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Going to the dentist is something that may feel unimportant, but dental preventative care is one of the most important things you can do for your health. Both dental insurance and dental discount plans can help make preventative and other dental care more affordable for individuals and families. Here’s what you need to know to help you choose the right option for you.
What Does Dental Insurance Offer?
Dental insurance is similar to health insurance. With dental insurance, you pay a monthly premium in exchange for your insurance coverage. Like health insurance, there is a deductible, waiting period, policy maximums and copays associated with each dental insurance policy. Dental insurance can be offered through employer-sponsored plans or directly to individuals through an insurance marketplace.
There are also different types of networks with dental insurance policies.
Dental health-maintenance organizations (HMOs) require you to select a primary care dentist from the insurance provider’s network just as you would with a health insurance HMO. These insurance policies typically only cover dental care that is provided by an in-network dentist, and the care must be coordinated through your primary care dentist. Most dental HMO plans also have a set copay amount you must pay for each procedure.
Dental preferred-provider organizations (PPOs) allow you to use any dentist in the insurance provider’s network. These plans usually provide partial benefits if you see a dentist outside of the provider’s network. Dental PPOs may come with waiting periods for both basic and major dental services.
Dental indemnity plans offer more flexibility by allowing you to see any dental provider without network restrictions. These insurance policies pay a predetermined percentage of each dental procedure based on what the insurance provider considers a “usual and customary” charge for the procedure. Like PPO plans, dental indemnity plans usually have waiting periods.
Dental insurance offers a few different areas of coverage. Every policy is different, but these are the areas of coverage most plans include.
No. 1: Preventative care
Preventative care is a major part of dental insurance coverage. Preventative care includes routine exams and cleanings. Typically, insurance plans cover 100% of the cost for up to two routine visits per calendar year. It also includes regular X-rays of your teeth.
No. 2: Basic restorative services and procedures
Some dental insurance policies offer some level of coverage for basic restorative services like fillings. Full-coverage dental plans also cover basic procedures such as crowns, root canals and surgical extractions.
No. 3: Major dental procedures
Most full-coverage dental insurance policies also cover at least some of the costs of major dental procedures. This can include dentures, dental implants and veneers.
No. 4: Orthodontic treatments
Your insurance policy may require your primary dentist refers you to an in-network orthodontist for orthodontic treatment. Some orthodontic treatments that may be covered by dental insurance include braces and clear aligners such as Invisalign.
What Do Dental Plans Offer?
Dental discount plans (also known as dental plans) can be a good alternative to dental insurance. Dental discount plans provide discounted prices for dental services from participating dentists. This is similar to dental insurance in that the dental discount plan and the dental care provider must agree for you to receive benefits when you use that dentist.
Dental discount plans typically don’t have deductibles, annual maximums or waiting periods. They can be an affordable option, with plans costing as little as $100 for an individual or $150 for families for the entire year. Discounts for normal dental work typically range from 10% to 60%.
No. 1: No waiting period
One of the greatest benefits of dental insurance plans is they typically do not have a waiting period. Waiting periods are common with dental insurance and can cause issues if you need major dental care immediately. In these cases, dental discount plans can help because you’ll be eligible for discounted dental services right away.
No. 2: A single fee
Dental insurance typically requires you to pay a monthly premium for your insurance coverage. Dental discount plans require members to pay a single annual fee upfront. After you’ve paid your membership fee, you’ll receive a dental discount card you can present at your dentist visits to receive your discounted prices.
No. 3: No annual benefit limits
Dental insurance can be great, but annual benefit limits can pose a problem for some people. If you need a lot of dental work, you may reach the annual benefit limit much sooner than you anticipated. When this happens, you’re left on the hook for the full cost of the remaining dental work. Dental discount plans do not have annual benefit limits. You’ll need to continue to pay the discounted fees for your dental services, but there won’t be a point where your plan no longer helps you save money.
No. 4: No copays or deductibles
When you have a dental discount plan, you can benefit from it as soon as you go to the dentist. You don’t have to worry about meeting a deductible or deal with confusing copays. Instead, you’ll be able to go to the dentist knowing you’ll receive discounted services with no insurance headaches.
Key Difference Between Dental Discount Plans and Insurance
While dental insurance policies are sometimes referred to as dental insurance plans, it’s important to understand that dental insurance and dental discount policies are different. When choosing which will work best for you, keep these differences in mind.
No. 1: Dental insurance may come with waiting periods in addition to deductibles, annual maximum benefits and copays.
No. 2: Some dental insurance policies offer more flexibility than others when it comes to which dentists you can visit and when. Some dental insurance policies require a referral from your primary dentist to receive coverage for other dental care.
No. 3: Dental discount plans do not have annual maximum benefits or waiting periods. You can receive discounted services as soon as you’ve paid your membership fee and received your discount card.
No. 4: Dental insurance policies typically require you to pay a monthly premium, whereas dental discount plans require you to pay a single annual fee.
Who Benefits Most From Dental Plans?
- People who need very little dental work and only visit the dentist for twice-yearly cleanings may be able to save money with a dental discount plan.
- If you need more dental work than the annual maximum benefits a dental insurance policy allows, dental plans may be more beneficial.
- Senior citizens who have Medicare may benefit from discount dental plans because they will not receive dental coverage through Medicare.
How Do Families Benefit From Dental Insurance?
Families benefit from dental insurance because it allows them to embrace preventative care to avoid large dental bills in the future. If you have children and purchase a family dental plan, you’ll be able to get your children’s preventative dental care started early. This can help dentists address issues and help you establish good at-home dental care for the entire family.
Dental insurance may cost more than a dental discount plan in some cases, but when there are multiple people involved, the benefits can easily outweigh the costs. Most dental insurance policies cover 100% of routine preventative care. Having dental insurance provides peace of mind for families because they’ll know their children’s dental health will be taken care of.
With regular dental visits, your dentist may also be able to identify issues that need orthodontic care early. Some dental insurance plans offer orthodontic coverage, but even if your policy doesn’t, early intervention may save money on your child’s orthodontist visits in the long run.
Compare Dental Insurance
If you’re considering dental insurance, compare policies to find the one that will benefit you most. Benzinga strives to provide the latest insights and reviews on dental insurance providers to help you make informed decisions. Some of the top dental insurance providers for you to consider include:
- Best For:No annual maximumsVIEW PROS & CONS:securely through Careington Dental's website
- Best For:Young adults and families with children and teensVIEW PROS & CONS:securely through Guardian Dental Insurance's website
Frequently Asked Questions
Do dental plans actually work?
Both dental insurance and dental discount plans can make dental care more affordable. That being said, make sure the insurance policy or discount plan that you purchase allows you to see dentists in your area. If you’re able to visit a dentist who participates in your insurance policy or discount plan, it can work very well for you.
Does every dentist charge the same?
No, dentists don’t charge the same amounts for services across the board. Each dental care provider sets its costs for each dental procedure. You may find that two dentists in the same town charge a different amount for the same dental procedure. The costs may differ because each provider’s cost of doing business varies. To make sure you’re getting the best deal on your dental care, make sure you’re seeing a provider that participates in your dental insurance or discount plan.
More on Dental Insurance
Dental Insurance Methodology
To determine the best dental insurance providers, we pored through all United States carriers. We winnowed the list by only including companies that have a wide coverage area and product offering. To further break down the list to the true best dental insurance providers, we gave weight to carriers that offer discounts, are available in all states and have multiple payment plan options.
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About Ashley Hart
Ashley Hart is a personal finance writer passionate about helping people feel empowered to take control of their finances. She has more than eight years of writing experience, focused on insurance.