Hard Time to Have Dental Insurance? Everything You Need to Know

Obamacare, Affordable Care Act or Medicare; many of you may have familiar with these words, as these actually relate to the American health care system. When it comes to the US healthcare system, a brief discussion is always going on as this country spends $2.8 trillion in health care annually, which is way more than any other country. 

But do you know nearly 1 in 4 Americans are skipping medical care just because of cost? Though Medicare and Medicaid cover nearly 1 out of every 3 Americans, limited coverage of these programs and tricky policies of private health insurance companies make 29% of people lagging behind to take medications as prescribed. 

Whether you are insured or not insured, there is an important part that missed out much. Well, it’s none other than having dental insurance. When oral diseases affect nearly 3.5 billion people worldwide, there are 74 million American cases were found who have no dental insurance coverage. But why this ignorance tendency about dental insurance is so common in US people? Or what are hidden policies that charge most of the people after having dental insurance? 

Dental Insurance Issues

Prior to 1920, most people had very low medical expenditures, and hospitals were thought to be places where people went to die. However, the Great Depression led hospitals and physicians to implement forms of insurance as means to ensure payment for services. Surprisingly, conventional insurance and managed care were developed at the same time.

Thus, from then there are no going backstories had been written. So far, right now over 297 million people in the United States have some kind of health insurance right now. Even you will be found uncountable suggestive reports about health insurance plans. 

Thus, one aspect of health insurance that has been missing is dental care, which has been a common concern among most Americans when they are looking for suitable dental insurance. With the type of insurance, your health insurance may offer a different pattern of dental care in some sort of emergency cases. 

In fact, for extensive dental care, many people in the United States cannot afford to pay out of pocket due to limited coverage and service provided by Medicare and Medicaid or the growing trend of dentists refusing Medicaid patients. And the cases are so severe that more Americans are experiencing higher rates of tooth decay, gum disease, and oral cancer, which have been linked to the progression of health issues such as cardiovascular disease or Alzheimer’s.

Furthermore, the more surprising fact is that common perceptions such as dental problems are less severe than “medical,” which is the most common reason for Dental problems can frequently wait. However, rising concerns can be seen if you look over the number of ER visits attributed to dental-related issues.

What is Dental Insurance? 

Until the mid-1950s, when dental insurance was introduced in California, dental work was done on a fee-for-service basis. It is a properly distinct type of insurance that covers the cost of routine dental care as well as accidental tooth damage, includes benefits for oral examinations and X-rays, as well as preventive dental treatment, and last but not least, it pays for treatment by a dentist. After hearing all these aspects, we are pretty sure that right now, your curious minds may wondering why people are becoming so oblivious to the fact that they don’t need any dental insurance? 

Types of Dental Insurance

Basically, there are four common types of dental insurance plans that are found to be popular among people like Preferred Provider Organizations (PPO), Dental Health Maintenance Organization (HMO), Dental Discount or Dental Savings Plans and Managed fee-for-service plans, each work differently in terms of out-of-pocket costs, benefits, deductibles, and so on. 

However, as the same size of shoes doesn’t fit all, so the existence of different types of dental insurance plans does not mean all are equally effective for you. Some dental plans will provide a larger network of dentists; others may be less expensive but limit coverage for certain procedures or require more out-of-pocket spending on treatments such as root canal therapy or dental implants. In fact, each dental insurance provider will provide slightly different plan types with varying benefits and levels of coverage. 

Considering Facts

Furthermore, you may not be able to obtain all of the types of dental insurance plans that we have mentioned. Therefore, your selection criteria will be determined by what is available in your area. Thus, if you have already decided to have dental insurance in the upcoming year and don’t want to discover yourself in out-of-pocket situations, you need to consider a lot of things first. 

Dental Coverage Plans

During shopping, you can find dental coverage plans in 2 ways as a part of Health plans that include dental coverage or stand-alone dental plans. In most cases, full coverage dental insurance plans use the 100/80/50 cost-sharing model, which means 100% of the costs of routine and preventative services, 80% of the costs of basic services, and 50% of the costs of major services will be provided by dental insurance that you are supposed to buy. 

Though many found it a pretty cool option for shopping, the reality is not as simple as you think. Well, issues like cosmetic dental services, teeth whitening or non-essential veneer placement can cause an out-of-pocket situation at any time, as dental insurance doesn’t typically cover these services at all. If you get an individual policy, periodontics and prosthodontics may not be available in the first year of coverage. And orthodontics often requires a rider, in which you pay an additional fee, for any kind of policy. 

Favorable Options

Even if you ask people why people are dissatisfied with dental insurance, they will tell you common stories like- ‘I do not have insurance through my employers, or the dentists do not accept the insurance I have! So apart from dental coverage, first it is important to check out your employment details or other group coverage programs such as AARP policies, Affordable Care Act marketplace health insurance policies, or public programs like Medicare or Medicaid. 

These plans are typically less expensive than purchasing individual insurance and may also include attractive benefits. So, before shopping for dental insurance, it’s a good idea to thoroughly examine the details of even an employer-sponsored plan. However, if these services are not enough, you can try Individual policies, which are more expensive than group policies. 

Whether you purchase a single policy or one for your entire family, there are some drawbacks to this coverage, such as the fact that it has more limited benefits and a longer waiting period before major procedures are approved. Yet, to cover these huge expenses a little, you can search for a dentist you like, ask which insurance plans they accept.

Splashy Tricks

Lastly, suppose you have already known all these facts and think that you are out of risk, then there is again a piece of bad news for you. Remember the day when your father signed insurance agreements. The signing ceremony for health insurance took one and a half hours to complete. 

Back then, you couldn’t count the pages as policies papers actually much heavier than your tiny little brain could ever be imagined. In most cases, many people ignore to review all the pages where all policies are written. Though these may save their time, they ultimately cause a great hazard too. 

You may have done all of your homework about covering issues, but you may miss the points about the waiting period or annual maximum coverage because of improper review. And these little wrong steps may cost huge expenses than you ever imagined, even they can lead you to a bankruptcy situation. 

Yet, recently, companies like Cigna, MetLife, and delta dental gained some customers’ trust by offering affordable dental plans, which generates little hope for Americans. Even reported cases were found where traditional health insurance companies are supplementing their medical plans with dental benefits. So, is this the new start of insurance industry policies? Or do we have to wait for another decade to see the change?? 

Anika Bushra
Creative, strategic and collaborative professional with hands-on-experience and broad knowledge in Copywriting, Content Writing, Campaign Ideation, Feature Writing, Public health, Biochemistry, Molecular biology, Genetic engineering as well as Biotechnology. Currently working on sustainable agriculture projects and my recent mission is to discover new things related to sustainable developments


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