When you’re on active duty, dental insurance seems essential. After all, most of us grew up visiting the dentist every six months. Lots of us spent quality time with the orthodontist. Frankly, many of us grew up eating a diet high in sugar and simple carbohydrates while perhaps not brushing or flossing often enough. Our mouths became perpetual cavity factories, some of us may have even needed braces while serving. But what about Retired Military Dental Insurance?
Maybe later you started a family of your own, and the cycle began anew.
When you leave active duty, though, you’ll suddenly become keenly aware of the cost of dental insurance. You’ll compare the premiums to the expense of visiting the dentist twice a year (“Would you like X-rays with that?”) and the deductibles for almost everything beyond a simple exam & cleaning. Depending on the size of your family and your dental hygiene, the cost of the insurance could be almost as much as the cost of the procedures.
Let’s talk about a taboo subject: going without dental insurance.
But before we get there, we’ll review the insurance business and the most popular policies.
The Finances Of Dental Insurance
Why is dental insurance so expensive, and why does it cover so little compared to health insurance?
The insurance companies are not necessarily the problem. (Admittedly the insurance industry has more than their share of waste, incompetence, and even customer abuse.) Even if a company is the best in the business, though, they still have to take in more money for premiums than they pay out in claims. (They also have to minimize their payroll and bureaucracy– and their cost of customer service.) The best way for any insurance company to survive is to sell policies to a bunch of clients who never file a claim.
By those standards, running a health insurance company seems a lot “easier” than dental insurance. Everybody needs some form of medical insurance to offset the catastrophic costs of life-threatening accidents or diseases, but not everyone files a claim. Those serious incidents can cost millions of dollars, so clients are willing to pay hundreds (or even thousands) of dollars in annual premiums.
But what if medical insurers had clients like dental insurers? Imagine if everyone visited the medical doctor every six months for a full-body scan, a head-to-toe cleaning, and education on using a better washcloth. Imagine if a most of the teenage patients had to have all the bones in their hands re-aligned with special “braces” for a couple of years to ensure that their fingers didn’t wear out too soon. The shortage of medical doctors would be a lot worse, and medical insurance would cost a lot more because everyone was filing so many claims. Meanwhile we’d all be complaining (even more) about the high cost of medical insurance because we’d feel as though the premiums were almost as high as the expenses.
What can we do about the expense of dental insurance?
Employer’s Dental Insurance
When you’re on active duty, your dental insurance is free. (A few “lucky” Reserve & National Guard servicemembers will appreciate this during the drill weekend if there’s a dental clinic with their unit.) Your family has to pay for dental insurance *, but you’re earning a paycheck and their premiums are subsidized by the “employer” (the Department of Defense). When you’re running a large corporation with a few million employees, it’s easier to negotiate rates with the insurance companies. It’s also easier to subsidize the employee insurance premiums instead of paying employees more money to buy their own coverage.
When you leave active duty for a bridge career, the logic is similar– with a different employer. Perhaps your corporation of your new bridge career offers a reasonable menu of dental care options with premiums that are lower than you’d have to pay on your own.
But what if you can’t get large-scale corporate dental insurance? What if your employer doesn’t offer it? What if you have to pay the entire premium by yourself? What if you’re unemployed, or an entrepreneur, or a financially-independent retiree?
VA Dental Insurance
Believe it or not, one option might be the Veterans Administration.
The VA started offering dental insurance in 2014 through civilian companies. The VADIP covers all vets who are eligible for healthcare through the VA, although the veteran still pays the premiums. It’s even available to families who are eligible for CHAMPVA.
I’m not going to cover the details of each policy, and veteran eligibility for VA healthcare is complicated. (Check your own eligibility at that link, and also review the priority groups for VA care.) Readers who are most likely to benefit from VA dental insurance usually already know that they’re eligible for care at a VA clinic, or they’re the families of veterans who are permanently and totally disabled.
[Note: Military retirees can use the VA for their healthcare, and can apply for VADIP or the Tricare Retiree Dental Program. If you’re a military retiree then your family is already eligible for TRDP. See the next section below for more information.]
Remember that dental insurance “coverage” is full of limits. For example, the VADIP will fully cover most routine exams and cleanings. However, it may only cover 50%-80% of the cost of fillings, 30%-50% of the cost of crowns, and (at most) 50% of orthodontia. There is also an annual maximum payout and an annual deductible.
