What are the Cons of Dental Insurance? 

Dental insurance is similar to medical insurance in that you pay a monthly premium for coverage of certain dental expenses. However, while medical insurance focuses on treating illnesses, injuries, and hospitalizations, dental insurance focuses more on preventive care, such as twice-yearly dental checkups and dental cleanings to prevent oral health issues. There are cons to dental insurance you should consider before purchasing a policy. 

Coverage Limitations 

Dental insurance has lower coverage limits than most types of medical coverage. Its primary focus is routine care and mild to moderate procedures such as a basic filling. Crowns or root canals may be covered at a lower rate, with you having to pay more toward the total cost. Some policies do not cover anything but preventive care. 

Out-of-Pocket Costs 

Your out-of-pocket expenses are higher with a dental plan than a medical plan. Expect to pay more deductibles, coinsurance, and copayments. Your medical insurance may have higher premiums but lower out-of-pocket costs and better coverage. You may also have to have expensive treatments pre-authorized before treatment begins for any coverage to kick in. 

Out-of-Network Care 

Most dental insurance limits you to specific in-network providers. If your dentist is not in their network, the reimbursement rate and coverage limits will usually be lower. You will have to pay the difference, paying more out-of-pocket. 

Cost of Coverage 

Although you will pay less monthly for dental insurance than medical insurance, you get far less coverage. Some dental plans are quite expensive when you compare your cost to the potential benefits. Common needs such as dentures, crowns, or bridges may only have partial coverage. At the same time, other procedures may not be covered at all, leaving you to pay for everything despite having dental insurance. 

Types of Coverage 

Because dental insurance focuses on preventive care, it does not typically cover cosmetic dental care or orthodontics, often the most expensive dental procedures. If you buy dental insurance hoping to minimize the cost of braces, aligners, or cosmetic treatments, you will be disappointed.  

Dental Insurance Resets Every Year 

Unlike medical insurance, which offers you seamless coverage year after year, dental insurance “resets” each year. What does this mean? It means at the end of the year, your coverage resets. If you do not take advantage of your full coverage for dental care, you cannot roll it over into the following year. You lose that coverage and start back at the beginning. This is why we suggest that our patients check their policy toward the end of the year. If you haven’t had your teeth professionally cleaned and examined in over six months, you should get it done before the end of the year to ensure you don’t lose coverage for the procedure. 

Is Dental Insurance Right for You? 

Dental insurance isn’t right for everyone, but may be right for you. Realistically, dental insurance is more like a dental savings plan. If you tend to neglect visiting the dentist, an insurance policy may encourage you to take advantage of your benefits for routine care, improving your oral health. It is often less affordable for seniors and does not cover their additional dental needs, such as dental implants, dentures, or periodontal treatment.  

An alternative for many of our patients is using their Health Savings Account, a low-interest credit card, or CareCredit, a low or no-interest credit card for health-related expenses. If you have questions about any of these payment methods, please feel free to contact our office at Tonka Smiles Phone Number 952-938-8533. Our office staff is happy to answer any of your questions. 

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