Dental insurance is one of the first benefits employers are looking to cut back, according to the Society for Human Resource Management, but it isn’t the only solution to dental care. Consider a discount dental plan.
Below is a quick table comparison of discount dental plans vs. dental insurance:
|Discount Dental Plan||Dental Insurance|
|Often marketed on an individual basis||Typically marketed through employers|
|As little as $99 per year for 1 person||Typically $30 – 60 per month for 1 person|
|Can use as needed throughout the year with no yearly limits||Typically has a yearly limit of $1,000 - $1,500|
|Can be used right away for any dental services||Typically required to wait 6-12 months for any minor or major dental work|
|Savings begins right away||Typically has a deductible that must be paid before savings begins|
Some types of insurance may require an enrollment fee to begin a policy. In addition to this, members must pay a monthly premium, though some dental insurance plans might even require payment for an entire year upfront. Premiums can vary based on
If you have a pre-existing condition, the insurance company already expects you to need dental work (and thus reimbursement from them), so your premium will be higher than someone with no history of oral health issues. This also determines what percentage of your treatment the policy will cover. The insurance company essentially takes the risk for your dental health, so they want to be prepared if they need to start paying for your treatment.
Discount plans do not collect premiums. Instead, members are charged a steady monthly or yearly rate regardless of pre-existing conditions. Discount plans can charge such low monthly rates because they are not responsible for reimbursing the patient or the dentist. They simply provide members with access to significant discounts at the dentist office, lowering the patient’s out-of-pocket costs from the start.
Most dental insurance plans require that you wait six months to a year before receiving benefits, though sometimes this is reduced for preventive or diagnostic work. If there was no waiting period, policyholders could sign up for insurance, receive treatment immediately, get financially reimbursed and then cancel shortly thereafter at little expense to themselves. For this reason, dental insurance plans simply don’t allow it. They typically require you to wait until you have paid enough money in premiums to cover any damage that might occur, and this comes in the form of a waiting period.
Most plans allow members to begin using discounts within a few days, because you pay the dentist directly, and not the plan provider. Patients can take advantage of the discount on their own without pulling money from the discount plan company.
Most individual dental insurance requires some kind of co-pay for treatment at the dentist office, which means that you are financially responsible for paying at least a portion of the cost of treatment directly to the dentist at the time of service. Insurance does not reimburse the co-pay – it is fully out-of-pocket. Reimbursement for further costs usually happens one of two ways:
With these plans, the patient receiving treatment pays a significantly discounted price directly to the dentist at the time of service. It requires no middle-man or lengthy paperwork hassle. Dentists in the network use
Since they are contracted into those prices, they cannot arbitrarily decide whether to offer the discount to members.
The term “full-coverage” dental insurance isn’t fully accurate, because it still doesn’t necessarily mean that you will be reimbursed for every procedure.
Members of discount plans have found that they can receive discounts on a wide range of treatment, including most cosmetic procedures. Some plans discount nearly everything except lab fees. The simple process has few restrictions.
The discount can be applied at any time regardless of the patient’s oral health status.
Insurance companies typically reimburse you for costs they have deemed usual, customary and reasonable (UCR). If the insurance company has decided that a UCR teeth cleaning costs $65 and your dentist charges $80, they will calculate their percentage of reimbursement based on the price they have determined rather than on the price you were actually charged.
Members typically pay a fixed, predetermined price for treatment with a discount plan. In the case of specialist treatments such as orthodontics, often a fixed discount is applied to the provider’s fee, reducing the cost of treatment by up to 20%.
Policyholders typically must reach a deductible before the dental insurance plan will financially contribute anything. For the patient, this means:
Next year, 12% of employers plan to shift to high-deductible insurance coverage to save money (National Business Group on Health / Towers Watson). This means that as a policyholder of one of these plans, you may be financially responsible for more of your dental bills than you are today.
Most insurance companies set limitations on how much money they will put toward the cost of your treatment. That comes in the form of a yearly maximum, which dictates at what point the insurance company will no longer provide assistance. Once your dental insurance for individuals has contributed a certain amount of money, you are responsible for all treatment costs for the rest of the year. This number usually resets yearly.
Discount plans require no deductible. Members do not have to meet a price quota before they begin receiving discounts, nor do they have to wait for the plan to become effective. This can occur because patients pay the dentist directly at a discounted price without reimbursement.
Members get the discount every time they visit the dentist with no limit regarding usage. Since it has no maximum, some people use this plan after their regular dental insurance plan has reached its yearly limit.
Dental decay is one of the most prominent diseases today, affecting 60 to 90% of teenagers and adults (World Health Organization). Perhaps that's because last year, 34% of the American population did not visit a dentist at all (Gallup-Healthways poll). Roughly just 48% of the US workforce can obtain a dental plan through their employer, although 74% have access to comparable medical-only benefits (U.S. Bureau of Labor Statistics). Those percentages don't match up, leaving thousands of people in need of an alternative method to pay for dental care. As the cost of dental care goes up, low-cost dental plans become more of a necessity.