The thing about dental insurance is that it isn’t really insurance — it’s more like a half-helpful discount plan with a maximum. And once you reach the maximum, you’re on your own, often to the tune of hundreds and thousands of dollars. As though going to the dentist needed to be less fun.
In the realm of all things health care, dental exists as a sort of overlooked stepchild. The American medical system doesn’t really consider dental care an essential service, despite mounds of evidence linking a healthy mouth to the well-being of the rest of the body, from better pregnancy outcomes to a healthier heart. Dentistry has always been siloed off.
Dental coverage has been off in its little — largely unregulated — corner, too. According to the American Dental Association, one-third of adults aged 19 to 64 don’t have any benefits at all. (For comparison, just 8.4 percent of Americans lack health insurance.) Many patients put off dental care and cite cost as the main reason they don’t go to the dentist — including those who are insured.
Even if you do have dental benefits, they’re often less than beneficial. Insurers may cover 100 percent of a cleaning or a checkup, but once you get into other more complicated services, they start to cover less, so patients have to pick up some or much of the cost. Plans have annual maximums ranging between, say, $1,000 to $2,000, after which the insurance covers nothing.
“When you look at the dental insurance model, it doesn’t protect the patient from financial risk. It’s the opposite,” said Marko Vujicic, chief economist and vice president of the Health Policy Institute at the American Dental Association. “Once the benefit runs out, the $1,400 or whatever it is, all of that financial burden is on the patient. So it protects the insurer, they’re limited on their exposure.”
Imagine being told your health insurer will only pay for 50 percent of your heart bypass surgery, and that it only covers $10,000 of all your health services each year. That would be considered unacceptable in this day and age. But that’s what would happen if I needed a crown — my insurance covers half, and it only pays out $1,500 total all year. My dentist screwed up on a filling last year. It didn’t take long before I hit my limit.
None of this is to say you should nix dental insurance and just go it alone. Insurers are often able to get patients better prices for services than patients would get on their own, and a $1,500 help on dental costs isn’t nothing. It’s just hard not to look at the landscape and wonder whether it can’t be better.
Your mouth is definitely part of your body, and yet that’s not how America treats it
To back up a bit and then some, dentistry was for centuries performed by barber surgeons, which is pretty much what it sounds like — the guy