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About Dental Insurance

 

Dental insurance works much like medical insurance, although it is usually far less expensive. For a monthly fee, your dental insurance entitles you to certain dental benefits. These usually include benefits associated with regular checkups (e.g., office visits, cleanings, x-rays and fluoride applications for children). Some policies also include coverage for oral surgery, including tooth extraction, fillings, dentures, root canals, etc. Review the dental insurance policy you are considering for deductibles and annual coverage limitations, as well as waiting periods for certain procedures.

About Dental Discount Plans

There is a 2nd option out there for dental insurance. Actually, this is technically not dental insurance, but rather a dental discount plan. This is more of a membership program --- the issuer of the card has negotiated discounts with a large number of dental providers --- and the subscriber pays a monthly fee to take advantage of these reduced rates. The discounts vary, but can often be 20-60% off of the standard fees for the providing dentist.

Which is Better?

Dental discount plans are usually less expensive than dental insurance. However, the benefits associated with each are different, so it is tough to say what is better for any individual person or family. We've highlighted some of the major differences below to help you make a more informed decision.

 

Type of Program Dental Insurance Dental Discount Plan
Pricing Regulated by state insurance departments, but premiums vary by provider. Do a free comparison here Unregulated . leading to more price competition and plan variety. Do a free comparison here
What do you pay for? Monthly premiums, deductibles and co-pays or coinsurance. Insurance company pays dentist directly for remainder of charges Monthly membership fee (may have to pay annually, up front). You pay the discounted charges directly to the dentist when services are rendered
Deductibles You may have to meet an annual deductible before the insurance company starts paying for services No deductibles --- you get the discounted rates upon your first visit to the dentist
Co-Pay After deductible is met, you may need to pay a nominal amount per office visit (e.g., $10). No co-pay --- you pay the discounted rates for the procedure involved at each visit
Coinsurance After deductible is met, you may need to pay a percentage of the cost of the procedure (e.g., 20%). This typically comes into play more for oral surgery than for routine office visits No coinsurance --- you pay the discounted rates for the procedure involved at each visit
Waiting Period Most dental insurance plans have a 6 to 18 month waiting period before paying for major dental services No waiting periods
Pre-existing Conditions May or may not be specifically excluded; by having awaiting period (see above) for major work, serious conditions that need immediate treatment are essentially excluded Covered at the same discounted rates as other procedures
Annual Maximum Benefit Most dental insurance plans will cap the amount of reimbursement each year; patient is responsible for costs after that Not applicable. Use the plan and its discounted charges as often as needed