4 Dental Insurance  
Dental Coverage


Dental Facts

Dental plans and dental insurance are different.  Click here to find out how.



Dental Coverage

Dental plan or dental insurance:  which is best for you?  

Dental coverage is available in a wide variety of forms.  You can get PPO dental insurance, indemnity, HMO dental insurance, discount dental plans and more.

The main distinction is between dental insurance and dental plans. 

Dental insurance works like regular insurance.  You pay a monthly fee and must pay a deductible, a co-pay amount (a percentage of the dental services you get - usually between 20-50%) and there is a maximum amount it pays per year.  After you hit their max you must pay 100% of the dental service.

Dental plans are much cheaper.  You just pay a certain amount for the whole year.  You pay a reduced rate for any dental services you get during the course of the year from a dentist within their network.  

Some questions to help you decide which dental coverage is best for you:

1.  Do you foresee large expenditures for your dental needs this year?

Carefully consider each option.  If you think these dental fees will add up to more than the dental insurance plan covers then it's best to go with a dental plan.  

For example, if you need 3 root canals (ouch!) and each one costs $900 then if you have a dental insurance plan that costs $35/month and has a $750 maximum cap with a 20% co-pay you would end up paying approximately $2360 for your dental care for the year. 

With a dental plan that costs approximately $100/year and gives a 50% discount on services your total out of cost expenditures for the year would be $1450.

2.  Do you foresee that your dental needs will be 'normal' this year?

If so, a dental plan is usually cheaper.  You pay one low fee for the year and don't have to pay an ongoing monthly fee.  Plus, there are no claim forms to deal with and you don't have to wait x amount of days to get approved by the plan provider.  Coverage starts almost immediately. 

Be aware though that with a dental plan you will have to pay more out of pocket at the time the dental service is provided (usually around 50% vs. a dental insurance's approximate 20% co-pay.)  Of course you won't have the monthly ongoing fee that you would with dental insurance coverage so if your needs are relatively normal then a dental plan is cheaper.  

3.  Do you have a specific dentist that you want to go to?

If so, check and see what plans the dentist is a member of and see what insurance the dentist accepts then shop around.   

4.  Do you foresee having orthodontic needs this year?

If so, you are going to pay regardless of whether you choose a dental plan or insurance.  Not all dental plans or insurance provides discounts for orthodontic services, but the good ones will provide at least some (usually around 20% for dental plans, it varies for insurance).  Depending on your orthodontist you can sometimes do a combination of plan and insurance which can cut your out of pocket expense but not all orthodontists will accept this so you need to check with him or her first.

For this month's top picks for best dental plan and best dental insurance, click here


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