Even when you meet the requirements for VADIP or CHAMPVA, you’ll still have to pay the premiums. The dental policies are offered by Metlife and Delta Dental, and the programs are similar to their corporate dental insurance. Premiums vary by ZIP code and may also be comparable (or slightly less) than the premiums of other Metlife or Delta policies. The range is from ~$30/month (for a veteran) to hundreds of dollar per month (for the vet’s family) depending on several factors.
You’ll have coverage through Metlife or Delta Dental, yet you’re still going to pay a meaningful amount of your insurance budget.
Tricare Retiree Dental Program
TRDP is the next-best insurance policy (after an employer’s benefit or the VA). For most vets (and their families), the major obstacle is being one of the 17% of servicemembers who manage to reach retirement. TRDP covers active-duty retirees (and families) as well as the Reserves and National Guard, even if the latter are “gray area” and not yet receiving a pension.
Coverage is offered by Delta Dental so the benefits are fairly similar to the other programs described above. Routine exams and cleanings are completely covered, but only 80% of fillings and only 60% of root canals. Orthodontics is only 50% covered, and it includes a lifetime cap of $1750 per person. TRDP also has annual deductibles and maximums.
One of the most frequent TRDP surprises is the requirement to enroll within four months after retiring. If the Defense Enrollment Eligibility Reporting System takes a while to update your family’s retiree status, or if you’ve held off applying for coverage while you find a job or move to a new location, then you may have to deal with a 12-month waiting period for crowns, bridges, orthodontics, or implants. If you’re one of the families who leisurely roams Asia or Europe after retirement, or who explores America in an RV for months before deciding where to live, then remember to plan your retiree insurance before you hit the road.
Premiums are a lot easier to parse (again by ZIP code) but are still roughly $30/month (just the retiree) to $135/month (family).
“Do We Really Need Retired Military Dental Insurance?”
At some point during the transition, almost every veteran asks that question. If you’re paying hundreds of dollars per year for coverage (or your family is paying thousands), then the expense of the insurance premiums can approach the actual cost of the dental care. This is by design– refer back to the section above on the finances of dental insurance.
How badly do you need dental insurance? What’s the worst that could happen?
First, check your sleep-at-night comfort factor. If dental insurance makes you feel happier about taking care of your family, then it’s worth more to you than merely the cost of the labor & materials. If you have a large family or busy accident-prone teens then the reassurance of having dental insurance may be well worth the cost. However, that comfort factor comes at a cost, and until you reach financial independence then you have to be willing to work the additional months to earn the money to pay for it.
Next, check your health. If you’re already dealing with chronic medical issues then they may affect your dental health as well. You may be genetically susceptible to gum disease or tooth decay, or blood-pressure medication may affect your oral health, or a straightforward cleaning could affect your heart. Living with diabetes may impact your gums. If you smoke or chew tobacco then maybe it’ll help you to compare the cost of dental care to the money you spend on nicotine… and on cancer treatment.
Finally, check your diet and exercise. If you’re consuming a lot of sugar or soda then you’re setting your mouth up for cavities and worse. (Seriously, check your labels. Food & beverage companies put sugar in everything, and dining out just exposes you to more of it.) The phosphoric acid and citric acid in soda have been linked to accelerated erosion of tooth enamel. If your kids are apathetic about brushing their teeth (or if they’re fueled by sugar & soda) then the cost of multiple fillings could be much higher than the insurance premiums. If you (or your family) engage in contact sports like martial arts, hockey, or soccer, then dental insurance (and a quality mouthguard) may cost less than some of your gear.
Once you’ve parsed your family history and your lifestyle, then how much risk are you willing to take? A severe vehicle collision? (Including motorcycles & bicycles.) Yardwork or home-repair accidents? A dozen root canals? A full set of implants or dentures? If a surgeon has to put your body back together (covered by medical insurance), then how much would it cost for the dentist to put the smile back on your face?
The questions in that last paragraph don’t have easy answers. However, the risks of those incidents are very small, almost in the same probability as lightning strikes and shark attacks. In addition, the financial impact may be relatively small (compared to other types of insurance): $10,000 or less per person.
After you’ve assessed the issues in those last five paragraphs, then analyze your insurance policy. How much of your expenses is it really paying? Note that $4500 of orthodontia (for adults as well as kids) might only have $1750 of insurance coverage. Insurance for other major procedures may only cover 30%-60% of the total cost. You’ll probably even pay at least 20% of the expense of most fillings. The policy only pays 100% for routine exams and cleaning.
