Difference Between Insurance and Dental Savings Plans

Understanding the Difference Between Dental Insurance and Dental Savings Plans

At Hamby Family Dental Center, your Fuquay-Varina dentist, our administrative team is knowledgeable about the different options for payment of services and can help you decide which is best for you. This article provides more detail about how each plan works.

Traditional Dental Insurance

Like traditional medical insurance, dental insurance is issued by an insurance company. The insurance company covers the cost of your procedures either in full or in part. The procedures that are covered and how much of the cost that is covered varies from plan to plan. Typically, preventative care like annual cleanings and exams are covered fully. 

How Traditional Dental Insurance Works

As the insurance holder, you pay a monthly enrollment fee; this is the premium. In addition to the premium, you are usually responsible for meeting a deductible or paying a co-payment, also called a “copay.” A deductible is a fixed amount that must be met each year before insurance begins to cover the costs of procedures. A co-payment is a fixed amount fee that you pay at the dental visit to cover a portion of the cost.

Different insurance policy types have different rules. A dental health maintenance organization (DHMO) requires you to go to in-network dentists. A preferred provider organization (PPO) may offer reduced coverage for out-of-network dentists. The dentist bills your insurance and then you receive a bill for the amount you owe.

Key Points of Traditional Dental Insurance: 

• You pay a premium.
• You probably will have a deductible that has to be met each year.
• There may be waiting periods for non-preventive services like fillings and root canals.
• You may have coinsurance or copays that are out of pocket for part of the cost that isn’t covered.
• You may have an annual limit on expenses the insurer will pay.

Dental Savings Plan

A dental savings plan, also called a dental discount plan, is a membership program that offers discounts on dental care in exchange for an annual or monthly fee. Usually, the annual fee is around $100 to $200. These savings plans are similar to a membership plan at a grocery store or wholesale club. Instead of bargains on steaks and TVs, you get discounted prices on dental services.

How a Dental Savings Plan Works

With a dental savings plan, you pay an annual fee upfront or split the annual fee into monthly installments and then you pay out of pocket for the discounted dental services you get throughout the year. Some dentists offer their own dental savings plans. With a dental savings plan, you will find a list of in-network dentists who take the plan and you choose one from the network.

Key Points of a Dental Savings Plan

• Dental savings plan members pay an annual fee to get discounts on dental care.
• The plans don’t have annual limits, deductibles, or waiting periods.
• You can sign up and begin getting discounts within three business days.
• These plans can be helpful as supplements to dental insurance.

Differences Between Dental Insurance and Savings Plan

	Dental Savings Plans	Dental Insurance
Plan Cost Billing	Billed annually/monthly	Billed monthly
Annual Maximum Benefit	No	Yes
Deductible	None	Usually. Some policies have annual deductibles
Waiting Periods	No	Usually for non-preventive care
Network of Dental Providers	Yes	Yes
Additional Costs	Yes. You pay the difference between the service cost and the discount.	Coinsurance/copays may apply for certain services. You are also responsible for expenses that exceed your plan’s maximum coverage limit.
Pay Dentist Directly	Yes	No
Copays	No	Typically yes. Depends on plan
Membership Fees	Yes	No
Premiums	No	Yes

Dental insurance usually offers more coverage than dental savings plans. For example, dental insurance may fully cover the costs of services such as dental cleanings and screenings. A dental savings plan would give you a discount, but you would still need to pay each time you see the dentist. Dental savings plans usually cost less than dental insurance because they offer less coverage. A dental savings plan costs between $100 to $200 per year while dental insurance can cost up to $600 per year for an individual plan, depending on the amount of coverage.

When to Opt for a Dental Savings Plan v/s Insurance

If your situation is in one of these categories, a dental savings plan could make sense for you.

• You need very little dental work. If you don’t need a lot of dental work, mainly routine cleanings twice a year, you can save money with a discount plan.
• You need more dental work than your insurance plan will cover. Most dental insurance plans have a limit they will pay for dental care in a year. If you need extra dental care, you could join a discount dental plan in addition to your dental insurance to help cover the costs.
• You have health issues that can be complicated by dental problems. People with certain health conditions may need to be especially careful with their dental care. For example, untreated gum disease can worsen health conditions like diabetes and heart disease. If you don’t have dental insurance, a discount plan is a good choice.
• You are 65 or older. Medicare doesn’t cover most dental care. If you are 65 or older and have Medicare but not dental insurance, a dental savings plan may be a good choice.

Contact Hamby Family Dental Center Today to Schedule a Dental Appointment

Whether you need a routine dental cleaning and checkup or have a serious dental need and/or emergency, our professional dental team at Hamby Family Dental Center can help. We take exceptional care in handling your specific issue. Reach out to us and see what a difference we can make. Call us at  919-552-2431 or complete the online form below to schedule an appointment.