News flash – not all “dental plans” are created equal. If you are searching Google for “dental plans” you will see two options – “discount dental plans” and “dental insurance.” While some use the phrases intermittently, there is a stark difference between discount dental plans and dental insurance. Here we’ve simplified both, making your decision easier for the type of dental coverage most suitable for you and your family.
Dental insurance has a similar pay format to health insurance, in that you pay a monthly premium for insurance benefits that cover a portion of your billed charges, depending on your plan and deductible//coinsurance options. Many times two dental exams are covered per year, and with some plans a copay is required. The copay goes towards a lifetime deductible. Coinsurance rates are determined by the type of plan you have. The insurance provider will share the cost of services rendered until you’ve met your annual out-of-pocket maximum.
For example, in Secure DentalOne’s ClassicOne dental insurance coverage, the monthly premium rate is about $X for a single person. There is no office copay and a lifetime deductible of $100. For preventive and diagnostic care, the coinsurance rate is 80 percent. For basic and major care the coinsurance rate is 50 percent. The annual calendar-year maximum is $750. If you’ve paid $750, the insurance provider will pay the rest of the claim for that year.
A discount dental plan is a program that offers discounts on select dental services. While appearing to cost less than dental insurance, in some cases, it could end up costing patients more because there is no calendar-year maximum and discounts are anywhere from 25 percent to 50 percent off select services.
In a discount dental plan, an individual or family pays an annual joining fee and from there they will receive discounts on dental services. For example, if a routine biannual check-up costs $57 dollars, a person on a discount dental plan will have to pay $24. Keep in mind, during these check-ups dentists recommend X-rays, which are not included in the routine checkup price of $24. Full-mouth X-rays, around $141, would cost about $65 on a dental plan, making the price around $90 for a checkup.
With a dental insurance plan such as Secure DentalOne’s ClassicOne, the biannual check-up would cost $11.40 (insurance would pay 80 percent of the cost), and the diagnostic care full-mouth X-rays would cost around $28.
In a dental discount plan, you will receive a discount on services rendered. So in addition to the joining fee, if for instance you need a root canal, and receive 50 percent off on root canals, which is $800, you will still pay $400.
Dental insurance may be a more financially viable option for those who are concerned about potential dental services or if dental services are needed. After the deductible is met, a family will pay a percentage of the cost until their out-of-pocket calendar-year maximum is met.