Is it cheaper to have dental insurance?

But whether dental insurance is worth it depends on how much it costs and what you get from the coverage. You also have to think about why you want dental coverage. Do you want something that just pays for prevention measures or would you prefer more comprehensive coverage?

Dental insurance picks up the tab on many covered services and treatments, up to a certain percentage, based on your plan. But make no mistake: You will be responsible for paying some or most of the expenses for most dental care.

Here are the types of costs with dental insurance plans:

Some plans add a portion of any unused benefits from the prior year to the annual maximum of the following year, helping to build a cushion for unexpected emergencies like crowns, root canals and surgeries.

The average cost of dental insurance is $47 a month for a stand-alone dental plan. The average cost of a dental plan for only preventive care is $26 a month, but these plans will not include coverage for fillings, extractions or major work such as root canals.

Premiums are only part of the cost equation. Depending on your plan, you may also be responsible for copays, coinsurance, deductibles and treatment that exceeds annual coverage maximums. A cheap dental insurance plan could leave you paying a lot out of pocket if you visit the dentist.

Related: How Does Dental Insurance Work?

Most dental insurance plans commonly cover three areas of care: preventive, basic and major. Michael Bass, client advisor for World Insurance Associates, says many dental insurance policies typically provide:

Many dental plans reject coverage for certain treatments, including:

If your dental insurance plan includes coverage for one or more of these services, it may be at a smaller percentage, which means you pick up more of the costs.

Dental insurance can provide numerous benefits, including paying for preventive care.

“Insurance usually covers preventive care in full,” says Albert Abena, assistant dean for Community Partnerships of the College of Dental Medicine at the University of New England. “Keep in mind that getting regular preventive care can safeguard your oral health from future issues and provide advance knowledge of possible problems that your dentist can address proactively instead of reactively.”

Bill Green, owner of Green Insurance Agency in Orange Park, Florida, says dental insurance can lead to lower costs when you need care.

“Even if you just get two cleanings a year, it should pay for itself,” says Green.

But dental policies have their drawbacks, too. Daniel Cho, a dentist in Portland, Oregon, says plans have special rules, such as age limitations for fluoride treatment or missing tooth clauses.

“Insurance typically does not cover 3-D X-rays, moderate or deeper levels of sedation, sleep dentistry and cosmetic work. And your plan may only cover a small portion of the total cost for advanced surgical procedures,” Cho says.

Here are pros and cons of dental insurance:

You may benefit from a dental insurance plan if you regularly see a dentist and can get a low-premium plan or if you need to see a dentist and find a plan with no waiting period and high annual benefits.

Be sure to look closely at the plan’s network of participating providers, different kinds of dental plans available within your area, and what’s covered in each plan, advises Joseph Dill, chief dental officer for Delta Dental Plans Association.

Green recommends a dental plan “that has the highest annual coverage limits as well as one that has the highest coinsurance for basic and major services.”

An estimated 76.5 million Americans lack dental insurance coverage, according to CareQuest Institute for Oral Health, a non-profit that advocates for accessible oral health care. If you need dental care but don’t want to acquire a dental insurance plan, you can pay the amount in full from your savings or pursue these options:

More: Best Dental Insurance For Seniors

Dental coverage makes dental care more affordable by providing cost savings on dental treatment and helping you avoid future dental health issues.

“Routine brushing and flossing at home are a great place to start. But care from dental professionals is critical to achieving and maintaining a healthy smile,” says Dill.

Green says a dental plan can be worth it if you get regular care, including checkups and cleanings, but considers a dental plan’s return on investment. In other words, ensure that you will save enough money to offset the plan’s premiums.

Let’s look at how to drill through these plans to find out if dental insurance is right for you.

First, here’s a breakdown of how individual dental insurance works. You select a plan based on the providers (dentists) who you want to be able to visit and what you can afford to pay.

The monthly premiums will depend on the insurance company, your location, and the plan that you choose. For many people, the monthly premium will be around $50 a month. This means that you’re spending $600 on dental costs each year even if you don’t get any work done.

Now, you may think that most people don’t come out ahead with most kinds of insurance, and you may be right. After all, if insurance companies didn’t make a profit, then they would all go out of business. Insurance is designed to protect you in a worst-case scenario.

