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Affordable Care Act

We realize that finances are one of the main reasons that people postpone going to the dentist and that the subject of money can be a difficult one to bring up, especially when your health and well-being are involved. If you are fortunate enough to be employed by a business that offers low-cost dental insurance often that is the most affordable way to subsidize the dental care your family needs. But what if you don’t have insurance? You should still take care of your teeth, right?

Now that the Affordable Care Act (ACA, or Obamacare) has made it possible to purchase dental insurance on an individual basis, the question of where the money will come from for treatment is even more confusing! Sure, at first glance it may seem to be a good idea to sign up for a plan that will cover your entire family, but we’ve been curious about the new dental insurance offered here in Texas and so we did a bit of research to get a little better idea about the true costs of dental care and dental insurance, mandates, and the like. Here’s what we found by looking at the rates at Blue Cross and Blue Shield of Texas, one of the ACA dental insurance providers, and our own fees:

  1. All children under the age of 21 are required to have dental insurance, according to the ACA. This can be purchased by the parent individually, offered by an employer, or through the Medicaid CHIPS program. Interestingly enough, though, this requirement is not a mandate; in other words, you won’t get fined for not having your kids covered, but when you start looking for dental insurance the wording is very strongly in favor of making sure that you’re not overlooking this essential service.
  2. If you do purchase dental insurance on your own, the expense for the most basic plan is a minimum $27 per month per child and $40 per month per adult. This comes to $330 per child and $480 per adult per year. The highest plans can cost upwards of $45 per month per child. This is over $2000 per year for a family of four. For five family members, that price jumps to $2600 per year.
  3. The bill for our typical patient’s checkup visit averages about $170 or less. This includes exams, diagnostic x-rays, consultations, cleanings, take-home products, and friendly service (of course!). That means for a family of four that visits us twice per year it will cost you less than $1400 for those eight visits. If everyone is healthy, you are saving a significant amount (at least $600 per year) by holding on to your money and paying for your family’s care directly.
  4. What if your family needs extensive care beyond the routine visits? The good news is that the new insurance may be a valuable option, at least for the kids. You may have to pay anywhere from 10% to 50% of the cost for fillings, braces, and sealants, but unlike adult care, there is not an 18-month waiting period for major benefits or a “max out.” Adults can only receive $1500 per year from the insurance company (which means if you are paying $480, then you really are only getting $1020 per adult in additional benefits). There doesn’t seem to be a yearly limit for children up to the age of 21, though, which is why it may be a sound financial decision to look into getting dental insurance for them.
  5. Rossen Dental is a preferred provider for most of the in-network plans, including Blue Cross and Blue Shield, but if you do decide to go insurance-free, we also offer our own Healthy Smiles Plan as a way to pre-pay for your family’s dentistry while earning significant discounts for future care.

Hopefully, this post has helped you become less confused about the financial aspects of dental care and insurance. We want to make sure that you know as much as possible about your care before you begin any treatment, including costs so that you and your family can feel confident that you will be doing everything possible to keep your teeth for a lifetime.