I hit the dental insurance jackpot. You are a winner if the dental plan pays more for the dental services than the annual premiums. The jackpot is if you hit your maximum annual dollar benefit before the year is up. I did that with an expensive cubic zirconium crown.
The Dental Insurance Jackpot is not necessarily a celebratory event; it means you had some serious dental work done. For this past year, my dental plan paid the maximum benefit amount toward my dental services. Those services included cleanings, exams, and x-rays covered at 100 percent. They then paid 50 percent toward my near diamond level crown. Near the end of year, after the crown, I had to pay for some of the x-rays because I had reached the dollar benefit for the year. In other words, I hit the jackpot.
Dental Insurance Maximum Benefit Jackpot
Dental insurance is analogous to gambling. You sit in front of the slot machine, put in the quarters, pull the arm, and most of the time you win nothing. However, gambling is entertainment, so you had some fun. Occasionally, you hit the triple teeth and win your money back plus a little extra.
The cost of the insurance entertainment is the monthly premium of approximately $50 for a dental PPO plan, about $600 per year, on the high side. The bi-annual cleanings, exams, and annual x-rays generally have no waiting period and are covered 100 percent with in-network dentists. The cleanings and exams average $150 with the x-rays approximately $135. For a regular year, the dental plans pays out approximately $435 on your behalf. This means you put in $165 in premiums more than the services.
Every couple of years I need a crown to replace a molar with an oversized silver filling. For 2021, the new cubic zirconium crown cost $1,319.00, of which the dental plan picked up 50 percent. Without a blink of the eye, the dental plan paid my dentist $659.50 for my shiny new crown, I paid the other half. Of course, the dental plan did not get to enjoy any of the pain I got to savor with the crown replacement.
After the crown installation, I visited my dentist for my second yearly cleaning, exam, and annual x-rays. Unfortunately, I had met my annual benefit with the second cleaning and exam, so I had to pay for some of the x-rays. However, the benefit paid was greater than all the premiums paid-in for the year. The dental insurance covered a large portion of the services for the year.
Dental Plan Paid All Of Their Responsibility
It was during the second visit that I noted I was having some sensitivity in a front tooth, unrelated to any dental work. A review of the dental x-rays showed some bone loss with possibly some irritation. The hygienist did a little deeper cleaning around the tooth. The extra cleaning has dissipated the sensitivity/pain I was having. The issue of the bone is still present. This underscores the value of regular exams to catch dental problems early for monitoring.
My goal is not to hit the dental insurance jackpot next year. The coverage on the routine dental services and paying 50 percent of the crown was welcome. Too many people think dental insurance will pay for all of their expensive dental work that they have neglected for years. That’s like going to the casino, putting one quarter into the slot machine and hoping to hit the $10,000 jackpot…it won’t happen.
Dental insurance, from a pure dollar investment, is a loosing proposition, just like playing the slot machines. The value of dental insurance is the regular maintenance, like changing the oil in your car, and having the dentist catch a problem before it turns into a raging inferno of pain in your mouth. There are lots of dental plans that cost less than $30 per month for an adult. I have a modest $1,000 annual benefit amount. Other plans can have maximum benefits of $1,500 to $3,000. If having dental insurance compels you to go the dentist on a regular basis, then it is a good investment. You don’t really want to hit the dental insurance jackpot.
