Dental insurance for self-employed types?

June 18, 2021 12:30 PM

I need an expensive procedure that has me seriously considering getting dental insurance for the first time. Help!

I'm self-employed, and I've never had dental insurance. I pay an average of $750/year out of pocket for dental care, so it's never seemed quite worth it.

But now I need an implant, for which I've been quoted $5000-6000, so insurance is suddenly looking quite appealing.

I know there's usually a waiting period, so I want to get started asap. I also know some plans don't cover implants - for example, all the plans through healthcare.gov, where I get my health insurance. (Although one dentist told me they can sometimes be billed as crowns?)

Is there anything more efficient I can do besides just googling "dental insurance"?

posted by gottabefunky to Health & Fitness (17 answers total)

I doubt you will be able to come out ahead by buying individual dental insurance. Almost all dental insurance plans have annual limits for how much they pay out. Since there's no mandate to have dental insurance, and since dental expenses are much more predictable than general healthcare expenses, there's not a lot of distribution of the risk pool with dental insurance the way there is with health insurance - the only people who want to buy individual dental insurance are people with big dental expenses coming up.
posted by mskyle at 12:36 PM on June 18, 2021 [9 favorites]

I've heard there are towns in Mexico that specialize in implants for visiting foreigners.

Of course with covid this may not currently be an option but you may still want to investigate dental tourism if you are paying out of pocket in case the travel situation changes.

And yeah, dental insurance doesn't get you $$$$ procedures for $, it doesn't work like that.
posted by TheAdamist at 12:48 PM on June 18, 2021 [3 favorites]

..if it doesn't creep you out, get dental work in Mexico City. Check Reddit threads for a referral, review, etc. There are professional dentists there offering quality work at a third of the cost, including tickets to Mexico.

I'm sorry, that's a significant amount of money a patient should not be obligated to pay.
posted by firstdaffodils at 12:49 PM on June 18, 2021 [1 favorite]

Be very careful about annual limits - my policy through my company and considered "premium" and I still have a $2500 limit. Also, many policies have months-long waiting periods for larger/more expensive procedures, so you'll be paying in for 6-9+ months before you're able to use the policy for an expensive procedure.

With some big procedures ahead of me, I'm also starting a HSA/FSA so I can at least use pre-tax dollars.
posted by quince at 12:50 PM on June 18, 2021 [3 favorites]

Response by poster: Mexico is an interesting idea I'd heard of before but hadn't considered. How would I go about finding a good dentist in Mexico City?
posted by gottabefunky at 12:56 PM on June 18, 2021 [1 favorite]

Check DMs 🙂
posted by firstdaffodils at 12:58 PM on June 18, 2021

You can also visit a Dental School. The students need to perform the actual work in order to pass their exams so you can get work done at a substantial discount down to free even depending on the case.
posted by magnetsphere at 1:18 PM on June 18, 2021 [1 favorite]

"Medical tourism" is the term for leaving the country for affordable care.

Our dentist offers really good discounts for cash (and I do mean literal paper bills, not gonna ask detailed questions about it) payment. They'll do an okay but not as good rate on work paid by CareCredit. Ask yours what they can do for leaving insurance out of it.

Most dental insurance in the US is at best a coupon book, and you'll generally only find very low yearly coverage caps or slightly higher lifetime caps on coverage - like max $1500 or $2500/year coverage or $5-8K lifetime. It's about as useful as vision insurance.
posted by Lyn Never at 1:22 PM on June 18, 2021 [3 favorites]

I just found out about Dental Discount Plans. Seems much better than insurance. Check those out.
posted by The Half Language Plant at 1:24 PM on June 18, 2021

Implants are tricky for tourism type dentistry. In most cases the implant itself doesn't replace "the tooth", it simply creates an artificial root for a crown to be placed on later (often 4-6 months out).
So you'll probably be looking at at least 3 visits to mexico city or wherever before you have a functional tooth, with little opportunity for quick recare visits should something raise a question or need a quick look to assure both parties that everything is proceeding normally.

Implants are often not the only solution. Conventional fixed bridges, removable partial dentures, doing nothing are all options to be considered.

I will agree that individual insurance plans are usually not going to work out, as they will not likely cover the implant itself and will likely cover the eventual crown at 50%.

I will push back against the idea that going to a dental school is a bad choice. OHSU is right in Portland. All of your care will be carefully overseen by the faculty. It takes longer, usually, but it can be much more affordable. One person's anecdote should not dissuade you from at least considering it.
posted by OHenryPacey at 2:54 PM on June 18, 2021

Some dental insurance (in Oregon, at least) is more like an HMO, like Kaiser Permanente, where you have to stay in their system to get coverage. The other big player in Oregon is Delta Dental / ODS / Moda. They act more like a standard insurance plan with in-network and out of network.

If I were in your place (and I sort of am, except for the upcoming implant need), I'd first talk with your dentist to see if they'll give you a cash discount (they'll probably want a check or cash, not credit card, so they can avoid cc fees).

Also, some independent dental offices offer their own 'insurance' plans. Like Wildwood. If you sign up for their annual plan, you'll get 2 'free' cleanings and 20% off all other services. You might even be able to combine that with a cash discount - always ask. That might be the simplest option.

The last thing to consider, at least for Kaiser and Delta is that you may not be able to enroll until open enrollment in the late fall. I'm not sure if dental insurance is like medical in that respect.
posted by hydra77 at 3:34 PM on June 18, 2021

I would 100% go to Mexico for this. I'd look at Yelp and realself.com for a recommendation. It doesnt have to be Mexico City -- any place that caters to wealthy tourists will likely have good dentists as well.

FWIW, my own excellent dentist in San Francisco goes to a dental conference in Costa Rica every year, and has recommended dentists there to her patients needing expensive work done that insurance wont cover sufficiently.
posted by ananci at 10:00 AM on June 19, 2021 [1 favorite]

My Dental Vacation in Mexico: A Mercedes Mouth on a Hyundai Budget
posted by Rash at 12:46 PM on June 19, 2021 [1 favorite]

Another thing to watch for if you do decide to get dental insurance and do this in the US is the waiting period. My wife was on Renaissance Dental through the Marketplace for a while. We totally missed that they had a ONE YEAR waiting period before they'd pay ANY claims. So basically we paid them for a year for no returns (and actually longer because she didn't end up needing dental work before we cancelled).
posted by possibilityleft at 3:04 PM on June 19, 2021

Addendum: ananci, DMs!
posted by firstdaffodils at 3:48 PM on June 19, 2021

You may be able to split the implant procedure across the end of the year and max out the dental insurance both years. You will still have a sizable out of pocket expense.
posted by joeyh at 6:21 AM on June 20, 2021

Most dental insurance plans do not cover implants. Going to a dental school will get you good results for the lowest fee yet require a lot of time for each appointment bc things move slowly in dental school clinics. Going abroad will be cheaper but if you need follow up or have an emergency after coming home, a local dentist may be hesitant to get involved. Also, they may not want to restore your implant (put a crown on it) if you decide to do that part in the States instead, partly bc they may not have access to the hardware kit that comes with the implant for screwing the crown on.
posted by choochoo at 7:14 AM on June 20, 2021