Why no dental insurance copay?

November 22, 2005 2:18 PM

Why doesn't dental insurance work like Health insurance with a copay and a deductible?

I just paid a huge amount of money at the dentist and I was wondering why it doesn't work like my health insurance. My dental insurance just gave me a discounted rate. If I paid this much on my health insurance I would be pretty close to meeting my deductable.

posted by renyoj to Health & Fitness (8 answers total)

There isn't enough variability in dental care costs for it to be "insurable" in the traditional sense of the word. So to the extent that you get something called "dental insurance" at work, it is usually more something like a group discount, or a pot of money that your employer pays towards your dental care costs each year.
posted by alms at 2:24 PM on November 22, 2005

Most dentists I've talked to consider dental insurance fairly useless, as a derail. It usually comes up every time I get a filling (no more than once in a very long time) and the insurance will only pay for silver while the dentists don't do anything but the +$50-over-silver ceramic/composites. So, paying $20/mo for the best dental insurance really leaves me $190 in the hole each year if I even get one filling. I guess the cleaning are discounted, but I'm not even sure two of those would offset that cost.
posted by kcm at 2:54 PM on November 22, 2005

I'd second what alms said. Dental coverage really isn't an insurance product in the same way that medical or life insurance is. Because of the low annual maximums, it's more like, say, vision coverage where what you're really getting is a network of discounted providers.

Most dentists I've talked to consider dental insurance fairly useless, as a derail. It usually comes up every time I get a filling (no more than once in a very long time) and the insurance will only pay for silver while the dentists don't do anything but the +$50-over-silver ceramic/composites. So, paying $20/mo for the best dental insurance really leaves me $190 in the hole each year if I even get one filling. I guess the cleaning are discounted, but I'm not even sure two of those would offset that cost.

Lots of dental plans are great -- I would suggest that someone who only needs dental work once in a very long time probably is making a mistake in purchasing it. If you have a good plan heavily subsidized by your employer, it can save you a lot of money. Coverage for white fillings for back teeth is becoming more common, but I'll stop the derail here.
posted by MarkAnd at 3:07 PM on November 22, 2005

The reason for co-pays is to keep people from running to the doctor everytime they feel the slightest pain. Most people will avoid any type of tooth pain in the hopes it will go away. I believe there's no co-pay mostly because people fear the dentist and if they can get away with only going once every 6 months - or year, they will.
posted by any major dude at 4:00 PM on November 22, 2005

How does your dental insurance work? In Canada, all the private (employer) plans I've had involved a copay.
posted by acoutu at 4:39 PM on November 22, 2005

Mine works purely on a percentage basis. 80% for cleanings and fillings (although many plans include cleanings) and 60% or so for something like a wisdom tooth removal or root canal. That 40% can be a lot. My wisdom teeth cost me $600.
posted by smackfu at 5:21 PM on November 22, 2005

The reason for co-pays is to keep people from running to the doctor everytime they feel the slightest pain.

Maybe originally, but co-pays have risen slowly while health care costs skyrocket. Nowadays, if anything—in the U.S., at least—your average co-pay encourages people to run to the doctor every time they feel the slightest pain.

Many plans do cover dental work traditionally, with deductibles, co-payments for preventive care, et cetera. The reason many other plans don't—and revert to the "discount" you mentioned—is that dentists' fees vary widely. Like really widely. Really really widely.

If you go see a frou-frou dentist in the city, you'll probably pay nearly twice what you might in a non-affluent suburb. Reason? If I had to guess, I'd say that doctors tend to pool resources and operate in shared facilities in cities, whereas dentists hang shingles and pay premium rent.
posted by deadfather at 5:33 PM on November 22, 2005

Maybe originally, but co-pays have risen slowly while health care costs skyrocket.

Mine has gone from $5 to $25 in the past decade. That's a pretty steep increase compared to the standard of living which has remained quite stagnant if it's gone up at all.
posted by any major dude at 8:17 PM on November 22, 2005