Be it health, dental, life, auto, or home insurance, we all know it's a smart idea to have financial coverage in order to give you peace of mind and protect yourself in the future. But what if your insurance plan doesn't cover everything you may need?
When it comes to health insurance and dental benefits, you may have heard the phrase "supplemental insurance." But what exactly is supplemental coverage, why might you need it, and is it really worth your money? Let's dive in.
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What Is Supplemental Insurance?
Simply put, supplemental dental insurance is additional private health coverage you can purchase to help you pay for costs that aren't covered by your primary insurance policy.
Depending on the supplemental benefits you choose, they may reduce or even eliminate your need to pay standard out-of-pocket expenses such as copays, coinsurance, and deductibles. Some supplemental plans may also pay for a portion of services and other costs not covered at all by your main insurance policy.
Since supplemental insurance is designed to fill in these gaps, supplemental policies for those specifically on Original Medicare are often referred to as "Medigap" plans.
Supplemental Insurance Definition
Supplemental insurance is a policy you have in addition to your primary benefits. It can help you pay for out-of-pocket costs or other expenses that aren't covered by your primary plan.
Why Do I Need Supplemental Dental Insurance?
Now, you might be asking yourself: "Do I need supplemental insurance?" And the answer is no. You can certainly go to the dentist and get the services you need without having the insurance that covers it. But the question of whether you should get supplemental insurance is different altogether.
Unfortunately, this is difficult to answer since everyone's situation is different. Whether or not you would benefit from supplemental coverage comes down to what your primary insurance covers, what services you may need in the upcoming year, and how much you can reasonably pay on your own for out-of-pocket costs. Deductibles, copays, coinsurance, and other out-of-pocket expenses can quickly add up to hundreds, if not thousands, of dollars in fees. Supplemental insurance gives you added protection against these financial burdens — especially in the event of an unpredicted illness or injury that may require dental care.
Who Should Buy Supplemental Health Insurance?
Those with employer-sponsored dental benefits may not need to worry too much about supplemental insurance. That said, many standard plans only cover 50% of major treatments such as crowns and root canals, and might not provide any coverage for orthodontics at all. If you or your family anticipate needing in-depth procedures or braces, you may want to consider a type of supplemental plan.
Others who could benefit from supplemental insurance are those with ACA-qualified health insurance plans. Under the Affordable Care Act, dental coverage is not considered an "essential health benefit" for adults. Those who have purchased health insurance through their state marketplace might want to think about buying supplemental coverage through private insurance.
The last group who may want to seriously consider supplemental insurance are those on Original Medicare. If you get these kinds of benefits through the federal government, you may wonder if you really need a Medicare supplement plan — and the answer is likely yes.
Original Medicare doesn't cover any dental procedures, unless the treatment in question is needed in conjunction with specific hospital care. (Medicare Advantage (Part C) plans combine Medicare Part A and B for comprehensive coverage. Part C plans can include additional coverage such as dental and Prescription Drug (Part D) coverage. Medicare Supplement insurance policies, also called Medigap, help pay the out-of-pocket expenses not covered by Medicare Part A and Part B. Medigap provides additional coverage, but is not part of the government’s Medicare program.)
Unfortunately, those in the Original Medicare program often go without necessary dental treatment. This is even worse given that seniors (the majority of people on Medicare) are already at an increased risk for problems such as cavities and gum disease. These issues have even been shown to contribute to or exacerbate other conditions such as diabetes and heart disease.
Opting to add dental coverage with supplemental insurance can help you address these issues early should they arise. What's more, you'll have access to preventative dental care that will reduce the risk of costly procedures later.
Is Supplemental Dental Insurance Worth It?
If your current health insurance plan doesn't cover or only covers a small portion of dental care, supplemental insurance could save you a lot of money in the end.
Think about it: Without dental coverage, the cost of just a preventative dental visit (exam, cleaning, X-rays, and fluoride) could cost you somewhere between $200 and $300. A good dental plan will likely cover most if not all of these fees. It will also greatly reduce the cost for any additional procedures you need such as fillings, crowns, root canals, or dentures.
And what about "Medigap" plans? Are Medicare supplement plans worth it? If you're in the Original Medicare program, it's a very smart idea to add supplemental insurance for dental care. According to the Kaiser Family Foundation, 65% of Medicare beneficiaries had no dental coverage in 2016, and 49% hadn't been to the dentist in the past year. Of those without supplemental insurance who did seek did dental care, 19% reported out-of-pocket costs of more than $1,000.
With the connection between oral and overall health, it's imperative to ensure you have access to dental care — but we know there are many things to consider. Use our tip to help you choose a plan that's right for you and your smile.
Looking for dental benefits? We offer a variety of plans for individuals and families with different coverage options to fit your needs.
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