December 13, 2024

N-Chiropractors

A Passion for Better Health

What Happens If You Don’t Have Dental Insurance?

What Happens If You Don’t Have Dental Insurance?
Dental Service Cost Without Insurance
Complete examination, cleaning, and X-rays $100 to $300
Teeth cleaning $75 to $200
Fillings $50 to $600, depending on material used
X-rays $100 to $200
Tooth extractions $75 to $800
Root canals $500 to $1,800
Crowns $500 to $3,000
Braces $3,000 to $10,000
Dentures $600 to $8,000, per set

With procedures such as root canals and extractions, prices can vary greatly based on which tooth requires treatment. The cost of braces can vary based on the patient’s age. Costs can also differ by dentist and local dental rates.

If you only require biannual examinations and teeth cleanings, you’ll pay around $200 to $600 per year. Meanwhile, individuals who have dental insurance pay an average of $360 per year in premiums. If you must seek dental services without insurance, it’s best to know the costs before agreeing to treatments.

“Seeing prices upfront and negotiating costs directly with dentists may aid affordability for uninsured patients,” Greenes said.

7 Dental Care Options If You Have No Insurance

Rather than skipping dental treatments, you can first find out more about affordable dental care in your area.

“Quality care is accessible through dental schools offering reduced cost treatment from supervised students, community health clinics providing sliding-scale services, and private practices willing to set up payment plans or discounts without billing insurance,” Greenes said. “Those unable to afford general dental fees can also seek free emergency extractions at donation-based clinics.”

Community Health Centers

Some community health centers offer dental services on a sliding scale, based on your income. The Bureau of Primary Health Care provides federal funding for almost 1,400 urban and rural community health centers operating 13,500 delivery sites nationwide.

However, a community health center might not be your best option if you need emergency dental care.

“They are usually booked out for many weeks or months, and they refer out more specialty procedures like root canals and extractions,” Dr. Jordan Weber, a dentist at Burlington Dental Center in Burlington, Kan., told Investopedia in an email. “If you need to see a specialist for multiple root canals, extractions, etc., it may end up being more expensive than if you had just found a regular private practice dentist that performs a wider scope of procedures.”

Dental Schools

To help train future dentists and hygienists, some dental schools and dental hygiene schools offer reduced-cost dental treatments to individuals seeking dental care. Licensed dentists supervise dental procedures to ensure you receive quality care.

“The downside with dental schools is that the treatment is usually very slow, so you will pay for the procedure with your time,” Dr. Weber said.

To find schools in your area, consult the websites of the American Dental Association or the American Dental Hygienists Association.

Medicaid and CHIP

Medicaid provides health care services to children, elderly individuals, low-income adults, people with disabilities, and pregnant women. Medicaid is a joint federal and state program. Benefits and eligibility vary by state. Some states offer full dental services for people 21 years old and older, while others only provide emergency dental services

Like Medicaid, the Children’s Health Insurance Program (CHIP) is federally and state funded. The program provides reduced-cost medical services to children in families that don’t qualify for Medicaid due to their income, but don’t earn enough money to afford private health insurance. While benefits vary by state, most states provide dental services for children enrolled in CHIP.

To find out more about CHIP in your state, visit the Insure Kids Now website, or call (877) 543-7669.

Medicare

The federally funded Medicare program helps pay the medical expenses of people with certain disabilities and folks 65 years of age and older. Unfortunately, some Medicare plans do not cover dental services such as routine examinations and cleanings and dentures.

Some Medicare Advantage Plans offer extra benefits, which may include dental, hearing, and vision coverages.

Clinical Trials

The National Institutes of Health’s (NIH) National Institute of Dental and Craniofacial Research (NIDCR) sometimes offers free and low-cost dental services to clinical trial participants.

To qualify for a clinical trial, you must have a craniofacial, dental, or oral condition on which a specific study is based. Unfortunately, clinical trials seek specific types of individuals who meet strict criteria, which can make it difficult to find studies for typical dental services.

To find out more about active clinical trials, visit the NIH Clinical Center website.

United Way

Local United Way offices might help you find free or low-cost dental services in your area. Bear in mind that free and reduced-rate services vary by location.

Visit the United Way website to find contact information for a local office in your area.

