There are plenty of companies who are willing to sell individuals a dental plan as an individual. Most of the time it’s offered as an employment benefit, and the reason it makes sense is because dental insurance then becomes tax deductible. Purchasing it on your own is a very different proposition. You need to understand what you are getting. Let me explain what these dental plans are, how they work, and the pros and cons of purchasing them.
From time to time while I was in private dental practice I had patients ask me if they could buy a dental plan as an individual. Here’s how the question would arise. They would have a checkup which informed them that they needed extensive work that would cost thousands of dollars. They then say that before beginning they want to see if they can buy a dental insurance policy. Now think of this. If you were a businessperson, would you start a dental insurance company where people would come to you and buy a policy for fifty dollars a month and then you would turn around and help them pay for thousands of dollars of dental care? You would never do it. Don’t expect these plans to be a free ride—it’s not going to happen. You need to understand what a privately purchased dental plan is and what it isn’t.
Here’s what goes on behind the scenes with these privately purchased policies. The “insurance company” solicits dentists to join. They promise the dentists that they will refer patients to them. What they ask as part of their contract is that the dentist will agree to their fee schedule, which would maybe be 2/3 of what the dentist would ordinarily charge. After they sign up the dentists, they then turn around and market this benefit plan to patients. Patients would pay them a few dollars a month, and they promise the patients lower fees for their dental care. Now this is a legitimate business proposition for this dental “insurance” company, but it may not be dental insurance the way you would think of it. The payment to the company is not really an insurance premium; it would be more accurate to call it a marketing fee. The company has negotiated discounts with participating dentists on behalf of the patients. I never was interested in signing up for these plans because I was busy enough with patients who were paying my full fee and their fees were usually too low to even cover my overhead. But some dentists were interested, and they provided this service.
If you buy one of these “dental insurance” plans, don’t expect to get coverage for oral reconstruction, bleaching, or porcelain veneers. If you get coverage for dental crowns, it won’t be much. You are going to get a very basic level of care at a discounted rate. Your premiums are not being used to help pay for the dental care, you are merely paying the company to negotiate a deal for you that you might not be able to negotiate on your own.
I would never recommend purchasing one of these plans. Not only do they tend to attract the least desirable dentists, but some of the plans provide for free checkups. Asking dentists to provide free checkups puts an unhealthy pressure on them to find something wrong so they avoid losing money on the patient—not a good situation.
Sometimes we have paid ads appearing on this website for some of these dental plans. Check them out if you’re interested in this kind of a deal. But recognize what you’re getting and what you’re not getting.
Whereas homeowners insurance or medical insurance is designed to protect the policy holder from catastrophic loss, dental insurance is more accurately called a dental benefit program. Dental expenses tend to be routine and more predictable. Dental care also tends to not be an urgent matter, and can be easily put off for a couple of months. Besides this, people who are shopping for these plans will tend to be people who already know they need extensive care. Thus, no company that is in business to make money will offer a true “dental insurance” policy individually to consumers.
More information about dental insurance:
- What is meant by usual and customary fees?
- What is a preferred provider?
- Read about Delta Dental insurance.
—Dr. David Hall