REGULAR CLEANINGS!
Sidenote: When you buy an individual dental policy, there is usually a 6-month waiting period for basic restorative services (like fillings) and a 12-month waiting period for major restorative services (like crowns). So, don’t wait unitl you have serious dental issues before buying a policy. THIS WON’T WORK. To find out more about individual insurance policies contact us. We will be glad to help.
