Good dental health begins with regular brushing and flossing, but regular visits to the dentist are just as important to your health as good eating, regular exercise, and routine preventative care. It is estimated that for every dollar spent on preventative dental care that $50 is saved on more expensive procedures to fix more serious dental issues that develop.
Dental insurance focuses on prevention and routine check-ups and cleanings are usually fully paid for by the insurance plan. A survey by Delta Dental found that “families with dental insurance are almost twice as likely to get preventative care as those without it”. Untreated preventable oral diseases result in more than 2 million emergency room visits a year in America.
Knowing where to find low-cost dental care is essential for the long-term health of your family.
Medicaid Insurance Options
Texas offers several programs that provide dental coverage. Texas Health Steps (Medicaid) and the Children’s Health Insurance Program (CHIP) provide dental services to most children and young adults aged 20 and younger who qualify. Low-income pregnant women may also be eligible for Medicaid health benefits for up to 2 months after the birth of the baby which can help pregnant women who can be at high risk for health problems during their pregnancy. The programs provide individuals with a managed care dental plan through a company such as DentaQuest or UnitedHealthcare Dental.
Texas also offers a problem called Title V which is available for low-income women and children who are not eligible for Medicaid or CHIP. This program covers children and young adults age 21 and younger, and pregnant women up to 3 months after they give birth.
If you are paying for dental care out of pocket (without insurance) there are some types of providers who offer care for free or at much lower costs.
Texas also has many Federally Qualified Health Centers (FQHCs). These are also called community health centers and are care facilities that receive grants from the government to provide comprehensive health services to underserved communities, including uninsured individuals, for free or at a significantly reduced cost. Some FQHCs even offer dental services.
Finally, most schools and universities that offer dental hygienist/doctor of dentistry programs have a dental clinic on campus that accepts public patients. These clinics are used to train students who are attaining their licenses and are supervised by licensed faculty. There can be varying arrays of available services, costs, and wait times for these programs, however, can be a much lower cost option than visiting a more traditional dental care facility.
Other Insurance Options
Many individuals can get dental insurance at a reduced cost through their employer’s health insurance plan. Your employer may even offer two or more different plans with different coverage options – the cheapest option may just cover preventative benefits, while more expensive options would provide coverage for more advanced procedures.
It is common for plans to follow a 100-80-50 coverage structure, meaning the plan pays 100% for preventative care, 80% for basic procedures, and 50% for major procedures. Common basic dental procedures include fillings, crowns, and non-routine x-rays, while common major dental procedures include implants, dentures, and bridgework. Orthodontic treatment may be included as a major dental procedure or covered separately.
Plans with more coverage will generally cost more than plans with more limited coverage, but this can be money well spent if you know you will access the plan’s benefits.
If you do not have a dental insurance plan available from your employer, you can purchase dental insurance either as an add-on to your health insurance or as a stand-alone plan. These plans work similarly to employer-provided plans, though can be more expensive because health insurers include significant “selection risk” surcharges in stand-alone plans.
Stand-alone plans can also have certain coverage duration requirements before providing benefits. For example, you may need to be enrolled in the plan continuously for 12 months before you are eligible for coverage of major procedures. Alternatively, plans may provide very minimal benefits initially and increase the coverage as you satisfy the plan’s duration requirements.
Dental insurance is an important component of good dental health, and good dental health is itself important for the health of your whole body. Understanding which coverage and provider options are available to you is an important step toward achieving your healthy lifestyle goals.