Dental Insurance – Pros and Cons: Dental Plans to Help Maintain Healthy Teeth and Prevent Gum DiseaseYL Authors
Dental examinations are free in Scotland and 80% of dental care costs are paid for by the state.
Dental treatment in England is only free for those under 18, in full-time education, receiving specific benefits, on a low income and who are pregnant or had a child within the last year.
All other categories will have to pay for their dental care, hence the reason increasing numbers are taking out dental insurance.
Why Consider Dental Insurance?
- Dental costs. Dental insurance covers the cost of dental care, such as gum disease and removing rotten teeth, that the NHS no longer financially assists with. As a new patient, an examination including X-rays might cost around £50, one white filling up to around £110, and root-canal work on a molar around £350;
- Peace-of-mind. Having a dental plan creates peace-of-mind. Dental surgery can be very expensive and dental insurance helps cover the associated cost;
- Regular dental check-ups. Having dental insurance encourages patients to get more regular check-ups because they don’t have to pay cover the cost of dental surgery. Regular check-ups allow the detection of problems before they become more serious.
The Negatives of Dental Plans
- Dental assessment. A dentist will perform an assessment of a patient’s teeth and this information will be provided to the dental insurance company. This will mean that higher risk patients will face higher monthly premiums or may even be rejected;
- Monthly premiums. A dental plan isn’t cheap, especially if someone has a history of needing dental treatment or dental surgery;
- Exclusions. Dental insurance rarely covers the cost of: orthodontic work, dental implants or cosmetic dentistry. Policies should be checked for other exclusions;
- Ceiling on charges. Most dental plans impose a limit in terms of how much they will cover each year in dental care charges. The more expensive dental insurance policies offer higher limits;
- Complexity. Many dental insurance policies are complicated meaning that it can be difficult for people to choose the right dental plan.
Brushing teeth costs pennies, but rotten teeth and gum disease is not only physically painful, it is financially costly. The relative complexity of dental insurance policies mean that it is sensible to utilise the services of a dental plan broker. They will be able to trawl the market and identify the most appropriate and cheapest source of dental insurance.
Average Premium Rates for Dental Insurance Plans: Comparison of Sample Online Dental Quotes
The following analysis compares monthly premium rates calculated for an IDC Insurance Direct dental insurance plan against 4 sample dental plans that Manulife Financial sells to members of an association.
Dental rates differ so widely principally because of higher maximums, lower insurance reimbursement percentages (also called co-insurance amounts) and different levels of what a dental plan actually covers.
Comparison of Dental Plans
The IDC dental plan discussed below reimburses 75% of basic dental care expenses subject to a $500 annual maximum in the first policy year.
However, no major dental services (inlays, onlays, crowns, bridges and dentures) are eligible until the second policy year, when the IDC plan pays 80% of basic dental services plus 50% for major expenses up to a combined yearly maximum of $740.
In the third year and after, IDC reimbursement percentages stay the same but the combined annual maximum rises to $1,000 per person.
The annual maximums and reimbursement percentages for Manulife’s different dental plans for association members are listed below.
- Base Dental Plan … Reimburses 70% of basic dental up to $245 annually (no major)
- Bronze Dental Plan … Reimburses 70% of basic dental up to $500 annually (no major)
- Silver Dental Plan … Reimburses 80% of basic dental up to $500 first year, $800 annually thereafter (no major)
- Gold Dental Plan … Reimburses 80% of basic dental and 60% of major starting second year, up to $500 first year, $800 in second year, $1200 in third and fourth year, then $1,500 annually.
Dental Insurance Premium Rates for Singles
For adults, dental insurance premiums may vary slightly by age. IDC dental plan rates cost about a dollar more for applicants age 35 and over. Manulife dental rates for adults are not differentiated by age.
The applicant’s place of residence is more important, since dental claims expenses can be much higher in specific locations. In this review, rates for the province of Ontario were almost twice as high as the average premium would otherwise be.
Below are the average monthly prices for the dental plans in this review. The lowest and highest quoted rates are shown between brackets.
- IDC Dental Plan … $29.29 average monthly premium (from $15.75 to $49.75)
- Manulife’s Base Dental Plan … $50.95 (from $44.10 to $57.80)
- Manulife’s Bronze Dental Plan … $60.25 (from $52.50 to $68)
- Manulife’s Silver Dental Plan … $60.25 (from $57 to $74.90)
- Manulife’s Gold Dental Plan … $94.15 (from $79.80 to $108.50).
Dental Insurance Rates for Couples
Average dental rates for couples doubled for the IDC plan when compared to single rates. In contrast, monthly premiums for the Manulife plans were lower for couples than if each person bought single coverage on their own.
- IDC Dental Plan … $58.64 average monthly premium (from $31.25 to $99.75)
- Manulife’s Base Dental Plan … $84.70 (from $72 to $97.40)
- Manulife’s Bronze Dental Plan … $103.50 (from $88.80 to $118.20)
- Manulife’s Silver Dental Plan … $116.20 (from $99.20 to $133.20)
- Manulife’s Gold Dental Plan … $170.30 (from $142.60 to $198).
Read the Dental Benefit Booklet
Most consumers overlook the level of coverage under each dental plan. For example, dental examinations and X-rays are among the most frequent dental claims.
The IDC dental plan covers complete dental exams and full-mouth x-rays once every three years, which is more restrictive than the typical Manulife plan’s 24-month limit.
However, IDC dental coverage allows for recall exams and x-rays every six months while Manulife’s Base, Bronze and Silver Plans only provide these recall services every nine months.
The Gold Dental Plan covers recall expenses every six months.
These details and others are in the dental benefit description booklet or brochure, which is often available online. Consumers should ask for a copy of the dental benefit material before making an informed decision that considers both rates and the level of dental coverage.