Dental Plan or Dental Insurance?

Dental insurance has copays, deductibles, payout limits,
waiting periods for major procedures, and high monthly premiums.

Dental Plans:

  • Use Immediately – No Waiting Period
  • No Copays or Deductibles
  • Unlimited Use
  • National Provider Networks

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The best plans at the best prices.

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Why You Don’t Need Dental Insurance

Dental insurance will not protect you against high dental bills. In most all cases, you will pay more in premium than you will get back in benefits. It makes absolutely no sense.

You can easily spend almost $1,000 a year in premiums to receive $900 in actual benefits. It happens more frequently than not. It is like paying $20 for a $10 dollar bill.

Furthermore, the amount that they reimburse you for major dental work is a drop in the bucket. You will still be looking at a huge bill that you will need to pay out of pocket. You cannot beat the insurance company.

No matter what you buy, with possibly the exception of a decent HMO dental insurance plan, you are still going to have significant out-of-pocket expenses for any major dental procedure like a crown, root canal, implant, etc.

Let’s look at the numbers. They tell the whole story.

A quality PPO dental insurance policy will cost you about $50 to $60 a month. This is for just one person. Family coverage can run into the hundreds – per month.

Most insurance plans will not even cover major work like crowns or root canals for the first year.

I know that there are a number of plans that advertise immediate coverage. But you must read the fine print. They mean they will only cover 10 to 20 percent in the first year and that is after your deductible and copays. Clearly, you are going to pay for almost everything out of your own pocket.

You will be paying premiums to the insurance company for a full year before they cover anything that is significant.

What happens after the first year?

For a major procedure like a crown, they will cover about 50%. Here are some estimated expenses and reimbursements.

  • Crown charges are $1,200 (instead of $1,600 because of the PPO)
  • You pay your $50 to $100 deductible which leaves about $1100 to be paid.
  • They will cover half or $550. You pay the other half.
  • But do not forget you are paying $60 a month in premium.
  • Add this to the $100 deductible.
  • Add in $550 for your share of the crown.
  • Plus $720 for premiums. This comes to $1370 out of your pocket.

Keep in mind that the first year you paid them about $500 more than the cost of the cleanings and x-rays they covered.

This means that by the end of the second year, just to get one crown fixed, you have shelled out almost $1,900.

Here is some more bad news. The plans have annual caps and most plans do not cover more than $1500 a year. If you want higher limits you pay more premium. If the dentist tells you that you need two crowns and root canals or implants, you can easily max out the plan and have no coverage at all when you need it the most.

How Much Can I Save With a Dental Plan?

A dental plan is essentially a discount plan that enables you to see your dentist at a “wholesale” rate for services. 

If you go to a dentist that is in the network they are obligated to give you a discounted rate for services listed in the plan documents.

For example, a crown might cost $650 instead of $1,200. Cleanings could be $35 instead of $135, and so forth.

You can save ten to sixty percent off standard out-of-pocket fees when visiting a participating network provider.

There are no pre-existing condition limitations, maximum limits, or deductibles to pay. Some of these plans offer discounts on vision as well as other benefits.

Just as you would for a PPO, you must use a dentist in the network. You must use a network dentist with any type of dental insurance or plan or else they are worthless.

Fortunately, there are literally dozens of discount plans with large dental networks from well-known names like Aetna, Cigna, Humana, etc.

The discounts on just the cleanings, exams, and x-rays alone make these plans cost-effective.

Are the Premiums for Dental Plans Much Less Than Insurance?

Yes, the premiums on dental plans are much less than insurance. A family can usually be covered for an entire year for about $200. This is the fee for the whole year, not just one month.

In my area, a full crown could easily cost $1,400. With most discount plans, the cost is around $750 (sometimes less). Plus, you do not have to wait a year to get this price. The discount is available right away.

On top of this, there are no deductibles and no copays. 

There are no limits on anything. You can have 4 cleanings a year if you want. The plan does not “max out”.

I Want to Keep My Dentist – What Are My Options?

I can completely understand anyone’s reluctance to change to a new dentist. I used to feel the same way.

Most people we talk to hate to change dentists. But, you need to put things into perspective. In most instances, you are having a cleaning (which is not even done by the dentist) or a routine procedure such as a filling or a crown. This is something that dentists do day in and day out. They have done thousands of them and most are pretty good at it.

Let’s be honest, neither of us could tell the difference between a perfect filling or one that is going to fall out in a year.

Routine dental care can be competently and comfortably performed by any licensed dentist. If it takes a few weeks to get an appointment, chances are they are doing something right.

When people describe how much they like their dentist it is usually a testament to their ability to manage pain. They can all do that. It is not a special skill.

Every dentist knows that the secret to the “dental business” is keeping you comfortable and as pain-free as possible. They all numb your gums before giving you Novocain and they know how to administer it with the least discomfort.

Making sure you are pain-free is what puts money in their pocket and builds a dental practice.

What all of this means is that if you can get a low-cost plan and save money on insurance premiums and dental expenses, even if you have to change dentists, you should consider it. I have used discount plans for years and never regretted it.

If your dentist does not take any insurance or forces you to buy an expensive insurance plan that covers next to nothing, he or she is doing you any favors and is most certainly not your friend.

Do the Plans Cover Orthodontia?

There is generally about a 20% discount for braces. But that could easily save you $1,000 or more.

No matter what type of plan you buy, orthodontia is never going to be inexpensive. Even regular insurance plans limit this type of coverage to children and payout a very small amount towards the total costs.

What this means for adults is that if your dentist told you that it would be beneficial to get braces (especially the invisible type), whether you have insurance or a dental plan, you will be paying for them yourself.

What Do I Do if I Need More Coverage?

Some of you will go to the dentist and find out that you need a lot of work costing thousands of dollars. If you find yourself in such a position, we recommend that you strongly consider an HMO Dental Plan.

This type of plan will handle all of your work at a low fixed rate. The discounts are deeper than the discount plan and the network is very large. This is an actual insurance plan.

There are no waiting periods and no maximums, deductibles, or copays. When your work is complete, if you want, you can drop the plan and move over to a less expensive discount plan.

Let’s look at the numbers. They tell the whole story.