After examining your risk factors, now you can research how much you’d pay for your own dental care (without insurance). This will take time and effort, and a lot of conversations with the dentist’s insurance expert. You may find that the dentist will give you a 25% discount for paying with cash (or a credit card). They’ll be happy to share the savings, too, because they won’t have to file insurance claims! The orthodontist may give you an even larger discount for paying up front (in cash) instead of stretching out the payments for several years. (The orthodontist’s insurance clerk does the math to compare an up-front lump-sum payment to a long series of monthly payments.) Instead of buying cheap toothbrushes, check into electric models (with oscillating heads) that your kids might actually want to use. Spend time on YouTube learning how to floss quickly and effectively, with quality dental floss and tools, and then make it part of your daily routine.
Now that you know what you’d really pay to visit the dentist (without insurance), how often do you want to go? Are you more comfortable continuing with the six-month routine, or do you have very low risk factors? Could you stretch out the time between dentist visits to a year? Two years?
You may be surprised to verify what the industry already knows: the cost of the premiums for routine care is close to the cost of the care itself. Even “worse”, when you factor in the discounts then the insurance premiums might be higher than your actual costs. When everyone shows up in the dentist’s office twice a year, the insurance companies have to pay out a lot of claims.
You might even determine that it’s cheaper to travel to Thailand or Latin America for your dental care– including airfare and lodging.
I Don’t Have Dental Insurance.
When I retired from active duty in 2002, we re-examined every single expense in our budget. We were pretty sure that we were financially independent, but we wanted to check every detail one more time. Dental insurance quickly went on the chopping block.
Going through the analysis forced us to examine our lifestyle as well as our budget. My spouse seems to be genetically blessed and her dental health is excellent (she’s never even had a cavity), while I had nine fillings as a teenager. Our daughter was nine years old when I retired and she’d never had a problem– although we already knew she’d have braces in a few years. When we reached financial independence and retired, we had plenty of time to overhaul our diet and cut back the sugar. I changed my flossing habit to daily (whenever I sit down to read a book) and we bought electric toothbrushes. When our daughter and I trained taekwondo we wore headgear and mouthguards.
Our dentists (and our daughter’s orthodontist) were happy to negotiate their fees. “No insurance” meant less hassle and bureaucracy for them, too, and our discounts ranged from 25%-40%. We asked the long-term questions too: how long would my fillings last? (Decades.) Would our daughter need to have her wisdom teeth extracted? (No.) My spouse and I stretched out our dentist’s visits to one year– then two years– and we couldn’t tell the difference. More importantly, the dentists couldn’t tell the difference either. By the time our daughter was finishing high school and headed for college, it was clear that she could revert to annual visits too.
We’ve been without dental insurance for over 14 years, and today we’re thousands of dollars ahead of the actual costs. There have been a few surprises: my spouse had a cracked tooth and I finally had to replace a worn-out filling. (Our daughter never had a problem.) A few years ago we visited Bangkok for a family vacation, and part of our medical tourism was a visit to the local dentist. X-rays, exams, and cleanings were less than $40 per person.
Over the years our net worth has grown faster than inflation, so today we’re completely self-insured for dental care. I enjoy the freedom to shop around our neighborhood for a dentist who will actually discuss the finer points of brushing and flossing. (Hey, I’m paying for their time now, not the insurance company.) I still try to remember to see a dentist every 2-3 years, and we’ll probably do that as part of slow travel through more of Southeast Asia or Latin America.
Should You Cancel Your Dental Insurance?
Maybe, but it’s an intensely personal decision.
Review the section above to decide whether you really need dental insurance. If you feel more comfortable with it, then keep it in your budget. (And be willing to work longer and save more to afford it.) At a minimum, review your lifestyle and start making changes in a healthier direction. This may be the wrong time to cancel your dental insurance, but in a few years you could take another look at the decision.
If you decide to cancel your dental insurance, then live healthy and floss regularly. It’ll save you a lot of pain and dental procedures, not just money!
* [Note: United Concordia takes over the world’s largest dental insurance contract from Metlife in early 2017. It’ll cover the families of active duty, Reserve, and National Guard servicemembers, including minor benefits improvements. The finances (and premiums) don’t change significantly.]
Military Dental Care (in 2011)