Individual Dental Insurance

Is Individual Dental Insurance Worth It?

Individual Dental Insurance
Individual Dental Insurance

Individual Dental Insurance is a dental plan that you get on your own, aside from your employer benefits. Most likely, you get individual  dental insurance when your employer doesn’t offer you a dental plan. If there is one thing worse than a visit to the dentist it is having to pay for the grueling torture inflicted upon your mouth. I honestly don’t know what is more painful; getting your teeth drilled or paying for cleanings, fillings, crows and root canals. I was one of the lucky ones, who stopped getting cavities after age 12, so I never considered private dental insurance a necessity for kids kids. Even then, I began asking myself, “Is private dental worth it?” Is any dental insurance worth it?

Individual Providers

Kids do get lots of cavities so at the average price of $100 – $250 per filling, I decided I wasn’t going to be without dental insurance. A good  individual plan covers up to 80% of the cost of fillings and provides free check-ups and cleanings after every 6 months. (That’s about $200 per child). If you don’t have kids and don’t get many cavities, there’s yet another reason to consider whether or not private dental insurance is worth it: All of those fillings you had as a child have likely started to weaken and cause cracks in the structure of your teeth. I’ve had three crowns since I was about 22 years old and my dentist says I will likely need about 3 or 4 more. At the uninsured price of around $1,000 each, this could get very expensive. And, that it’s only for me, not including the wife and kids. Face it, a mouth full of teeth is one of the most expensive liabilities we all share. Are Dental Insurance for Individuals and Family Dental plans, PPO Dental Plans, etc., worth the cost of having no Dental Insurance at all? To answer this question, I did some basic research. This is what an uninsured dental patient can expect to pay for the most common procedures at the dentists office:

Average Cost of Dental Procedures

  • Cleanings and Checkups: $80-$100
  • Tooth Fillings: $100 – $250 (Depends on size of the filling)
  • Ceramic or Porcelain Crowns: $1,000-$1,200
  • Root Canals: $600 – $1,400 (Depends on tooth type: Bi-Cuspids and Molars cost more than incisor, canine cuspid and eye-teeth)
  • Spacers: $300-$400

Even Individual Dental Insurance Is Worthwhile

With the risk of expenses like these for a family of four, I’d have to guess that Dental Insurance is worth it, but which Dental or PPO Dental Plan is best? My group plan at work is costing me about $500 a year for family coverage. In lieu of 4 or 5 crowns I am going to eventually need, $500 a year seems relatively small. So, private dental insurance is worth it too, especially if you’re at the age where previously filled teeth are beginning to crack and present the need for expensive crowns. And as you’ll see, Private Dental Insurance isn’t neccessarily any more expensive than the portion you’ll pay through a company sponsored dental healthcare provider.

Individual Dental Insurance vs. Family Dental Plan

I looked up the information on my Dental Plan through my employer. The cost for a family dental plan verses an Personal Dental plan is about a 3-to-1 ratio. I pay roughly $60 a month. Personal dental insurance through my company plan is about $18.66 a month. Still, for company sponsored Dental Insurance, these premiums seemed high to me. I did some quick research to see what it cost to get my own Dental Insurance Plan. A found a great website called, DentalInsurance.com, which offered me a complete Dental Insurance price quote within a few seconds of providing them my email. From a quoted list of about 20 different Dental and PPO Dental plans, I’ve outlined three different plans to get an idea of the typical coverage and costs. Whether you are Choosing a personal dental plan or a Family Dental Plan, the costs and premiums are indicated below for each of the three plans. Note, these Dental Insurance Plans do not reflect any discounts you might get from a company Group Dental Plan. My own Company Insurance is nearly identical to the Ameritas Access 1000 plan. My monthly expense for being signed up in this plan is around 45% of the $134.00 cost that an individual would have to pay without group Dental coverage at all.

Family and Individual Dental Insurance Plans Sample

Patriot Dental Plan (Gold Plan 15) Cleaning Filling Crown Root Canal
Amount you Pay $39.00 $61.00 $534.00 $428.00
Premiums
Individual Premium $7.95
Family Premium $15.95
Beta Health (Alpha Dental Plan)
Amount you Pay $18.00 $48.00 $357.00 $374.00
Premiums
Individual Premium $14.25
Family Premium $34.25
Ameritas Group (Access 1000)
Amount you Pay $0.00 $35.00 $500.00 (50%) $400.00 (50%)
Premiums
Individual Premium $44.94
Family Premium $135.24

Plans like Ameritas Access 1000 provide 100%-paid dental checkups and cleanings.  If you’re a young invidual with a high number of cavities or head of family household, you’ll save money on fillings and regular dental checkups and cleanings.  Crowns are typically $500. These plans come with a steep premium, few people without a company group dental plan will consider paying $135 a month for family dental insurance.   My own dental plan, similar to the one above, is costing me $60 per month. This is considerably more than I would pay for one of the other two plans. When I discovered this I began to seriously wonder whether or not I would be better off with an individual plan over a company group plan. In order to get to the bottom of this, I decided to devise a spreadsheet based on my current situation and needs over a five year time span. Despite the fact, my current group dental plan includes 2 cleanings per year, most of my own family only use it once a year. I stress daily flossing and good brushing. Once a year for a dental checkup is very reasonable in my opinion. Twice a year, is a tad bit excessive. My children are past the high-risk cavity stage and both my wife and I rarely require fillings.  So, given these facts, I made a rather conservative calculation of the dental needs of our family of four over a 5-year period:

Family Dental Needs over 5 Years

  • Total Number of Checkups/Cleanings: 20
  • Total Number of fillings: 5
  • Total Number of Crowns: 3
  • Total Number of Root Canals: 1

The Chart Below compares the costs, including premiums for five years of personal insurance, vs. Group Dental Coverage , vs. having No Insurance at all.

5 Year Estimate Family of Four
Dental Plan Cleaning Filling Crown Root Canal Premium Total
Patriot Dental Plan (Gold Plan 15) $780 $244 $1,602 $428 $957 $4,011
Beta Health (Alpha Dental Plan) $360 $192 $1,071 $374 $2,055 $4,052
Ameritas Group Invidual $0 $140 $1,500 $400 $8,100 $10,140
Ameritas Access 1000  Group $0 $140 $1,500 $400 $3,600 $5,640
No Insurance $1,600 $500 $3,000 $800 $0 $5,900

As you can see from the chart above and based on the five year estimate of my family’s dental needs, I would pay less money if I drop my company sponsored Group Dental Plan in favor of a personal lan with either Patriot Dental Gold Plan or the Alpha Dental Plan by Beta Health.  The high-premium Insurance Plans provide high maintenance coverage in the way of teeth cleanings, checkups and fillings, but don’t do any better than these other plans when it comes to expensive Porcelain Crowns and Root Canals.  In fact, the cheaper plans pay a little more for the more expensive Dental Work.  The most alarming discovery is that my $60 per month premium is almost going to cost me as much after 5 years than if I had no insurance at all! The bottom line is that Dental Needs are very different for all families and individuals. Before you make a decision on a Company Sponsored Group Dental Plan or an Invidual Dental Insurance Plan, it is important to assess your needs and choose accordingly.  Don’t assume that just because you’re company is paying for half of your dental insurance, that you are saving money.  I plan on taking a closer look at the costs of the various Individual Dental Insurance Plans, and will be posting a review on the one I chose in a future column.

Update: Affordable Personal Dental Insurance Plan

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