Is it more cost efficient to pay out-of-pocket for a dental exam, cleaning, and cavities…or get insurance?

March 16, 2013 | By

Question by hyperactivemiss: Is it more cost efficient to pay out-of-pocket for a dental exam, cleaning, and cavities...or get insurance?
I am a 22 year old freshly graduated from college and unemployed. My dad has been unemployed for a year and my mom is self-employed, which also doesn't pay much. I would really like to hear your opinions on what would be most cost efficient. I haven't been to the dentist in over a year and I can tell I'm developing maybe 5 different cavities. They are on 4 different teeth. Visually, they look very small. 3 teeth have a cavity on the chewing surface, while 1 tooth has many tiny little spots on the chewing surface and one on the "buccal" side facing my cheek. I would like resin-based composite fillings (the white ones that match your teeth).

Dental insurance seems to be more affordable but at the same time I was considering the option of going to the dentist ASAP and pay out of pocket, and take better care of my teeth until hopefully I can find a job and take care of the bills myself. However, estimating the costs, I would say that would be at the very least $ 500 isn't it? (note: that is my rough estimate after Googling online. I have no idea of the true cost) Whereas I could get insurance for a yearly bill of $ 100 and pay cheaper copays for what I need taken care of. (note: I have little experience and knowledge about dental insurance.) Anyone have any thoughts or experiences to share? Thank you.
Yes, I want to make it clear I will get full health insurance in the long run, but right now with everyone in my family unemployed (this includes my adult brother who still lives with us) except for my self-employed mother, I am looking for most cost efficient as of *right now.*

Best answer:

Answer by gi
Have you tried applying for state medical?Another thing insurance most def suppose your teeth need major things done you can't pay out of pocket evey time

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Comments (1)

  1. Alice

    I’ve worked for oral surgeons/dentists for 15 years doing insurance, so I’ll just tell you what I know, but you’ll still probably have to do a little more investigating on your own. If you don’t have a dentist, many offer coupons or specials on their websites for new patients. These often include a cleaning, x-rays and exam, or just x-rays and exam, so you might want to look into that. I suppose my thought there is if you know the fees going in to the insurance search, then you are much better armed to determine what will be more cost efficient.

    When you are shopping for individual dental plans, here are some questions to ask and things to consider:
    1. How much is the deductible?
    2. What are the waiting periods for preventative, basic and/or major services? (Preventative = cleaning, exam, x-rays; Basic = fillings, root canal treatment; Major = Crowns, bridges)
    3. Is my dentist a provider for this insurance? (An in-network provider agrees to accept a lower allowed amount as full payment and writes off the difference between this and his fee)
    4. What is the maximum yearly benefit? (typically ranges from $ 750 to $ 2000)
    5. At what percentages are each of the service levels paid? (Typically plans pay preventative 100%, basic 80%, major 50%)
    6. Does the policy run on a calendar year, is it based on my effective date or some other date? (Dental plans pay a certain amount per year, you just need to find out when that year starts over.)
    7. Talk to the agent who handles the insurance on your home and/or car. Most insurance agents sell dental policies as well.
    8. In my state, Blue Cross Blue Shield offers individual dental plans, so you might want to check out the BCBS website for your state.
    9. AFLAC offers dental plans and has a set fee schedule for each procedure code. They do not operate from a list of in-network dentists, so they will pay no matter who you go to. They may pay it to you instead of the dentist.
    10. Stay away from discount dental plans. You pay these plans to access their network of dentists and get services at a discounted rate. These plans are not worth the paper they are printed on.

    This is probably way more information than you were looking for, but I hope some of it helps. Best of luck to you, your dad and your brother on your job searches. It sounds like your mother is overdue for a spa day!