Is dental insurance real insurance?

“Dental insurance isn't real insurance” is a useful provocation, but it is too broad to be a factual definition. Insured dental plans do exist. The frustration usually comes from annual payment limits, waiting periods, exclusions, and bills that remain with the patient.

Why the phrase resonates

Many dental plans cap what they will reimburse in a year. The ADA describes annual maximums and fee schedules. A patient may also owe a deductible, coinsurance, or an out-of-network balance. The ADA's explanation of benefits guide shows how those amounts add up.

What the phrase misses

A fully insured dental policy transfers covered claims risk to an insurer under its terms. A self-funded plan leaves that risk with the employer. Discount programs are a different product and are not insurance. The ADA distinguishes these types of dental arrangements.

A better question for employers

Ask: How much of the premium or employer spend reaches actual covered care, and what will an employee pay for three realistic treatments? The answer depends on the plan and claims, not a slogan.

Denta administers self-funded dental benefits and has an interest in that alternative. Compare our model with an insured quote using the same benefit and cost checklist.