Dental Self-Insuring Update: Why Flossing Is Profitable

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A recent post at Miserly Bastard reminded to post about this – Like him, I don’t have dental insurance because I don’t think it’s worth it. It fits into my philosophy to only insure against large losses, especially as most plans have a cap on benefits (mine is $1,500 annually).

I recently went in for another semi-annual cleaning, exam, and bitewing x-rays for about $150. Last time I didn’t have to do any x-rays so it was only $100. So my total dental costs are $250 for the year, and I’m going to claim it on our Flexible Spending Account so it’s basically pre-tax. That’s almost a $400 annual savings over paying the insurance premiums and deductibles.

Now, some people have heavily subsidized dental insurance (like my wife) and/or poor dental health, so it may not be worth it. But I recommend finding out the details anyways and perhaps running the numbers. In my case – best case scenario is saving $400 a year. Worst case – I need some kind of surgery and max out the benefit of $1,500, which is only a real loss of $1,100 since I have to use $400 of that benefit on the regular stuff anyways.

If I restrict it only to either gaining $400 or losing $1,100, according to strict odds I should only self-insure if I think there is greater than a 73.3% chance that I won’t need surgery. I’m pretty confident my chances are better than that 🙂 Add in the fact that a loss won’t be catastrophic (you won’t want to use this method for life insurance), and I’m happy with my choice.

As a side note, if you are paying cash, you can haggle with the doctor. Some are flexible, some are not. I deem the prices pretty fair at my current dentist so chose not to, but I did ask if they had a discount for paying cash – and they had one for 5% off. Not enormous, but every bit helps.

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  1. John Wilks says

    My dental insurance only costs me about 2 bucks per week, taken right out of my check. I agree with you that only the big things should be insured. However, breaking or chipping a tooth is one of my biggest fears EVER! For me, teeth are still to expensive to pay for out of pocket.

  2. I went 3 years without dental insurance. It cost me about $6,500 for several problems that popped up in those 3 years. I had to get 3 root canals and crowns, and remove all of my wisdom teeth. I wish I had dental insurance then. I learned my lesson and now floss, use a sonicare toothbrush, and have dental insurance.

  3. I’m happy with my HSA insurance in that there’s no copay to go to the dentist twice a year for cleanings/check up and once a year for ex-rays. I have Aetna’s HSA and when I switched from BCBS I was paying 20 dollars each time, so I’m savings at least 40 dollars a year now. I haven’t had anything really serious yet, but each money the money pot in my HSA keep growing that I’m happy that I’m able to go twice a year for the checkups free.

  4. But don’t the dental insurance companies also negotiate lower prices? I have MetLife through work and the cost of procedures for in-network providers is as much as half the cost for the same procedure at an out-of-network provider.

  5. The dental insurance/out-of-pocket [OOP] debate can favor either being insured or self-insured, depending on circumstance. However, one comment was that the OOP costs could be put into the Flexible Spending Account [FSA] of the family through one of their employers. This allows both the insurance premium AND the OOP costs to be paid pre-tax, as mentioned, saving the employee both FICA and Income Tax, while also saving the employer FICA and other payroll taxes. “Micro-sized” [0-10 EEs] employers can do the same, but have all of the same hoops to dance thru as do the “big guys” — we help the “micro-sized” biz [profit and non-profit], including sole props and LLCs do the same via proper administration of a Sec 105 MERP [Medical Expense Reimbursement Plan]. Send us a note to for info.

  6. Just wanted to add my two cents and agree that you loose absolutely NOTHING by trying to work the dentist down on price. I am 24 and like many 24 year olds lack dental insurance. After just a couple minutes of begging and pleading, he agreed to cut the cost of my two crowns by 20%!!! It always pays to ask!

  7. heather – that is a very good point. You’d want to take that into consideration. I can’t find my old bills, but from what I recall they were pretty close. But I’m sure it varies between insurance carriers and providers.

  8. Close friend of mine: After a night of light drinking (typical friday for a 20 something) slipped and fell down a long metro escalator in the Adams Morgan (Washington DC) station. Happened to be in b/n jobs and knocked out 10+ teeth, broken jaw, arm etc. No dental coverage and walked around like a puzzle piece for more than six months. I am still amazed at his composure through the whole thing but it’s certainly worth the $15/mo average for dental coverage not to walk in those shoes. Sorry Jonathan, I’m going the other way on this one.

  9. There are two basic types of dental coverage that you can get.

    The more expensive type is more like traditional insurance, with a deductible, copayment, and maximum coverage. These typically run $50+ per month, and I totally agree that they’re not worth the money for most people.

    The other type of dental coverage is the dental discount plans. They typically run about $100 per year for an individual and $200 per year for a family and the discounts range from 30% to 50%. If you just go for a cleaning every 6-12 months and have only minimal work needed, you basically break even. But if you need a crown, root canal, or anything beyond the basics, you can save quite a bit. I think these types of plans can be worthwhile.

  10. I am curious if anyone else has had experience with these discount plans Michael is talking about, as I am looking into this for my wife. She is a nanny with no dental plan. She has nothing in terms of dental coverage now and these plans seem worthwhile. Are there any catches that I’m not aware of? I found my information from
    ex) $99.00/year + 3 free months gets you half price for cleanings ($36 vs $75), x-rays ($22 vs $49), etc. Seems like it pays for itself right there.

  11. While I agree with you that one should usually only insure for major/expensive events, I think medical/dental are very different.

    When buying health insurance, you are not only buying insurance, you also are buying into collective bargaining power. An example illustrates this point.

    Consider a simple blood panel (simple blood tests) which most MD’s would charge $30-$50 to perform in their office (this is a small scale example, but one of the most dramatic). Insurance companies have negotiated drastically reduced fees for this service (and others). BC/BS, for example, has negotiated for a reduced fee of $3. Hence, you pay $0.30 with your 10% copay. In this case, you saved $2.70 from the “insurance” and $27+ from the collective bargaining power provided through your insurance company. Obviously this is on a small scale, but it applies to more expensive doctor’s visits, tests, procedures, etc.

    The collective bargaining power is why medical insurance is so vital today. It is becoming that way with dental.

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