Examining the Financial Paradox of Dental Insurance: Higher Out-of-Pocket Costs for Individuals Without Private Health Insurance?

Objectives: This study seeks to investigate the relationship between private dental insurance coverage and out-of-pocket expenses among financially vulnerable populations.

Methods: Data from the 2022 Medical Expenditures Panel Survey (MEPS) were analyzed to compare out-of-pocket costs between individuals with and without private dental insurance. Focusing on individuals without private health insurance, MEPS participants with dental insurance are matched to participants without dental insurance using full optimal matching on the propensity score. The outcomes measured include average out-of-pocket dental care costs, incidence of any dental costs, and average out-of-pocket costs among those incurring non-zero dental costs.

Results: Matched analyses show higher out-of-pocket costs ($386, 95% CI: -169, 603) and a higher likelihood of utilizing dental care (OR 5.00, 95% CI: 3.62, 6.90) among individuals with private dental care. Higher out-of-pocket costs hold but lose statistical significance when limiting analyses to those with any dental costs ($115, 95% CI: -184, 415).

Conclusions: Individuals with private dental care pay more out-of-pocket costs than those without private dental care, even when accounting for confounding demographic and socioeconomic factors. High costs of dental care, with or without insurance, remain a barrier to dental care among those without private health insurance.