Dental insurance is significantly different from most other kinds of insurance, however. With health insurance or homeowners insurance, for example, the potential downside is so high that almost no one can afford the risk of not being insured. With dental insurance, the potential downside is fairly low—as is the potential upside.

In a good year, when you only need the standard cleanings, exams, and X-rays that make up good preventive care, you could lose money by having dental insurance. For example, if you paid out of pocket for these services, you might spend around $400 for the year, whereas you might spend $600 for the year on insurance premiums.

Older adults represent a group that may find it worthwhile to enroll in a dental insurance plan. Dental insurance for seniors is similar to plans for other individuals but focuses on the types of coverage that seniors may need. These include crowns, root canals, dentures, and tooth replacements. Even though these coverages are not unique to older individuals, there is a higher probability that seniors will need one or more of these procedures. Note that seniors on Medicare may require a different dental insurance plan than those without it.

What about when you need some work done? In a really bad year, your dentist could inform you that you need a couple of fillings, a root canal, and a crown. On top of that, you’ll still have to pay for your usual cleanings, exams, and X-rays. This is the time to be insured, right? That depends.

Unfortunately, your insurance may not be as helpful as you would expect. Some dental insurance plans have low annual maximums of around $1,000 (this will vary by plan and provider, of course). Once your dental bills exceed $1,000 in any given year, you’re stuck paying the rest of the bills in full. The insurer won’t pay for more than $1,000 in treatment.

You may still pay a lower negotiated fee for the work that you need as a benefit of having insurance, but even negotiated fees could be quite high. For example, if the dentist’s regular fee for a filling is $150, then the negotiated fee might be $100. In this situation, your regular oral maintenance and fillings could use up most or all of your annual maximum, so only a fraction of your large dental-work bill might actually be covered. You might still pay $1,000 to $2,000 out of pocket, plus your annual $600 in premiums.

On top of that, while you may pay 0% in co-insurance on preventive maintenance and 20% on fillings, root canals, and extractions, the policyholder’s share of expensive procedures such as crowns, bridges, and implants tends to be a whopping 50%. This is known in the industry as the 100-80-50 coverage structure. Even if you haven’t used up your annual maximum by the time you need the expensive procedure, you’ll still have to pay several hundred dollars for it.

Dental insurance also rarely covers expensive procedures such as orthodontics and cosmetic dentistry, even if you try to argue that you need a procedure to alleviate emotional pain and suffering. When insurance does cover them, the annual maximums still often prevent you from saving very much, if anything, after you factor in your biannual cleanings and exams.

If you think that you’ll just hold out and purchase dental insurance when you need it, think again. Because of what’s called a waiting or probationary period, this strategy won’t work (you didn’t really think that you had found a way to outsmart the insurance companies, did you?). Waiting periods mean that, for example, one year after you first become insured, your insurance will not cover any major work (such as crowns or root canals), and for three months after you first become insured, it won’t pay for any minor work (such as fillings). Waiting periods vary by policy.

Insurance companies know that when you need a filling or a crown, you need it now—you won’t be able to find out that you need a crown, buy insurance, wait 12 months, and then get it taken care of. If you tried to do that, you would probably suffer from a lot of discomfort and ultimately lose your tooth (and have to pay full price for that extraction).

Surprisingly, even if your employer offers dental insurance, you might be better off skipping it. Many people assume that employer-sponsored benefits are automatically a good deal because you’re receiving a group rate, but this isn’t necessarily true.

When evaluating your employer’s dental plan, make sure to examine the monthly payments, the annual maximum, and the co-insurance. Your employer may offer you a great plan that’s only $20 a month to cover your entire family with a generous annual maximum, or a mediocre plan that’s $50 a month with a $1,000 annual maximum. With the former, you can really benefit, but with the latter, you could be wasting your money. Do the math for your own situation to determine whether you’re likely to come out ahead.

One situation where it can make sense to get dental insurance regardless of whether it seems like a good deal in the long run is if you are living from paycheck to paycheck with little or no money saved. When you don’t have dental insurance, you have to be able to pay a $1,600 bill when you have the work done (if not in full, then in prompt installments). If you can’t do it, and your options are to overpay for dental insurance, neglect your only set of teeth, or put dental work on a credit card that you’ll have trouble paying off, then your best bet is to get the insurance. You’ll probably waste less money on insurance than you would paying interest on a credit card or letting your dental health deteriorate.