If you bought an insurance policy for your house and it burned to the ground, you’d expect your insurance to cover the rebuilding of an equivalent house. If your tooth broke, you would expect insurance to pay for its replacement. (Bonnick 85)
Yet this is not exactly how it works. Sure, on a homeowner’s insurance policy after you meet the deductible they will pay whatever cost (up to the limit of your policy) to rebuild your home. In dental insurance it’s not as simple as “I pay the copay and they pay for the rest.”
Dental insurance companies have UCR (usual, customary, and reasonable) fees, which they will rarely explain how they determine. In each zip code, different insurance companies have varying numbers for UCR fees (Bonnick 86).
What does this mean for you?
Dental insurance companies are for-profit entities. Since their UCR fees are what they consider “reasonable” for various dental services, you may run into confusion if a procedure you’re having done costs more than they say it should. They may only cover what they claim it should cost, leaving you with the balance. Furthermore, many dental insurance companies only cover 50% (minus the deductible) for procedures such as extractions and crowns.
Look into the details of dental insurance policies to see what works best for you. If you need some major work done, insurance covering even 50% could be a life saver. On the other hand, if you have fairly healthy teeth and really only need cleanings, it’s probably cheaper to just pay out of pocket twice a year than owe someone every month.
For example, if your insurance was $30/month, you’re paying $360/year. If you only need cleanings once every six months and a cleaning costs $110 out of pocket ($220/year), you’re actually overpaying to have insurance cover it. You can see where maintaining your dental health can save you a lot of money long term.
Overcoming Dental Fear
How To Overcome Fear of the Dentist, written by Dr. Bonnick, is available on Amazon.com:
If you’ve got some anxiety about the dentist or simply want to know more about how various things work, we urge you to check it out! It’s an easy read and a great way to understand some complicated-sounding (and even intimidating) topics.
Bonnick, DDS MAGD DDOCS AFAAID, Bertand A., and Kaye Bonnick. How to Overcome Fear of the Dentist. Bloomington: Author House, 2010. 28. Print.