Thursday, January 9, 2025

The Reality of Dental Insurance vs Dental Plans

 



Last week, I was checking out health insurance on the marketplace for my spouse and I. As we were choosing our coverage we decided to take a look at the dental insurance being offered. I was astonished at what I saw. Now, I remember the days of updating our comparison zone on our website, and having to gather all of the data from dental insurance companies to make sure it is accurate, however this was different than that. When I was gathering data, was more of a routine thing and I was not really comprehending the full data that I was gathering. However, when I was looking at dental insurance from the perspective of a consumer, it was a whole different view. As a businessman, I am a numbers guy. Numbers is the language that gets my attention. So I decided to run the numbers and what I found, I put in the video above.

As we perused through multiple policies offered, the cost, the waiting periods, covered procedures, and exclusions, the numbers just did not make sense. My spouse asked "why would anyone sign up for this". I responded, "because it's insurance, and people automatically assume it's better. Most people do not read the whole policy. They see the $45 dollars a month, and the 2 free cleaning a year, and run with it." Little do they know that if they need a root canal, it's either not covered, or you have to wait 12 months before it is. Even then, most of them that I saw only cover 30%-40% after the deductible. If you need a filling, you have wait 6 months.

When it comes right down to it, dental insurance companies will always put profits over the patients. They will collect as much as they can, get the patient to pay as much as they can, and cover as little as possible. Even if it means denying coverage on medically necessary dental procedures, which as I did not see one policy that even covered it. Most of the money that you pay for dental insurance, stays with that insurance company. You pay a lot more that what they are paying out. As my dad says "They are in the business of collecting premiums, not paying claims". That statement hold true, and if you look at the policy disclosures, you will see it.

We hear it all the time that "discount plans" are sub-par coverage. However when you break down the numbers, you get more benefit from a dental plan, then you do from dental insurance. We also hear that "discount plans" cost you more at the dental office, because you have to pay out of pocket. It does appear that way, however if you look at what you are paying to the insurance company each month, during the waiting period, the deductible, the maximum out of pocket, the full price on non-covered procedures, and take into consideration that after you exhaust the "$1,000" coverage cap, you have to pay full price; then it evens out. It basically comes down to do you want to pay on the front end for your dental work, or do you want to pay on the back end of it and have most of what you pay go to an insurance company who at any time can deny your claim and make you pay more.

Needless to say, my spouse and I hit decline on the dental insurance as we had intention of signing up for it to begin with, especially because we have our plan. I would however, invite everyone of you to run the numbers and see what you are actually getting for your hard earned dollars when it comes to dental insurance!

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