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Written by: Nick Houser
Date: January 8, 2016

Smile! Flickr: eperales

Smile! Flickr: eperales

We are right in the heart of open enrollment season for health insurance. Whether you’re selecting an employer-sponsored plan, an individual plan or Medicare, one of the biggest questions you’ll face is what to do about dental insurance. 

Do you need dental insurance? Is it worth it? What if you are making decisions for an aging parent? What dental needs might they have? Is it cheaper to just pay for dental services out-of-pocket?

Ultimately, only you can make that decision, but here are two important things to know as you consider your dental options for 2016:

  • Original Medicare doesn’t cover most dental care, including cleanings, fillings, tooth extractions, dentures, dental plates, or other dental devices.
  • The Affordable Care Act doesn’t require dental coverage for adults, so your employer is not required to offer you dental coverage.

Because of these facts, many adults and seniors will make the decision to forgo dental coverage. There are a few other stats you need to consider.

By forgoing dental coverage, many are actually forgoing preventive oral care. The Centers for Disease Control and Prevention (CDC) report that nearly 40 percent of adults age 65 and over did not go to the dentist at all in 2013.

You don’t have to be a senior citizen to have problems with your gums and teeth. The CDC also states that one out of every two American adults aged 30 and over has periodontal disease.

So what’s the risk? In addition to cavities, gum disease and other oral problems, the National Association of Dental Plans (NADP) says those without dental benefits (and the subsequent preventive dental care) are:

  • 67 percent more likely to have heart disease
  • 50 percent more likely to have osteoporosis
  • 29 percent more likely to have diabetes

Going without dental insurance can also be harmful to your wallet. Routine dental exams allow problems to be caught early and treated inexpensively. Every $1 spent on preventive oral care can result in $8 to $40 in savings on future dental costs, according to The American Dental Hygienists’ Association, and a major procedure like crowns or dentures can cost up to double what you would pay if you had insurance, the NADP reports.

Hopefully this makes the decision more clear, but you still have some work to do. Not all dental plans are alike, so you’ll want to do a little bit of research before choosing your dental insurance provider.

Understand whether procedures you may need are covered by your dental plan and at what percentage. This goes beyond routine cleanings and x-rays, as the 50+ crowd is more likely to experience gum decay and require care to address it. 

Check your dental plan’s annual maximum benefit. When that maximum is reached, the dental plan no longer pays for additional services. If you are in need of a lot of dental work, this could become a big consideration. 

During  open enrollment season, consider dental benefits along with your medical options. Protecting your mouth and teeth is an important component in protecting your overall health.  

Editor’s note: Bryan Fair is Central Ohio Market Manager for Dental Care Plus Group, a sponsor of WOSU Pubic Media.