The Pricing Anomaly in Dental Insurance
Single parents can claim more than they spend on dental insurance
It’s a rare phenomenon for an insured to able to guarantee themselves an economic advantage by holding an insurance policy. One of those situations exists for dental benefits.
Here’s how it works
Healthy single parents below the age of 39 can purchase up to $3,750 of annual dental coverage for their families for just $950 per year. For $79.69 per month, a single parent can purchase a plan which would cover themselves and up to 4 children. It’s the same price whether you have 1 child or 4 and policies have annual dental coverage limits of $750 per person. Even a single parent with one child reaps a small economic benefit from these policies if they regularly visit the dentist.
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See the Numbers
The Numbers
Annual Per Person Maximum Dental Reimbursement: $750
Co-Insurance: 70% – You Pay: 30%
Monthly Cost = $79.69 x 12 = $956.28 Annually
Number of Insured: 1 – 5
Scenario #1;
Wilma , age 33 has a 3 year old child. Her dentist charges an average of $340 per visit so she and her daughter can visit twice per year. That would be a cost of $1,340 annually. A benefit policy would cover $952, but would cost $950 annually.
Scenario #2
Marc, age 27 is the father to Marissa and Dillila, ages 3 and 5 respectively. They found a more affordable dental office charging them an average $250 per visit. They can technically visit 3 times each per year but only choose to visit twice. The families total annual dental expenses are $1500 where $1050 is covered by a dental policy costing $950 annually. The family is not even fully taking advantage of the scenario and is still reaping a $100 annual benefit.
Scenario #3
Lucy, age 36 has 4 kids. Ryan who is 15, Kimmy age 12, Melvin who is 11 and Ricardo who just turned 6. Their dentist charges on average $300 per visit and they take full advantage of the same benefits policy. Each family member would have an annual dental cost of $900, 70% of which would be covered by a benefits policy. This would cover over $2500 of dental expenses for the cost of $950 annually.
Policy Details
Dental Coverage
This coverage provides for reimbursement of costs of the eligible services described below.
Preventative Care – Preventative services are reimbursed at 70%
- Examinations and diagnostic services
- Radiographs
- Laoratory tests
- Preventative servcies
- Case presentation and treatement planning
Basic Care – Basic care services are reimbursed at 70%
- Removal of erupted teeth (uncomplicated surgery)
- Restorative services
- Endodontics
- Periodontics
- Denture services
- Surgical services
- Adjunctive services
All of the eligible services listed above are subject to annual maximum reimbursements of $750 per insured.
Dental treatment due to an accident is covered at 80% up to an annual maximum of $2,000 per insured
Extended Health Benefits
Hospitalization – private or semi-private accommodations (up to $200 per day, up to 90 days per year)
Hearing Aids – $300 every 5 years
Prosthetics – $2,500 per year
Nursing and Home Care Services – $2,500 per year
Orthopedic Shoes – $200 per year
Equipment Purchase & Rental – $2,500 per year
Ambulance – 80% coverage
Specialist Services
- Chiropractor – $20 per visit up to 25 visits per year
- Acupuncturist – $20 per visit up to 25 visits per year
- Osteopath – $20 per visit up to 25 visits per year
- Physiotherapist – $20 per visit up to 25 visits per year
- Podiatrist – $20 per visit up to 25 visits per year
- Psychologist – $65 per visit up to 12 visits per year
- Speech Therapist – $45 per visit up to 12 visits per year
- Naturopath – $20 per visit up to 25 visits per year
- Optomologist – $20 per visit up to 25 visits per year
- Message Therapist – $20 per visit up to 25 visits per year
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