Your dentist may allow you to use your discount dental plan to reduce the cost of your dental visit once you have reached your annual maximum for your dental insurance plan, or before your benefits kick in. This means that they cannot be used on the same dental visit; however, owning both plans could benefit you in a number of ways.
Reasons I Might Need a Dental Insurance Plan and a Discount Dental Plan
If you have a dental insurance plan already, you might think it’s pointless to have a discount plan, too. There are some instances in which a discount dental plan is a good supplement to your current dental insurance plan, or a good alternative.
Below is a list of possible scenarios in which having a discount dental plan along with your dental insurance plan could be helpful:
1. Waiting Periods
Many dental insurance plans have waiting periods of some kind.
What is a waiting period?
A waiting period is the time that must pass after you’ve purchased a plan before you can receive the full benefits of that plan.
These waiting periods vary. They can be anywhere from a few months to as long as a whole year (but that’s getting a little crazy).
They might also vary by procedure. Some procedures may have a waiting period while others do not. Talk to your plan provider or examine your benefits’ package to find out more.
Why Do Dental Insurance Plans Have Waiting Periods?
Most dental insurance plans have waiting periods to protect themselves from individuals signing up for their plan just for a costly dental procedure and promote long-term use of the plan.
While this makes some sense, there are a few caveats to waiting periods if you’re a member. Not only are you not able to receive the full benefits of your plan right away, but you end up spending many months paying high premiums for your plan without getting to use its full benefits until much later.
Here’s how a discount plan can help during dental insurance waiting periods:
Discount dental plans can be used immediately. While you wait for your dental insurance to activate, or for certain benefits to apply, you can use a discount dental plan for work you need now. Or, if the waiting period seems too long, you could purchase a discount plan instead.
2. Annual Maximums
When you reach your annual maximum, you pay the full price of your dental work for the rest of that plan year. A discount dental plan can offer you discounts off those out-of-pocket costs.
What is an annual maximum?
This is the maximum dollar amount a dental insurance plan will pay toward the cost of dental care within a specific timeframe (usually a year). Once this amount is reached, the insured member is responsible for paying the full price on any additional dental work.
Here’s how a discount plan can help when you reach your annual maximum:
Start using your discount dental plan once you’ve reached your annual maximum with your dental insurance. It will give you significant discounts off the full cost of those dental treatments and procedures so you don’t have to pay full price.
3. Cosmetic Work
Dental insurance doesn’t usually cover cosmetic work. Many discount dental plans offer a discount of 15-20%!
Cosmetic dental work generally refers to work that improves the appearance of teeth, gums or a person’s bite but is not medically necessary. This often includes:
There are services that can improve the appearance of your smile and are medically necessary. These include:
- Defective fillings that need to be replaced
- Crooked teeth that affect your ability to bite and chew
- Discolored teeth that have been weakened due to large restorations and need a couple of crowns to restore and strengthen the teeth
Call your dental plan provider and see what procedures and treatments are covered under your specific plan.
Here’s how a discount dental plan can help with cosmetic dental work:
If there is a cosmetic procedure you need that is not covered by your dental insurance policy, use a discount dental plan to get 15-20% off, or more. It might not seem like a lot, but if you have a procedure that would cost $2,000, a 20% discount would save you $400 immediately. Imagine what you could do with that money!
4. Price Comparison
Check with your dentist at the start of your visit to find out which plan can save you the most money. Many dentists are willing to do this for you. There may be certain procedures or treatments that your dental insurance plan may not cover, or only covers a fraction of the cost (say 20%), whereas, your dental plan may offer you 15-60% off the treatment cost.
Here’s how a discount plan can offer greater savings at your dental visit:
Use your discount dental plan instead of your insurance plan when it offers greater savings at your dental visit! Your dentist can check to see which plan saves you the most.
Here’s How You Can Use Your Dental Insurance and Discount Plan at the Same Visit
There is one rare instance in which you can use your discount dental plan and dental insurance at the same dental visit.
If your insurance company accepts reimbursement claim forms, you can…
- show your membership card to an in-network provider (dentist)
- pay the discounted fees for your dental work at the time of your visit
- ask your dentist for a copy of your bill
- file the claim with your insurance company to reimburse you for what you spent
This will reduce your out-of-pocket costs and stretch your dollar a bit further so you can reach your insurance plan’s maximums more slowly.
Word of Caution: Keep in mind that submitting reimbursement claim forms to dental insurance companies isn’t always easy and, in this case, there is a chance it might not work. It may not be worth the risk.