# Why are medical and dental insurance two separate entities? **URL:** \ **Category:** Factual Questions\ **Created:** [May 17, 2012, 5:46pm UTC](https://boards.straightdope.com/t/why-are-medical-and-dental-insurance-two-separate-entities/622229 "2012-05-17T17:46:14Z")\ **Posts on this page:** 12\ **Page:** 1
**Author:** ![Taomist](https://avatars.discourse-cdn.com/v4/letter/t/53a042/32.png) [@Taomist](https://boards.straightdope.com/u/Taomist)\ **Post date:** [May 17, 2012, 5:46pm UTC](https://boards.straightdope.com/t/why-are-medical-and-dental-insurance-two-separate-entities/622229/1 "2012-05-17T17:46:14Z")
No one can argue that an unhealthy mouth is as dangerous as an unhealthy body, yet dental insurance and medical insurance are two separate entities; it seems even government medical insurance leaves one out in the cold regarding dental health. Is there some reason the two are so separated? Is it because dental health isn’t considered important? Is it an industry thing? It can’t be as simple as ‘teeth aren’t part of the body’, because obviously they are. :dubious: ---
**Author:** ![dolphinboy](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dolphinboy/32/330_2.png) [@dolphinboy](https://boards.straightdope.com/u/dolphinboy)\ **Post date:** [May 17, 2012, 5:59pm UTC](https://boards.straightdope.com/t/why-are-medical-and-dental-insurance-two-separate-entities/622229/2 "2012-05-17T17:59:13Z")
I think the reason is historical. I’m pretty sure medical insurance was introduced before dental insurance was, and employers routinely offered medical coverage to employees, but not necessarily dental insurance, years ago. You could say the same thing about eye insurance. Why not bundle that in with medical and dental insurance? Wouldn’t that lower administrative costs and save everyone money? ---
**Author:** ![TriPolar](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/tripolar/32/3008_2.png) [@TriPolar](https://boards.straightdope.com/u/TriPolar)\ **Post date:** [May 17, 2012, 6:12pm UTC](https://boards.straightdope.com/t/why-are-medical-and-dental-insurance-two-separate-entities/622229/3 "2012-05-17T18:12:08Z")
> [@Taomist](#): > > Is it because dental health isn’t considered important? That is part of it. You can lose all your teeth without endangering your life. If something like an infection became bad enough, health insurance would kick in. > [@dolphinboy](#): > > You could say the same thing about eye insurance. Why not bundle that in with medical and dental insurance? Wouldn’t that lower administrative costs and save everyone money? Health insurance covers eye diseases. Insurance to cover glasses and contacts is for non-necessary care. Unnecessary from a medical perspective anyway. ---
**Author:** ![Taomist](https://avatars.discourse-cdn.com/v4/letter/t/53a042/32.png) [@Taomist](https://boards.straightdope.com/u/Taomist)\ **Post date:** [May 17, 2012, 6:43pm UTC](https://boards.straightdope.com/t/why-are-medical-and-dental-insurance-two-separate-entities/622229/4 "2012-05-17T18:43:24Z")
> [@TriPolar](#): > > That is part of it. You can lose all your teeth without endangering your life. If something like an infection became bad enough, health insurance would kick in. I sure hope so; I admit the question is somewhat personal at this point. 😛 I’ve always wondered, though, why the distinction. ---
**Author:** ![Shagnasty](https://avatars.discourse-cdn.com/v4/letter/s/9dc877/32.png) [@Shagnasty](https://boards.straightdope.com/u/Shagnasty)\ **Post date:** [May 17, 2012, 7:07pm UTC](https://boards.straightdope.com/t/why-are-medical-and-dental-insurance-two-separate-entities/622229/5 "2012-05-17T19:07:51Z")
It is because medicine and dentistry are separate professions despite that some dentists are more similar to some types of medical doctors (e.g., oral surgeons) than some types of medical doctors are to each other (orthopedic surgeons and psychiatrists for example). We have discussed the reasons for this on this board a few times and the basic answer is that it is for historical reasons that don’t apply nearly as much today. I admit that explanation doesn’t explain why medical insurance often covers other types of professionals like psychologists and even chiropractors but not dentists. The biggest reason for that is that everyone should see the dentist at least a couple of times a year and that is expensive to cover outside of a specialized dental plan that is often optional. ---
**Author:** ![kenobi\_65](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kenobi_65/32/13178_2.png) [@kenobi\_65](https://boards.straightdope.com/u/kenobi_65)\ **Post date:** [May 17, 2012, 7:57pm UTC](https://boards.straightdope.com/t/why-are-medical-and-dental-insurance-two-separate-entities/622229/6 "2012-05-17T19:57:18Z")
> [@dolphinboy](#): > > I think the reason is historical. I’m pretty sure medical insurance was introduced before dental insurance was, and employers routinely offered medical coverage to employees, but not necessarily dental insurance, years ago. Medical expense insurance (i.e., to pay fees to doctors), hospital insurance (i.e,. to pay fees to hospitals), and disability insurance all developed independently. In the case of medical and hospital insurance, they were apparently developed separately, both in the early decades of the 20th century. Each originated to provide coverage for visits to specific doctors / specific hospitals, rather than offering “blanket” coverage. > **[Health insurance | History and evolution](https://en.wikipedia.org/wiki/Health_insurance#History_and_evolution)** > > In the late 19th century, "accident insurance" began to be available, which operated much like modern disability