Dental Insurance VS. Dental Discount Plans: Pay Now or Pay Later

With medical costs rising, many employers are getting rid of the extras. Things like eye care and dental insurance are no longer being offered. You can live without the eye care. Most people only go for an eye exam every 3 or 4 years. A visit to the dentist, even if only once every calendar year, can cost one person $125-$250 for an exam, Xrays and a cleaning. If the dentist finds a problem your cost can be hundreds of dollars more. I work in a dental office and process patients with no insurance, dental discounts and insurance. Having seen it all, I can offer some suggestions.

Buying insurance for a family can be very expensive. Just browsing at the Internet, I found dental insurance plans that provided family coverage in the zip code of 44060 (Mentor, Ohio) starting at $75 per month. The highest priced plan was $128. The typical coverage paid 100% for twice yearly exams.cleanings and Xrays. A filling was covered 60-80% and crowns and root canals were covered at 30-50%. Most of these plans had a yearly maximum of $1000 per person. Even if you picked the $75/month plan it would cost a family of four $900 per year just to have the insurance, plus out of pocket costs at 20-40% for fillings and 50-70% for root canals and crowns.

Without insurance at all a family of 4 would pay $1000-$2000 or up for twice yearly dental exams and cleanings. Most dentists are self-employed and you can find a big difference in price from one to the next. Some of the dental insurance plans force you to pick a provider from their network. Others give you an option of going to a dentist that accepts their plan (the dentist agrees to charge what your insurance company pays) or let you go anywhere. If you decide to go out of the network the insurance company has a set fee they pay and if your dentist charges more, you pay the balance. All of the dental discount plans force you to go to a dentist in their network, so it's important to look at every plan that's offered. By reading all of the information you can make the best choice possible.

Dental discount plans typically start at around $16 per month for a family plan. The highest plan I saw in my area was $58. Of course, the coverage varied widely depending on the price of the plan. The $16 plans had set fees for services. A cleaning was $37-$45 (this price does not include the cost for the exam and Xrays). A filling was $58-$67 and up, and crowns and root canals were priced $404-$583. The higher priced plans charged a low $27 or had free dental cleanings (including exams and Xrays) and the costs for fillings was $48-$50. With the set fee schedule, most of these plans are reducing your cost by only 10-25%. So you are picking up 75-90% of the charged fee. If you are planning on buying a dental discount plan it's very important to read the fine print. If you're comparing plans on-line you need to look specifically at the plan features. They tell you your cost for every procedure and exclusions, if there are any.

If you have healthy teeth and gums a dental discount plan may be a great choice for you and your family. But if you have a family history of periodontal disease, smoke or haven't seen a dentist in many years you'd probably benefit more with dental insurance. The only real difference I can see between dental insurance and dental discount plans is: pay now or pay later.