Dental insurance and dental savings plans both aim to lower what you pay at the dentist, but they work in very different ways. Insurance shares the cost of your care with you, up to certain limits. A savings plan is a membership that gets you discounted prices at dentists who have agreed to take part. Which one saves you more depends on how much dental work you expect to need and how soon you need it.
How dental insurance works
Dental insurance usually comes with a monthly premium. Many plans also have a yearly deductible, which is the amount you pay before the plan starts sharing the cost of certain services. After that, you typically pay a percentage of each bill, called coinsurance, or a flat copay.
Coverage is commonly organized into tiers. Preventive care, such as exams, cleanings and X-rays, is often covered at the highest rate. Basic care, such as fillings and simple extractions, is usually covered at a lower rate. Major care, such as crowns, bridges and dentures, is usually covered at the lowest rate.
Insurance also tends to come with limits that surprise people:
- Waiting periods. Some plans make you wait a few months after enrolling before they pay for basic or major work.
- Annual maximum. Most plans cap what they will pay in a year. After you reach it, you pay the rest.
- Networks. A plan usually pays more when you see a dentist in its network and less when you go outside it.
- Exclusions. Some plans limit or skip certain services, such as replacing a tooth that was already missing before you enrolled.
How dental savings plans work
A dental savings plan, sometimes called a dental discount plan, is not insurance. You pay a membership fee, often once a year or by the month. In return, you can get reduced prices from dentists in the plan's network. The discount is taken off that dentist's regular fee for each service.
There are no claim forms and no insurer paying part of the bill. You pay the dentist directly at the time of your visit, at the discounted rate. In most cases there are no waiting periods and no annual maximum, which can make a plan useful when you need work done soon.
The tradeoff is that the plan never pays any part of the bill. Discounts vary by service and by dentist, and a discount is not a guaranteed saving. If a plan takes a portion off the price of a crown, you still pay the remaining balance yourself.
Side by side
- Cost to join: Insurance charges a premium and often a deductible. A savings plan charges a membership fee with no deductible.
- Who pays the dentist: With insurance, the plan pays its share and you pay yours. With a savings plan, you pay the full discounted price at the visit.
- Waiting periods: Common with insurance, especially for major work. Usually not a factor with savings plans.
- Yearly limit: Insurance often has an annual maximum. Savings plans generally do not.
- Paperwork: Insurance can involve claims and pre-approvals. Savings plans involve very little.
- Oversight: Insurance is regulated as insurance. Discount plans fall under different rules, and those rules vary by state.
How to run the numbers
Start with what you expect to need over the next 12 months. Two checkups and cleanings are a very different situation from a cracked tooth that needs a crown and a couple of fillings on top of your routine care.
For each option, add up the fixed yearly costs: premiums or membership fees, plus any deductible. Then estimate what you would pay for the work you expect, using the plan's fee schedule or its listed discounts. Ask your dentist's office for a written estimate, and ask what the price would be under each plan.
A few patterns tend to hold. If you mostly need checkups and cleanings, insurance that covers preventive care at a high rate may come out ahead. If you need significant work soon, a savings plan may help because insurance waiting periods can push coverage months away. If you expect to need little or no care, either option may cost you more than it saves.
Questions to ask before you sign up
- Is my dentist in the plan's network? Call the dentist's office to confirm, not just the plan.
- What will this cost me for a full year, counting premiums or fees and any deductible?
- Are there waiting periods, and which services do they apply to?
- Is there an annual maximum, and what is it?
- Can I see the fee schedule or list of discounts for the services I need?
- What is the cancellation and refund policy, and can the price go up when I renew?
Be cautious with any plan that promises big savings but will not show you a list of participating dentists or actual prices. Read the plan's terms before you pay.
When neither one fits your budget
Plans are not the only way to lower your costs. Community health centers and some other clinics use sliding fee scales, where the price depends on your income and household size. Dental schools often offer care from students supervised by licensed faculty at reduced prices, though appointments can take longer.
Public programs may help too. Medicaid and CHIP cover dental care for children, and Medicaid dental benefits for adults vary widely by state. Original Medicare generally does not cover routine dental care, though some Medicare Advantage plans include dental benefits, so check the details of your plan.
Find affordable care near you
Before you pay for any plan, it helps to know which dentists and clinics are close to you. You can browse sliding-scale and free dental clinics by state or compare low-cost dental service options in top states.
When you call, ask for the price of the exact service you need and whether the office accepts your plan or offers a discount. This article is general information, not financial or insurance advice, so confirm costs and plan rules with the dentist and the plan itself.