insurance. This payment model continued until the start of the 20th century in some jurisdictions (like California), where all laws regulating health insurance actually referred to disability insurance. > Accident insurance was first offered in the United States by the Franklin Health Assurance Company of Massachusetts. This firm, founded in 1850, offered insurance against injuries aris... Dental insurance, meanwhile, apparently may have only come into being as late as the 1960s or 1970s. [http://www.smilemoretoday.com/financing/dental-benefits2/](http://www.smilemoretoday.com/financing/dental-benefits2/) > **[What Tools Do Dentists Use?](https://careertrend.com/about-5398919-tools-do-dentists-use.html)** > > Dentists need a variety of tools to complete procedures for their patients. It can be somewhat scary seeing all of the tools that are often laid out next to the chair when you visit a dentist, but each tool has a specific use for a certain procedure. So, in short, they’re probably separate because (a) they always have been, and (b) the origins of health insurance were to provide specific, rather than general, coverage. ---
**Author:** ![Taomist](https://avatars.discourse-cdn.com/v4/letter/t/53a042/32.png) [@Taomist](https://boards.straightdope.com/u/Taomist)\ **Post date:** [May 18, 2012, 12:00am UTC](https://boards.straightdope.com/t/why-are-medical-and-dental-insurance-two-separate-entities/622229/7 "2012-05-18T00:00:33Z")
Interesting and useful answers; thank you! I love this place 🙂 ---
**Author:** ![JuliaSqueezer](https://avatars.discourse-cdn.com/v4/letter/j/82dd89/32.png) [@JuliaSqueezer](https://boards.straightdope.com/u/JuliaSqueezer)\ **Post date:** [May 18, 2012, 2:36pm UTC](https://boards.straightdope.com/t/why-are-medical-and-dental-insurance-two-separate-entities/622229/8 "2012-05-18T14:36:59Z")
Years ago, an actuary at the health insurance place where I worked explained that the rating structure and terms of contract are different. I’m probably over-simplifying, and I admit I don’t remember all of the details of a rather complex set of calculations, but here goes: Basic health insurance contracts normally run one year, and the rates are recalculated annually. Dental insurance contracts are two to three years in length and rated accordingly, because generally when people get dental insurance for the first time, they run to the dentist and get all of their old neglected dental problems fixed. Utilization is very high the first year, so the benefit payouts are high. Then it tends to dwindle into the second and third years, as people have less expensive, preventive and maintenance procedures done. The rating system attempts to average out the risk over a longer contract term. It made sense at the time, but I have no idea if the same thinking applies today. ---
**Author:** ![Taomist](https://avatars.discourse-cdn.com/v4/letter/t/53a042/32.png) [@Taomist](https://boards.straightdope.com/u/Taomist)\ **Post date:** [May 18, 2012, 7:01pm UTC](https://boards.straightdope.com/t/why-are-medical-and-dental-insurance-two-separate-entities/622229/9 "2012-05-18T19:01:19Z")
Thank you,\*\* JuliaSqueezer\*\* I am trying to understand a lot of things about the insurance industry, including why health insurance is considered so important that the country may require it, but dental insurance isn’t even offered through many jobs. ---
**Author:** ![Rand\_Rover](https://avatars.discourse-cdn.com/v4/letter/r/db5fbb/32.png) [@Rand\_Rover](https://boards.straightdope.com/u/Rand_Rover)\ **Post date:** [May 18, 2012, 7:08pm UTC](https://boards.straightdope.com/t/why-are-medical-and-dental-insurance-two-separate-entities/622229/10 "2012-05-18T19:08:12Z")
Good question, and I don’t have "the " answer, but it does make sense to me that the two types of insurance would be priced differently. People typically go to the dentist several times a year, having something relatively expensive done is not that rare, and the line between cosmetic and medically necessary can be fuzzy. With health insurance though, many people don’t use it at all for years until something happens and they absolutely must go to the doctor. ---
**Author:** ![Mdcastle](https://avatars.discourse-cdn.com/v4/letter/m/958977/32.png) [@Mdcastle](https://boards.straightdope.com/u/Mdcastle)\ **Post date:** [May 18, 2012, 11:28pm UTC](https://boards.straightdope.com/t/why-are-medical-and-dental-insurance-two-separate-entities/622229/11 "2012-05-18T23:28:25Z")
A few things worth noting: Government regulation and consumer demand have mostly put a stop do it, but there used to be radically different benefits between medical, psych, and chiro coverage for private insurance and Medicare. Some of the individual plans my company offers have the option of decling psych or substance abuse coverage, but the cost difference is very small so most people elect them. Hospital insurance and outpatient insurance also have been conceptionally seperate at times. Originally Blue Cross was hospital insurance and Blue Shield was outpatient insurance, until they merged. And witness the differences between Medicare A and B. ---
**Author:** ![Mdcastle](https://avatars.discourse-cdn.com/v4/letter/m/958977/32.png) [@Mdcastle](https://boards.straightdope.com/u/Mdcastle)\ **Post date:** [May 18, 2012, 11:34pm UTC](https://boards.straightdope.com/t/why-are-medical-and-dental-insurance-two-separate-entities/622229/12 "2012-05-18T23:34:22Z")
Cancer insurance is another outlier. Nowdays it’s mostly a scam but in the days before outpatient medical coverage was common it did at least make some sense, as the cost of cancer chemotherapy is one outpatient expense that is absolutely astronomical.