As freelancers, we work hard for every penny of income that comes in — which means that we are also extremely cautious about every expense we agree to cover. So, while health insurance is clearly a non-negotiable (even now that lack-of-coverage penalties have been eliminated), you may be wondering: do I really need to shell out for dental insurance? Before we can help you answer that question, let’s take a closer look at how dental insurance typically operates.
Dental insurance vs. dental discounts
When it comes to purchasing dental insurance, you may be distracted by discount plans. These offer a guaranteed discount on approved services, every time you see your dentist. And there are no limits on how many times you can cash in on those discounts. Sounds tempting, right?
It may, until you consider this: while you will be spending less money on each visit, you will still be spending money each and every time you step into your dentist’s office, whether it be for preventative care or for a scheduled procedure like a root canal or a cavity filling.
If, however, you purchase a dental insurance plan, the entire game changes. While you do pay a monthly premium for your plan, you get some serious benefits. First and foremost, most dental insurance plans offer 100% coverage for preventative care — sometimes or only one annual checkup and cleaning, but often for two visits each year. This is a big deal, since annual visits are likely to reduce the need for major procedures by catching problems early on.
If, however, you do need to undergo dental work, your insurance plan will still have you covered. While each plan is different, most forms of dental insurance cover between 70-80% of basic procedures (fillings, extractions and gentle gum work), and around 50% of major procedures (root canals, crowns, implants etc.)
Limits on dental insurance
While dental insurance plans offer guaranteed coverage, they aren’t limitless. Many plans have waiting periods for dental procedures (meaning you must be a plan member for a set amount of time before any portion of your major procedures will be covered.) Waiting periods vary by plan, although they typically range anywhere from six to 18 months. It is important to note that those waiting periods do not apply to preventative coverage, so you will still be able to enjoy a cost-free cleaning as soon as you sign up for a plan.
The other limit that comes with dental insurance is your maximum annual benefit (the top dollar amount that your plan will agree to pay towards dental procedures.) Again, the cost of preventative care is usually not counted towards your maximum benefit, but costly procedures like dental implants can quickly take you to the limits of your plan. Once that annual maximum has been reached, you will be responsible for 100% of your remaining balance.
What are the different kinds of dental insurance?
There are three main types of dental insurance: DHMO, PPO and Indemnity plans.
When you purchase a DHMO plan, you will be given a list of dental providers that you can visit (you will not receive coverage for work performed by providers who are not on that list.) With this type of plan, routine care — annual exams, cleanings and X-rays — will be covered in full.
For most procedures, like a filling or tooth pulling, you will be subject to a co-pay rather than a portion of the procedure’s total cost. That co-pay will be due at the time of your procedure. If, however, you need a more complex procedure, you will need your primary dentist to give you a specialist referral. DHMO plans tend to offer lower premiums and great coverage, which is why Freelancers Union offers members the MDG Dental plan, Guardian’s DHMO coverage option.
With a PPO plan, you can visit any dentist you like, although you’ll be billed less for an in-network provider and pay a higher premium if you go out-of-network. With this plan, you do not need a referral in order to see a specialist. Most PPO plans are subject to deductibles, which means you will have to pay 100% of costs (even for preventative care) until that deductible has been met. Once you reach your deductible, however, you will only have to pay for the agreed-upon percentage of your dental work — i.e. 20% in an 80/20 plan. Monthly PPO premiums are higher than those for DHMO plans, but coverage tends to be more extensive if you need care that goes beyond the basics.
Indemnity plans allow you to visit any dentist you wish, with no restrictions. The catch? You will have to pay your entire bill upfront, then submit your claim to the insurer. Of course, with this type of plan, you will not immediately know the value of your reimbursement.
Why dental insurance is a smart investment
Now that you understand how dental insurance works, you are hopefully convinced of its importance. The ability to visit your dentist, free of charge, for preventative care will help protect you from costly and invasive dental procedures down the road. Still need convincing? Know this:
According to the U.S. Bureau of Labor, Americans lose 164 million work hours each year because of dental problems. When you freelance, even one day off of work is a day you don’t get paid. Investing in preventative care for your teeth is a good way to make sure you’re able to keep earning.
Dental costs are on the rise: according to the Pew Center for Research, they went up about 58% between 2017 and 2018. When you invest in den
tal insurance, you know that you will only have to pay a small portion of whatever those increasing costs may be.
Your teeth are a good indicator of your overall health. While many freelancers are too busy to see our primary physicians regularly, your bi-annual dental exams can help identify illnesses like diabetes and certain cardiovascular disorders, which both carry oral health symptoms.
Ready to make the investment? Check out the coverage available through Freelancers Union, or reach out to us at firstname.lastname@example.org with any of your burning insurance questions.