Dental Insurance vs Dental Plans: What’s the Difference?

Oral health is a bit like oxygen: when you have it, you don’t even notice it – but when you don’t have it, it’s the only thing you notice! Even minor dental problems like gum disease and toothaches can make day-to-day life miserable.

Young or old, rich or poor – we all need regular dental care to look and feel our best. One decision many Americans have to make is whether to buy a dental insurance policy or enroll in a discount dental plan. Below we break down the key differences and show you the advantages and disadvantages of both offerings.

Dental Insurance

Dental insurance works the same way as health insurance: individuals and families pay a yearly premium for their policy, as well as a deductible and, if applicable, a co-pay at the time of the procedure. 

Millions of Americans receive dental insurance through their place of work, although employers usually only provide very basic policies. If you buy dental insurance privately, premiums typically range from $200 to $400 per year.

Most dental policies have an annual cap, meaning patients are only covered up to a set dollar amount each year. If your dental costs exceed the cap, you have to pay the difference out of pocket.

Of course, with dental insurance you’ll have to do the required paperwork and submit your claims to your insurer, just as you would with a health insurance policy.

Some dental insurance policies also have mandatory waiting periods, where certain procedures aren’t covered for a specified amount of time, usually ranging from six to twelve months from the day you sign up. Check the fine print of your policy – the last thing you want to find out is that your expensive root canal procedure isn’t covered because you are still in the waiting period. 

You should also check to make sure the policy doesn’t have a pre-existing condition clause that would exclude certain dental work from being covered.

Discount Dental Plans

Discount dental plans work differently than dental insurance. Think of a dental plan as like being a member of a special club, where you get discounts on dental procedures – a kind of Costco for the teeth.

Dental plans have the benefit of being simpler than dental insurance. For starters, you won’t have to deal with insurance claim forms – all you have to do is show your card and pay the cost of the discounted procedure when you're at the dentist’s office. You also won’t have to worry about deductibles, co-pays, or annual coverage maximums, which nearly all dental insurance policies have. 

Enrollment fees for dental plans range from $75 to $150 per year, and members receive discounts ranging from 10 percent to 60 percent off the regular price of the procedure. 

One thing to check: make sure you’re using a dentist who is part of the discount network. 

Head-to-Head

If you’re having trouble deciding between dental insurance and a dental plan, here are some of the key differences:

 

Dental Insurance

Dental Plan

Costs

Annual premiums of $200-$400, plus co-pays and deductibles.

Annual enrollment fee of $75-$150.

Annual Limit

Typical dental policy cap is around $1500.

None.

Waiting Period 

Up to twelve months for some procedures.

None.

Paperwork

Claim forms and policy renewal forms.

None.

Restricted Procedures

Yes, depending on the plan.

No.

Savings

Dental care costs after deductible are covered, up to the policy limit.

Discounts of 10 to 60 percent off the regular price of dental care.

Cosmetic Procedures Covered?

No.

Yes, depending on the procedure.

Mixing and Matching

You can also buy discount dental plans even if you already have a dental insurance policy. This way, if you exceed your policy’s coverage limit, which is easy to do, you’ll at least receive discounted care through the plan. Remember, discount plans don’t have annual caps, so if you have a lot of expensive dental work to be done, you’ll reap big savings.

Assessing Your Needs

Of course, everyone needs to figure out which dental care program works best for their own unique needs. For families who just want regular check-ups and the odd minor procedure, a dental insurance policy may be best, especially if it’s available through an employer. For those who are pinching pennies or who need major dental procedures, discount dental plans, with their low annual fees and unlimited coverage, probably work better. The third option, of combining an insurance policy with a discount plan, is great for those who want maximum coverage and peace of mind.

So, which option works best for you?