There are 2 primary reasons why I get insurance, when not legally mandated. One reason is to protect against a severely negative, rare outcome, often financially. An example, is protect against my home being destroyed in a fire. The home might cost over $1M to replace, which I wouldn’t want to pay out of pocket. This reason doesn’t apply as well to dental insurance, with the limited maximums.
The other reason is being positive expected value, often relating to having special information that the insurer does not. This could apply to dental insurance, if I know that I am at higher risk than the average person in my category. It can also apply, if the insurer has pre-negotiated rates that are lower than I’d pay without insurance. Positive expected value can also include psychological value, such as improved peace of mind.
I currently get dental insurance through my employer. I chose the $0 per paycheck option with $1k annual maximum instead of the higher cost plan with $2.5k annual maximum, as I expect the higher cost plan is negative expected value for me. If I didn’t get insurance through employer, I’d need to review the specific numbers to decide whether it is worthwhile for me.
I pay $12/mo for a dental plan that was offered as an option when I signed up for ACA medical insurance. There’s a low maximum for other work, but the plan more than pays for itself with just cleanings.
My insurance is 2K/yr max with three cleanings. I don’t want to pay for on my own, but since I’m retired, nobody pays it for me. Keep your employer sponsored plan as long as you can, as it isn’t cheap to pay for it yourself.
@rhododendron just wrote they pay $12 month - not sure if that’s one or two people - but in general, I’d think as they know you’ll get two cleanings a year - the insurance would need to cost more than that - or how would they make money? Maybe the state pays them a subsidy?
One contributing factor is encouraging the insured person to have regular cleanings leads to reduced risk of expensive claims, which can reduce the net cost to insurer over a large number of buyers. The insurer loses money in the short term on cleanings, but saves money in the long term on other procedures.
Another factor is insurance negotiated rates per cleanings are usually not high. A $12/month type plan that has 100% coverage without deductible likely requires you to go to specific in-network dentists that have negotiated rates, which are likely to be well under $100 per cleaning. Another factor is a good portion of insured persons do not use the 2 cleanings – either they chose not to or they are not eligible. For example, dentist may tell persons with periodontal disease that they need a different type of cleaning, which is not fully covered by insurance.
That is for one person. My only idea of how they make money is that many people don’t end up getting cleanings or using the insurance at all. Due to my life delaying an appointment by a couple months I will only get one cleaning this year, cutting the insurance’s cost in half.
Cleanings in my HCOL area are over $150.
My father dentist hopped for low priced introductory offers.
dang - makes you think my dentist has no machinery. We are well under $100 (negotiated rate with insurance) but I think the full rate is too - because I get 3 a year and pay in full for the third - and i think it’s $70/75.
Abnormal high cost dental cleanings can relate to using a different cleaning procedure that the insurance approved method. The majority of dentists in my area seem to add on some kind of additional step not covered by my insurance, without low pre-negotiated insurance rate.
As an extreme example, I tried a new dentist a few years ago that had extremely high marks on Yelp, Nextdoor, and among persons I knew. My expected bill for a regular cleaning with 100% insurance coverage was close to $1000. The cleaning emphasized several different services that were not covered by my insurance – lasers, something with resin, something involving water pic, … I asked if we could get the bill down to $300. Eventually they reluctantly agreed to not use lasers, and did the quickest and I suspect most incomplete cleaning I have ever had in my life. They also recommended that I schedule $10k in additional things that no other dentist has ever recommended or mentioned to me as issues (pulling healthy teeth to increase space, …). I did not return.
The dentist I went to after that covers my cleanings 100% with no charge to me after insurance and did not recommend any kind of additional work. They charge the insurance negotiated rates of well under $100 for cleanings. I live in a VHCOL area.
I live in CT in a VHCOL area. Everything costs more from haircuts to lawn service. $325 for the cleaning with the hygienist and the ‘exam’ by the dentist. Bitewing X-rays are another $100 or $125, I think.
I suspect this is on the high side, but I don’t want to change dentists at this point in my life. A couple of my doctors have stopped accepting any insurance, and I have changed from them but have not been as happy with the new providers.
Fluoride treatment is a huge money maker for dentists. Insurance doesn’t cover it for folks over 18 (Delta Dental through many employers). So it is $40 oop here for something of little value. Our water is fluoridated and we use fluoride toothpaste.
I said goodbye to a very good but expensive dentist who decided to supplement his business by hiring an aesthetician. Nope, I am not interested in Botox.