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Dental Insurance and Your Wallet

Good dental care is about more than brushing your teeth and keeping an attractive smile. Teenager Dominique Allen of Petaluma, California, was rushed to the hospital in 2010 with a life-threatening infection. The cause? Bacteria from four rotting molars that had caused crippling pain for months, had spread into her jaw and neck, triggering so much swelling she could barely breathe.

Allen's case isn't unique. Between 2000 and 2008, more than 60,000 Americans were hospitalized with abscessed teeth a preventable problem and 66 of them died. Researchers have also linked gum disease to heart disease and other serious illnesses.

The problem: Dental care can be expensive, which is why many people look for ways to cut costs. Before you sign up for any sort of dental plan, make sure that it's the right investment.

Wanted: Dental insurance

Finding affordable dental care is especially challenging for poor and middle-class adults on a tight budget. Even if they could afford dental insurance, they might have trouble finding a plan.

Private insurers, Medicaid, Medicare and the Affordable Care Act marketplace, for example, don't have to even offer dental care to adults. Employer health insurance policies may or may not include dental insurance. Some companies offer "discount dental cards," but these cards are not insurance and not all dentists accept them.

As of February 2017, the Affordable Care Act continued to offer expanded dental benefits to children. The act made dental care for children one of the 10 essential health benefits. It's credited with major improvements in childhood dental health, but it didn't do much for adult dental care.

Even though ACA marketplace plans aren't required to offer dental coverage for adults, some do. If you decide you want dental coverage and your plan doesn't offer it, you can buy and enroll in a stand-alone dental plan.

The bottom line: Check whether dental coverage for adults through ACA programs are cost effective for you. The government marketplace website has programs that allow you to check the costs and benefits, along with premiums and co-pays of stand-alone dental plans. These vary state by state. Choose your state at HealthCare.gov to check plans available to you.

When cost is a barrier

If you don't have insurance or enough money to pay for dental care, here are some options to consider:

  • Working out a payment plan with your dentist. Most dental offices understand patients may have difficulty paying for their services. Billing is usually handled by the office personnel, not the dentist directly. Be sure to tell the office personnel about your situation. They may be able to offer you advice or even a payment plan.
  • CareCredit, a non-interest loan for dental care It may hurt less to pay for that $2,500 root canal and crown combo if you can pay it off over time say six, eight or even 24 months with no interest. The companies that allow you to do so include CareCredit health financing. The catch: if you don't pay it off within the time your contract specifies, you'll pay walloping interest rates almost 27 percent on the total amount, retroactively from the date of service.
  • Clinics at dental and dental hygiene schools. Many dental schools and oral health teaching facilities have clinics that can be a good source of quality, reduced-cost dental care and treatment. These clinics provide students with experience in treating patients while offering care at a reduced cost. To find a clinic at a dental or hygienist school, look on the list of dental and hygienist schools searchable by zip codes on the website of the Commission on Dental Accreditation.
  • Community health centers. Thousands of federally funded Community Health Centers around the country offer low cost and even free health care, including some dental and oral health care, to those who can't afford to pay.
  • Oral Health America. This national nonprofit supports an informative website called Tooth Wisdom that can direct you to some affordable resources in your state.
  • Other state and local resources. Your state or local health department may know of programs in your area that offer free or reduced-cost dental care. To find out, call your county or state health department and ask about their financial assistance programs or check their websites. You can find your state public health department contact information on the website of the Centers for Disease Control and Prevention (CDC).

Keeping your smile intact

You'll save big money on dental care if you don't put off seeing the dentist when you have swollen gums or a tiny cavity. Left unchecked, gum disease could cause you to lose a tooth. And if that cavity leads to an abscess down the road, it could be costly (not to mention dangerous). Besides getting routine dental exams, dental experts advise that you do the following:

  • Brush your teeth at least twice a day with a soft-bristled brush.
  • Floss your teeth once a day (before you brush).
  • After brushing, use a mouthwash to rinse your mouth.
  • Have your teeth cleaned every six months.
  • Ask your dentist about dental sealants, which help protect your teeth against decay.
  • Rinse your mouth after eating crackers or other food that sticks to your teeth.
  • Eat a balanced diet with plenty of fruits, vegetables and protein.
  • Avoid sodas and too many sugary foods.
  • If you smoke, stop.
  • If you have any tooth pain, a small crack or a hole in a tooth, see your dentist right away. A filling can cost less than $50 in some places, while an untreated cavity can turn into an abscess costing hundreds of dollars or more.

References

Udesky, Laurie. "State Lags in Dental Care for Children." New York Times. http://www.nytimes.com/2010/05/23/us/23sfdental.html?_r=0

Vujicic, Marko. (2016). Health Affairs. Dental Care Presents The Highest Level Of Financial Barriers, Compared To Other Types Of Health Care Services. Health Affairs 35.

HealthCare.gov dental coverage. https://www.healthcare.gov/coverage/dental-coverage/

CareCredit dental financing. https://www.carecredit.com/faqs/dentistry/

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