Dental insurance can cost a single person on a group policy $366 per year. Family coverage can cost as much as $680 per year. This is nothing compared to the average cost of dental procedures, though.
Read this shocking report to learn more about dental insurance, who it benefits, and who it may hurt.
Almost all private insurance policies require the insured person to pay a co-pay when visiting a doctor or any other health care provider. The co-payment amount varies depending on the insurance plan. Typical co-pays for a visit to a primary care physician range from $15 to $25. Co-pays for a specialist will generally be between $30 and $50. On average, patients with dental insurance plans can pay 50 percent of the overall cost, depending on what tooth or teeth are being treated. If you regularly visit your dentist, expect that your out-of-pockets costs will increase. Apparently, most types of dental insurance require a small co-payment for every visit.
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Average Dental Insurance and Expenses
- What is the average cost of dental insurance?
On average, dental insurance premiums from an employer-sponsored plan cost between $14 and $30.50 per month, or $168 to $366 per year. Family coverage costs an average of $27.00 to $56.00 per month, or $325 to $680 per year. - How much is individual dental insurance per month for one person?
Individual insurance policies generally cost more than group policies. Employers are able to secure a “group discount.” Individuals don’t have that luxury. Generally, individual policies cost up to $15 more per month than group policies. On the high end, the average is around $46 per month. - How many people have dental insurance?
77% of Americans have some type of dental benefit. This is an increase of 20% over the last 20 years. 249.1 million people have some type of coverage today. Of this amount, 164.2 million people have private coverage. In 90% of the cases, the coverage is through an employer. - What percentage of people don’t have dental insurance?
Almost 35% of American’s don’t have dental insurance. This amounts to 74 million Americans without dental coverage. - What are the average out-of-pocket dental expenses per year?
Many dental insurance policies have coverage called 100-80-50. They cover 100% of preventative (annual) work, 80% of basic work (fillings), and 50% of major work (crowns and bridges). - What is the average yearly maximum for dental benefits?
The most common dental plan is the PPO. Among those plans, 50% have a maximum yearly benefit of $1,500. The other half is less than $1,500. - How many people reach their yearly maximums for dental insurance coverage?
Less than 10% of people with dental insurance hit their annual maximum. However, this is a 7% jump from the previous year.
Services Without Insurance
- How much is a dental cleaning without insurance?
Dental cleanings cost anywhere from $105 - $200 for an adult. The average cost throughout the U.S. is around $139. - How much does it cost to get a tooth pulled without insurance?
A simple tooth extraction costs anywhere from $219 - $475, with an average cost of $293. - How much does it cost to get a root canal without insurance?
A root canal (with the removal of pulpal nerve tissue) costs an average of $300, with prices ranging from $250 - $400. - How much is a dental crown without insurance?
A ceramic dental crown costs an average of $1,675, with the cost ranging from $1350 - $2250.
Types of Dental Insurance
- What’s the difference between PPO and HMO dental insurance?
Employer-sponsored dental plans usually offer PPO or HMO options. PPO dental insurance gives you flexibility in choosing your provider. You can use a dentist in or out of network; however, you receive larger benefits using an in-network provider. The providers in the PPO network have negotiated rates with the insurance company, providing you with savings.HMO plans require participants to see a particular provider. You don’t have the option to see an out-of-network provider. You won’t receive any benefits. HMO providers are often more restricted in the services they can offer. Members must also get a referral to see any type of specialist.
- What’s the benefit of a group plan over an individual dental plan?
Group plans often cost less because you get the “group discount.” Individual plans take on your risk on its own (in other words, you pay higher premiums). When there is a large group, the insurance company balances out the risk of those who use their benefits often with those who don’t use their benefits at all.Group dental insurance also often costs less because the employer may pick up a fraction of the cost.
Dental Care
- How many people delay dental care because of the cost?
Just under 60% of Americans don’t visit the dentist because of the cost. - How many adults visit the dentist every 6 months?
Just a little over 52% of American adults visit the dentist every 6 months. More shocking, however, is the 21% who have not visited the dentist in the last few years. - How many adults visit the dentist once a year?
Around 15% of adults visit the dentist one time a year. - How many children visit the dentist every 6 months?
Just over 10% more children visit the dentist twice a year than adults. 64% of children have regular visits. However, around 10% of children have not seen a dentist in the last few years. - How many children visit the dentist once a year?
Unfortunately, 20% of children only see the dentist one time per year.
Avoiding the Dentist
- What’s the top reason people avoid the dentist?
Money tops the reasons people avoid going to the dentist. With 74 million Americans without dental insurance, it makes sense. Dental services without insurance can get expensive. However, money isn’t the only reason. 22% of Americans have some type of fear of the dentist and 19% are too busy. - How many people have untreated cavities?
Around 18% of children have untreated cavities. However, 26.5% adults and 16.7% of seniors also have untreated cavities.Families living within 400% of the federal poverty level had the lowest level of untreated cavities. 9.8% of children, 12.2% of adults, and 7% of seniors fell within this category.
- How many people have gum disease?
Untreated gum disease can lead to very serious health conditions, including heart disease. However, almost half of Americans suffer from this serious disease.
Average Dental Copay
Other Options
- How many states offer some type of dental benefits through Medicaid?
46 states in the U.S. offer some type of dental benefit through the public aid system. However, the benefits are often limited.Only 15 states provide extensive dental insurance benefits. In other words, they provide more than just emergency extraction or pain relief. These 15 states provide access to more than 100 dental services.
However, 13 states of the 46 provide strictly the emergency services necessary after an injury or trauma.
- How many dentists in the U.S. accept Medicaid?
38% of dentists throughout the United States accept Medicaid for children and adults.
Bottom Line
Dental insurance can help minimize your out-of-pocket costs. It’s protection against an emergency or major dental work. Dental procedures can get costly if you don’t have the insurance. If nothing else, you save money on your cleanings and avoid invasive procedures if all is well.
Sources and References:
- National Association of Dental Plans
- ADA.org
- Members Benefits
- Fair Consumer Health
- CDC
Write to Kim P at feedback@creditdonkey.com. Follow us on Twitter and Facebook for our latest posts.
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Average Dentist Pay
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Average Dentist Copay Vs
Cost estimates for services provided by out-of-network dentists (available in the out-of-network estimator) are based upon submitted claims data for out-of-network providers. The data is based on actual, non-discounted charges that providers have billed.
Average Dentist Copay Insurance
Cost estimates are specific to geographic areas, as defined by the first three digits of a ZIP code (e.g., the geo ZIP for 12345 is 123).