When Is Insurance Not Really Insurance? When You Need Pricey Dental Care.

David Tuller with the University of California, Berkeley, notes in Kaiser Health News that medical and dental care coverage are segregated in many countries, including the United States. "Dental policies are more like prepayment plans for a basic level of care," Tuller writes. "They generally provide full coverage for routine preventive services and charge a small copay for fillings. But coverage is reduced as treatment intensifies." Medicaid covers pediatric dental services, but it is up to states themselves on whether to offer adults such benefits. "Many dentists won't accept persons on Medicaid, child or adult, because they consider the reimbursement rates too low," Tuller says. For example, in 2016 Kaiser Health News reported that Medicaid in Colorado pays $87 for a filling on a back tooth and $435 for a crown, versus $150 and $800 that private customers typically pay. Furthermore, many older Americans lose employer-based dental coverage when they retire, and basic Medicare plans exclude such coverage, although options exist for seniors to purchase it. Tuller notes in 2015, nearly 35 percent of American adults of working age lacked dental insurance, while only about 12 percent of adults under 65 did not have medical insurance. "That lack of coverage and treatment can diminish economic and social opportunities," he warns.