When looking for ways to lower dental costs, you may come across both dental insurance and dental discount plans.
Although they can both help with dental expenses, they work very differently.
Understanding the difference can help you decide which option may make more sense for your needs and budget.
How Does Dental Insurance Work?
Dental insurance works similarly to other types of insurance. You typically pay a monthly premium in exchange for benefits toward covered dental services.
Depending on the plan, benefits may include:
- Routine exams and cleanings
- X-rays
- Fillings
- Extractions
- Crowns
- Bridges
- Dentures
- Other covered dental procedures
The amount the insurance company pays depends on the specific plan and type of service you receive.
You may also have a deductible, copayment, or coinsurance.
What Is a Dental Discount Plan?
A dental discount plan is not insurance.
Instead, you generally pay a membership fee to receive access to discounted rates from dentists who participate in the plan.
For example, a participating dentist may normally charge one amount for a particular procedure but agree to charge members of the discount plan a lower negotiated rate.
You are still responsible for paying the dental bill yourself — you’re simply receiving the plan’s discounted price.
What’s the Biggest Difference?
The biggest difference is who pays for your dental care.
With dental insurance, the insurance company may pay a portion of covered services according to the terms of your policy.
With a dental discount plan, there is generally no insurance company paying part of the bill. Instead, you receive a discounted price and pay the remaining cost yourself.
What About Annual Maximums?
Many dental insurance policies have an annual maximum, which limits how much the insurance company will pay toward covered services during the year.
Dental discount plans generally don’t work this way because the plan isn’t paying your dental bills.
However, discounts and participating services can vary, so it’s still important to review the details carefully.
What About Waiting Periods?
Some dental insurance plans require you to wait a certain amount of time before benefits are available for particular procedures, especially major dental services.
Dental discount plans may not have the same type of waiting periods, although the terms vary by plan.
If you already know you need significant dental work, this is something you’ll want to investigate before enrolling.
Can I Keep My Current Dentist?
This is one of the most important questions to ask.
Both dental insurance and dental discount plans may use participating provider networks.
Before choosing either option, check whether your dentist participates. If they don’t, find out whether you can still receive benefits or discounts when seeing them.
Which Option Is Better?
Neither option is automatically better for everyone.
Dental insurance may make sense if you want help paying for routine and potentially larger dental expenses and are comfortable with the plan’s premiums, network, and coverage rules.
A dental discount plan may make sense if you’re comfortable paying your dental expenses yourself but want access to negotiated discounts from participating providers.
Before deciding, compare the total cost, benefits, participating dentists, exclusions, waiting periods, and expected dental needs.
Be Careful When Comparing Plans
A low monthly price can be attractive, but make sure you know what you’re purchasing.
If something is advertised as a “dental plan,” don’t automatically assume it’s dental insurance.
Ask whether it’s insurance or a discount program and make sure you understand how your dental bills will be handled before enrolling.
Need Help Understanding Your Dental Coverage Options?
Choosing between dental insurance and a dental discount plan can be confusing, especially when you’re trying to compare costs and benefits.
Jordan Shanbrom can help you review available options, understand how different types of dental coverage work, and determine what may fit your needs and budget.
Schedule an appointment to discuss your dental and vision coverage options and get help making an informed decision.