Dental insurance is topic that divides dentists and patients alike. Some see it as a necessary safeguard against high dental costs, while others see it as a hindrance to quality care. In this article, we will explore the pros and cons of dental insurance to help you decide whether it’s worth it for you.

Pros of Dental Insurance

• Lower Negotiated Fees: When you have dental coverage, the insurance company negotiates with each dental office on your behalf, which can result in lower fees for dental services.
• 100% Preventative Coverage: Most dental insurance companies offer 100% coverage for preventative services like check-ups and cleanings, which encourage regular dental visits and helps prevent more serious dental issues down the line.
• Employer Benefits: Dental insurance is often provided as an employee benefit from your employer, which can help make it more affordable.
• Financial Protection: Dental insurance can provide financial protection against unexpected dental costs, such as emergency dental work or major dental procedures.

Cons of Dental Insurance

• Limited Coverage: Most dental insurance companies have an annual maximum coverage limit of $1000-$2000, which has not been adjusted for inflation since the 1970s!
• Insurance Denials: Each insurance company has its own criteria for what they will or will not cover, which can lead to confusion and misunderstanding.
• Downgrading: Insurance companies may downgrade treatments to cheaper and less effective options, which can compromise the quality of care you receive. For example, at MiBöca Dentistry we do not utilize harmful mercury amalgam fillings, and instead use biocompatible and biomimetic materials that include composites and ceramics. Unfortunately, your insurance company will not pay for these materials. They often will pay on the cheapest and likely the most toxic, less esthetic materials.
• Deductibles and Copays: Patients are often required to pay a certain amount out of pocket before insurance kicks in, and even after that, they may still be responsible for a copay.
• Limited Provider Options: Insurance companies have a specific list of dentists they will work with, which can limit your options and prevent you from seeing your preferred dentist. Don’t worry, you can still see us as an independent provider. We will file the claim for you and you’ll receive the reimbursement in the mail directly from the insurance company. This is something your insurance company does not want YOU to know about!
• Unnecessary Treatments: Providers may be potentially incentivized to perform unnecessary treatments, such as crowns, small fillings, root canal therapy, extra x-rays (radiographs) or fluoride treatments, in order to get paid more by insurance companies.
• Disconnection from True Service Value: Dental insurance can disconnect patients from the true value of dental services, leading to neglect of oral health and delayed treatment.
• Less time with your provider: The dentist and Hygienist needs to see more patients in order to be profitable. This forces the dental office to see more patients in less time: not a good situation if you need quality care.
• Zero access to MiBöca’s biological dentistry: You won’t get ozone treatments, stepwise caries removal techniques, zirconium implants, infant tongue tie assessments and treatment, PRP/PRF, remineralization protocols, nutritional consultation, biomimetic restorations, and much more that may save you thousands over your lifespan.
• Sending your dollars out of your community: Warren Buffet and the large insurance conglomerates do not care as much about local community as you do. Supporting independent providers, like MiBöca Dentistry will keep your dollars local and your community strong and vibrant.

Wait a minute, there’s another way?

Given these pros and cons, you may be considering whether dental insurance is the right choice for you. We have your answer right here. You’ll want to divorce your dental insurance after you learn about it. This better option is called a membership discount plan, and we think MiBöca’s Platinum Plan is the best!

Read more about it by clicking here, “What is a dental membership plan and reasons why I need one”

In conclusion, dental insurance has it pros and cons. While it can provide financial protection, lower negotiated fees, and encourage regular dental visits, it also has limitations, including limited coverage, insurance denials, downgrading, deductibles and copays, limited provider options, and a potential disconnect from the true value of dental services. Ultimately, the decision to have dental insurance is a personal one and depends on your individual needs and financial situation. As a functional and biological dentist, I recommend regular preventative care and early intervention, regardless of whether or not you have dental insurance. Call our office, we’d be happy to help you understand your plan and different options and help you afford high-quality dentistry.

Do you want to learn more about why your dentist may not participate as an in-network provider?

Read the article here to learn more, “Why Independent Dentists May Not Participate in Dental “Insurance” Networks“

Dr. Trino Nuño, DDS Owner & CEO, Functional Dentist