Dental care is expensive, making dental insurance almost mandatory if you want a healthy mouth.
But Medicare doesn’t include a dental insurance plan, and many employers either do not provide dental insurance or they are scaling back their offerings, leaving consumers to pay for dental care on their own. As a result, many consumers are going without. A 2009 poll by Harris Interactive and HealthDay found that 30 percent of U.S. adults with health insurance did not visit a dentist because of the prohibitive costs. Of those who were uninsured, more than half required dental care, but costs kept them away.
If your employer doesn’t offer dental insurance, you can buy an individual policy, paying anywhere from $225 to $396 per year in premiums. However, another alternative is the discount dental plan, a membership-based network offering discounted dental services from select providers.
Analyzing the differences
With dental insurance, consumers typically pay a monthly premium and a deductible before insurance kicks in, but even after the deductible, “policies vary widely on co-pay requirements. Some policies have no co-pay while others require the consumer to pay a substantial portion,” says Lou Geremia, president of InsureMe.com.
Dental insurance plans also often come with a coverage cap, meaning consumers are only insured for about $1,200 to $1,500 per year. Once the dental patient exceeds that amount, he or she pays out of pocket. Consumers who go the insurance route also get the benefit of oversight from their state department of insurance, which could prove helpful if they have insurance complaints.
With discount dental plans, consumers typically pay an enrollment fee and an annual fee of about $80 to $120 per year and get access to discounted services from member providers. Discounts can range anywhere from 10 percent to 60 percent, says Buddy Johnson, chief executive officer of DentalPlans.com, a discount dental plan provider. Because there are no deductibles or caps to worry about, consumers aren’t limited by the number of services they receive in a given year, and there’s also no paperwork to fill out for reimbursements. For those seeking cosmetic services, discount dental plans may be the way to go since they often cover cosmetic dentistry, while insurance plans typically don’t.
When it comes to selecting an insurance plan or a discount dental plan, some of the same rules apply.
“Because the differences between plans are so great, it is important for the consumer to completely research and understand what services are covered before signing anything. It is also important to verify that any preferred dentist is part of the plan selected,” says Geremia.
|Dental insurance||Discount dental plans|
|Costs||Premiums, co-pays and deductibles||Enrollment fees and monthly fees|
|Regulating entity||State Department of Insurance||None|
|Annual limits||Typically between $1,200 to $1,500 per year||None|
|Exclusions||Varies by plan, but typically excludes cosmetic procedures||Varies by plan|
|Savings||Cost of dental care after deductible is paid up to annual limit||10 percent to 60 percent off the regular price of dental procedure|