Why do I Have Dental Insurance? Why do I need Dental Insurance? I don't Understand Dental Insurance?

Published on November 6, 2014 by Dr. Joe Jankowski

As a dentist I have been practicing for quite some time and I have had the opportunity to talk with patients and the staff about the frustrations dealing with and understanding dental Insurance.  

I would like to share with you some of what I have learned and try to explain what is going on.  First, dental insurance is very different from health insurance.  Health insurance is provided to cover routine and preventative medical needs but specifically is there for some catastrophic event such as a major surgery and/or life threatening event that the average person could not pay for otherwise. You have the insurance mainly for the one time you need it and hope that doesn't come for a very long time.  Like homeowners insurance where you pay premiums year after year without a claim and hope the house never burns down! Dental insurance is very different in that it is there to help pay for a set amount of benefits and that's it! I can't think of the last time someone died from not going to the dentist. Your employer sat down with a dental insurance company representative and decided what the company wanted to provide for the employees as a benefit. The more money the company spent, the better the plan. Two people with the same insurance company, but have different employers will have different plans with different coverage, waiting periods and reimbursements. This makes it hard for the dentist staff to discuss money when there are so many differences. We then have to research each patient individually. Many patients are fortunate to receive benefits from their employer which is what dental insurance is. The amount of dental benefits has not really changed since the 1960's. $1,000-$1,500 does not pay for much more than preventative procedures and basic care such as fillings and maybe a crown.

Many people know they have necessary dental work that needs to be done and they say to me "I am waiting until I have dental insurance.". People need to realize that there are waiting periods before any benefits are provided and usually major work is not covered for the first year. The insurance companies only stay in business by keeping some of your money.  Most people are better off taking the dental insurance if the employer offers it. Think of it as a coupon for $1,000-$1,500 with restrictions for redemption. If your employer doesn't offer dental insurance, look into health savings accounts and flexible spending accounts if you know you're going to be incurring major dental bills such as major rehabilitation such as wisdom teeth or orthodontics. 

Insurance companies do their homework before they offer plans to your employer or individuals. They can be vague and misleading in what is and what is not covered. Most people do not like surprises. We do our best to send pre-estimates and to check and verify the patients insurance benefits. My best advice with insurance is to do your homework, read the literature that you receive when you get your insurance.