Why Is Dental Insurance Separate From Medical Insurance?

Updated · Jun 18, 2022

Dental care is a vital part of our overall health.

Yet, for some reason, our teeth don’t get the same treatment as other parts of our bodies.

And while it’s cheaper than medical care, the costs of dental services can accumulate quickly. Often, they are more than people can afford.

As a result, millions of Americans neglect their oral health, which leads to serious consequences for their overall well-being.

But if the main issue is the price, why is dental insurance separate from medical insurance?

Let’s go back in history to find the answer.

Separation Between Medicine and Dentistry

Dentistry has been a separate field from medicine for centuries.

In fact, until the 1800s, barbers were also dentists! Imagine going to trim your beard and getting a tooth extraction as a bonus.

How did that happen?

How come a medical exam doesn’t cover dental care, but a visit to the barbershop does?

Well, one of the main reasons was that the medical field was more scientifically advanced. It was also a respected discipline in universities.

And it wasn't until the beginning of the 19th century that dentistry started making scientific advances.

In the 1840s, the first specialists attempted to make dentistry a medical specialty. After being rejected by several universities, they opened the Baltimore College of Dental Surgery.

Gradually, they evolved as separate disciplines and are treated as such to this day.

Separation Between Medical and Dental Insurance

The separation of the two fields has spread way beyond science and education. And we don’t mean just to medical or dental insurance.

We’re talking about business operations, governmental regulations, and even market prices.

Business Structure

Most dentists have their own private practice. This means they are both the owner and the lead dentist.

In contrast, doctors most often work in clinics or hospitals. In other words, they are part of a large healthcare system.

As a result, there are more governmental initiatives for medical care.

Let’s see ​​why dental care isn't covered by health insurance programs by the government so much.

Politics

Health insurance emerged in the 1920s in the US. Dental benefits programs appeared later—around the time the government started introducing regulations for medical care.

So, part of the reason why dental insurance is so bad is the different pace of development of the two fields. Still, to a great extent, it’s an oversight by governmental institutions.

In 1965, Congress enacted Medicare but did not include dental care. In fact, health insurance still doesn’t cover dental care.

The Affordable Care Act doesn’t do much better in that regard.

Although it defines it as an essential benefit for those under 18, insurance providers aren’t required to offer dental coverage for adults.

Insurance Companies

Insurance providers view dental and medical care differently. The former requires mostly preventive care, and the latter—mostly sick care.

Because of this distinction, dental and health insurance have different deductibles, premiums, and coverage. Since dental services are cheaper, policies are smaller and more affordable.

Besides, the urgency of treatment also varies. Unlike a heart attack, for example, dental work can often wait.

But while not necessarily life-threatening, oral care can cause serious health issues if neglected.

So why is dental insurance separate from medical coverage if our overall health depends on both?

Well, given all distinctions we discussed, it is easier for insurance companies to treat dentistry and medicine as separate divisions.

Dental and Medical Insurance Networks

To be able to provide competitive conditions, insurance companies create a network of providers. They form relationships with a wide range of hospitals, clinics, and specialists.

But given the structure of the fields, dental and medical services require different systems and networks.

This is the main reason why dental care isn't covered by health insurance.

Even when providers offer both types of insurance together, they still handle them as separate divisions.

Employers treat the two types of insurance differently, too.

Most of them don't offer dental coverage at all. Meanwhile, they see health insurance as an essential part of a competitive benefits package.

Since dental care is cheaper and premiums are low, you can find an affordable plan on your own.

While there are some attempts to overcome the separation of medicine and dentistry, this is still far in the future.

For now, you can get dental and medical insurance combined from private providers. You can also find it in supplemental coverage options, like FSAs or HSAs.

Wrap Up

Dental care is just as important as medical care for our overall health.

Even the ACA defines dental coverage as an essential benefit for those under 18.

So, why is dental insurance separate from medical coverage?

Somehow over the years, the two fields have evolved differently. While this might change, for now, the options to get the two types of coverage combined are limited.

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Aleksandra Yosifova
Aleksandra Yosifova

With an eye for research, Aleksandra is determined to always get to the bottom of things. If there’s a glitch in the system, she’ll find it and make sure you know about it.