Overview of Dental Insurance 

Finding the right insurance coverage, no matter what it’s for, presents you with a long list of challenges and obstacles. After all, it’s not like you’re going to purchase the first policy that comes your way. You want to find something where the monthly premiums provide value and won’t rake you over the coals. 

With dental coverage, it gets a bit more complicated. That isn’t to say it’s an overwhelming burden that’ll keep you up at night. It’s just that your oral health is something of a grey area. 

More specifically, many believe that if you brush your teeth a few times a day and remember to floss, you won’t need dental work that requires coverage. Some people looking to save money forego care with their personal bottom line being top of mind. 

However, is that really the ideal approach? Dental insurance plans might prove pivotal in the case of major procedures such as a root canals. 

Furthermore, many professionals will tell you that dental insurance coverage encourages you to focus on preventative care. 

Weighing your dental health versus your financial well-being isn’t always straightforward. Fortunately, we have a firm grasp of how insurance works in the industry across Canada. Read on as we clarify necessary information that’ll help guide your plan purchasing process: 

Is Dental Insurance Worth It?  

Truthfully, whether the answer to this question is yes or no depends on your priorities and how you intend to use your plan.

Also, say you’re paying $5,000 out-of-pocket because you didn’t have a dental plan and needed a root canal. While it isn’t an ideal expenditure for some individuals, their rainy-day fund might more than cover the balance. Plus, the chances are that this won’t necessarily happen to you. In which case, the premiums are nothing but a net loss. 

Again, though, this comes down to priorities. 

More specifically, the damage done from not having dental insurance doesn’t come close to what could happen without, for instance, home insurance.

Still, for many, having the peace of mind of knowing you’re covered in the case of a more serious dental procedure is enough. And the cost of monthly premiums might be well worth it. 

Beyond these factors, some plans offer more value than others. If you receive coverage where the monthly premiums don’t seem too over the top, it is entirely worth it. Beyond that, insurance isn’t necessarily about netting a profit or return on your investment. It’s more about finding a reasonably affordable policy that protects you when you most need it. 

What Does Dental Insurance Cover? 

The philosophy followed by most dental plans is based on something called 100/80/50 coverage. 

This model takes the coverage level and bases it on the given procedure or treatment’s severity and extensiveness.

Many plans cover 100% of preventative care visits, which generally extend to exams, cleanings, and X-rays performed during standard checkups. You’re supposed to receive two cleanings per year. 

You’ll generally find that basic procedures, a classification usually designated for fillings, extractions, and periodontal work, don’t receive full coverage. Instead, your insurance plan should take care of 70–80% of the costs. 

Only 50% coverage (or less) is provided for more comprehensive procedures (e.g., crowns, root canals, dentures, bridges, or implants). 

Be aware that not all plans follow these rules precisely. Take a root canal, for example. This procedure can be classified as major or minor, depending on your provider. Moreover, orthodontic care might have to be purchased separately (or could already be part of your policy), whereas something cosmetic, such as teeth whitening, is almost always universally an out-of-pocket cost.

Seemingly, dental plans shine a light on preventative care to ensure you won’t require more extensive procedures. 

You might find you don’t entirely offset your premium by scheduling twice-a-year cleanings. But over the long run, you’ll have gone to the dentist more and not faced the financial consequences of needing a root canal.

Furthermore, most people without a plan simply don’t go to the dentist. Then, when they finally do (likely after receiving benefits from work), they have a multitude of cavities. Sure, you might have coverage. But you’re still on the hook for 20% of the cost for multiple fillings. That adds up over your visits—in some cases, you might need nine or ten appointments. 

How Much Does Dental Insurance Cost? 

Unfortunately, there aren’t any Canada-specific averages to work from. We can tell you that the Pacific Blue Cross, for instance, offers a single-person plan at $69 per month or $782 per year. 

Keep in mind that prices will vary depending on the province or territory you reside in. 

Maximum annual benefit/coverage limits are generally associated with these insurance plans. This amount ranges from $1,000 to $2,000. 

Coverage limits come into play once you’ve reached your annual limit with your dental spending. From that point onward, you pay expenses yourself.  

Where Can I Get Dental Insurance?  

A Canadian Health Measures Survey (CHMS) cites that 62% of Canadians pay for private dental insurance. 

While some might think that Canadians’ free medical care extends to oral health, this isn’t the case. Dental treatments aren’t included in the Canada Health Act.

You might have a job where your employer offers dental benefits. However, in many cases, you’ll find that the coverage only extends to routine visits for checkups and cleanings. More thorough plans might be available, so do some research to see if your organization provides anything comprehensive.

Most people who receive top-tier dental benefits from their jobs are in relatively cushy roles. Thus, it should come as no surprise that so many Canadians find themselves ponying up for private providers. 

Finding an ideal dental insurance company isn’t overly complicated, but you need to perform your due diligence. Sure, a plan could appear to be favourable and affordable, but it might not cover very much. Ensure that you’re squeezing every ounce of value out of the policy you choose.

Additionally, sites like RATESDOTCA can help you find the best available dental insurance rates in Canada. Of course, what you’re able to land upon will depend on where you live and your current personal circumstances. 

Frequently Asked Questions about the Value of Dental Insurance 

You want to get as much value as possible from your dental insurance. There’s no point in paying for something that only acts as a financial drain.  

One way to ensure you are getting the best bang for your buck from your policy is to ask the right questions. 

Fortunately, we’ve done the legwork for you and answered some of the most frequently asked questions about this subject below.

What’s the point of getting dental insurance? 

The primary reason you should purchase dental insurance is for the extra impetus it gives you to leverage preventative care.

We discussed it earlier, but you’re less inclined to schedule a cleaning or checkup if you don’t have insurance. With coverage, it’s almost entirely pointless unless you’re receiving frequent dental maintenance.

This line of thinking pays off for two reasons. First, preventative care reduces the chances that you’ll require a more expensive procedure. Second, in the instance that there is an emergency or if a more severe treatment is required, you’ll receive coverage to soften the financial blow. 

Sure, 50% coverage for a root canal doesn’t sound like much. But $2,500 is substantially less than $5,000. 

How often should you get your teeth cleaned?  

At the very minimum, you should receive a teeth cleaning once per year. 

But most dental professionals suggest making your way to their office for two yearly cleanings. 

Some dentists even suggest getting your teeth cleaned three times per year. While that might seem over the top, it can only help. This notion rings doubly true if three times per year doesn’t exceed your coverage limits. 

Is it better to get dental insurance or pay out of pocket? 

This question is difficult to answer since you don’t know the future. 

The highest cost for one dental cleaning is around $200. Provided you’re only going to one annual appointment, paying nearly $700 per year for insurance doesn’t make much sense. Conversely, when you make frequent visits to the dentist, you’re probably better off paying with insurance. 

All the same, you might be receiving benefits from work—which is a much better option than paying out of pocket. 

Are dental discount plans worth it? 

Dental discount plans are 100% worth it if you don’t have any insurance. 

With that said, they don’t come close to replacing insurance since it’s not actual coverage you’re receiving. Instead, these discount plans are memberships, and when you pay the dentist, you’ll usually receive around 10% off. 

When you can’t afford a private insurance plan and your work benefits don’t extend to dental care, a discount plan offers some much-needed value.

Conclusion

Dental insurance can be quite tricky to understand. Hopefully, through this article, we’ve enlightened you on how to get the most value from your policy.