Research has clearly documented that unaffordable medical bills and resulting medical debt affect large portions of the U.S. population, including a significant portion of those with health insurance. Previous analyses of data from the 2007 Health Insurance Survey of Farm and Ranch Operators showed that although the vast majority of respondents had health insurance, one in five had outstanding debt that resulted from medical bills and one in four reported that health care expenses contributed to their financial problems. However, these analyses did not include data gathered in the survey about dental insurance coverage and out-of-pocket costs that resulted from getting dental care.
There is little research on the contribution of dental costs to people’s difficulties paying medical bills or their likelihood of accruing medical debt.
This brief presents basic data on the costs of dental care, the prevalence of dental debt, and the impact of having dental insurance on the costs of dental care, access to care, and the likelihood that people will experience financial hardship because of health care costs.
Three-quarters of survey respondents reported having any dental out-of-pocket costs; percentages were similar for those with (73%) and without (77%) dental insurance.
Dental out-of-pocket expenses constituted more than one-quarter (27%) of overall health care out-of-pocket costs. The overall average amount of out-of-pocket health care costs per household for medical, prescription, and dental care was $3,231. The average for dental out-of-pocket costs was $873. Dental out-of-pocket costs exceeded the average amount of prescription out-of-pocket costs ($700).
Seven percent of respondents had debt resulting from obtaining dental services. The average amount of dental debt was $1,018 and the median amount was $500.
Forty-two percent of respondents had dental insurance, lower than the national rate of 60 percent. This reflected the high percentage of respondents with non-group insurance (36% of our sample compared to 60% nationally). People with non-group insurance were much less likely to have dental insurance than those who obtained insurance from off-farm or off-ranch employment.
Factoring in the estimated cost of premiums for those with dental insurance, the average amount spent on dental care was similar for those with ($978) and without ($1,007) dental insurance.
Although the amount spent on dental care was similar for those with and without dental insurance, those without dental insurance experienced much greater variability in their dental expenses. Those with dental insurance thus experienced greater predictability in their dental expenses and were less likely to face extremely high dental costs.
Seven percent of respondents said they delayed dental care because of cost; this included 45 percent of those respondents who said they had delayed any type of medical care. Those without dental insurance were significantly more likely to have delayed dental care than those with dental insurance.
Having dental insurance somewhat reduced the likelihood of people experiencing financial hardship because of health care costs. Financial hardship was defined as 1) spending more than 10 percent of household income on health care or 2) reporting that health care expenses contributed to financial problems.