Dental Tourism

The high cost of U.S. dental care has prompted some dental patients to seek care abroad. For example, a dental implant in the United States may cost $2,000, but just $1,070 in Hungary. However, relying on foreign dental providers may present risks.

“The challenge is that the standards for dentistry are incredibly variable outside of the United States,” Dr. Weber said. “You might find a great dentist that saves you a substantial amount of money, or you might find a bad office that does tens of thousands of dollars of irreparable damage to your teeth.”

Dental Services Not Covered By Insurance

Even if you have dental insurance, your policy likely won’t cover all types of dental services.

“Elective dental services, such as veneers, bleaching, and orthodontics, often aren’t covered by insurance,” Dr. Weber said. “However, some insurances provide a benefit for orthodontics and bleaching even if they aren’t medically necessary. It depends on the insurance carrier and the particulars of your plan, so you need to verify everything yourself.”

Common exclusions often include:

  • Cosmetic procedures
  • Pre-existing conditions, like missing teeth
  • Orthodontic appliances such as braces (some policies)

Although a policy might not cover orthodontic appliances, some may cover specific orthodontic services.

Should You Get Dental Insurance?

Before enrolling in a dental plan, evaluate your current and future needs. For instance, if you are single, relatively young, and don’t have a history of dental problems, you might opt for a low-cost dental plan. But, if you’re retirement age, or a parent with several kids, you probably need a more robust policy that covers braces or dentures.

Before signing up for a dental plan, consider these factors:

  • Budget: Determine how much you can pay for a policy and evaluate a plan’s premiums, annual maximum, deductible, coinsurance, and copayments.
  • Coverage: Coverage levels can vary by plan. Some plans might impose coverage limits on certain types of dental services.
  • Waiting periods: Look for plans that feature a six-month waiting period for basic services and a 12-month period for major procedures.
  • Network requirements and size: Some dental plans require you to obtain all dental care through a network of service providers. Others offer partial coverage when seeking care outside of a network and some allow you to acquire services from any dentist or specialist.

“Many routine and elective treatments involve out-of-pocket costs even for the insured, like teeth whitening, veneers, custom orthodontics, and certain implants or high-end restorations,” Greenes said. “Reviewing limitations enables realistic expectations when selecting plans.”

How Much Does Individual Dental Insurance Cost?

Dental insurance premiums can vary widely, based on location and plan, but generally cost around $20 to $50 per month for individuals and $50 to $150 per month for families.

What Is the Most Common Type of Dental Insurance?

Dental PPO plans, also known as DPPOs, account for 86% of all U.S. dental insurance policies, according to the National Association of Dental Plans.

What Is the Cheapest Type of Dental Insurance?

Of the three most common types of dental plans (HMO, indemnity, and PPO), HMOs usually are the most economical, while PPOs are more expensive. Besides lower premiums, many HMO plans also do not require a deductible. Typically, indemnity plans are the most expensive, although they do allow you to choose your own dentist regardless of network affiliation.

What’s the Difference Between a Dental Savings Plan and Dental Insurance?

In exchange for a monthly premium, dental insurance pays cash benefits for dental services. Some dental insurance plans impose annual maximum coverage limits and require you to seek care within a network of dentists and specialists. Usually, dental savings plans don’t impose annual coverage limits and don’t require you to pay a deductible.

Does Dental Insurance Cover Veneers?

Before enrolling in a dental plan, research what it will and will not cover. “Dental insurance typically doesn’t cover veneers, but this is plan dependent,” Dr. Jordan Weber, a dentist at Burlington Dental Center in Burlington, Kan., told Investopedia in an email. “If the veneers are required due to tooth decay or a malformation of the teeth, it is more likely that insurance will cover the service.”

The Bottom Line

Dental insurance is relatively affordable, providing preventive care benefits which can help ensure that you and your family maintain proper oral health. But if you can’t afford dental insurance, or if you’re facing a dental emergency, you have ways to get affordable care. For example, you can often get dental care at dental schools and community health centers.

Medicaid features dental services for children but, in most states, the program doesn’t cover adults. Seniors can enroll in a Medicare Advantage Plan that includes dental benefits. If you have unique oral issues, you may qualify for a clinical trial. Regardless of how you pay for dental services, maintaining regular dentist visits can help you avoid costly problems later in life.