Discount dental plans have become a popular alternative to dental insurance. However, if you’re like many consumers, you’ve likely wondered about the differences between dental plans and dental insurance. It’s important understand that the terms are not interchangeable. There are significant differences between the two approaches to dental care.
Networks and Dental Plans
Dental plans and dental insurance providers both have access to a network of providers. All you have to do is select a dentist from the list of providers. Once at the dentist’s office, simply present your membership card to make sure that you’re charged based on your plan.
Premiums and Dental Plans
Dental insurance plans as well as discount plans require that members pay a yearly or monthly premium. Discount plans typically carry a lower premium than dental insurance plans. A plan with a low deductible will require that you pay a higher premium.
Dental Plans and Deductibles vs. Discounts
It is important to understand how each plan works. One major difference between discount dental plans and dental insurance is the yearly deductible. If you have insurance, you generally pay 100 percent of the service fee until you meet the yearly deductible. Once you meet the yearly deductible, you only pay your co-payment portion for each procedure. A new yearly deductible starts at the beginning of each new year. Note that dental insurance generally doesn’t cover pre-existing conditions.
In contrast, if you have a discount plan, you pay the yearly premium and you don’t have to worry about a yearly deductible. You simple pay the discounted fee for each procedure.
Dental Plans and Provider Fees
Providers generally require that members with dental plans pay the discounted rate at the time of service. If you have insurance, however, your dentist will have to submit a claim to your insurance carrier. Depending on your dentist’s policy, your dentist’s office might bill you for your portion of the service fee. Other dentists require payment at the time of service.
Moreover, if you have dental insurance, your dentist is not paid for his services until your insurance company approves the claim. If your dental claim is denied due to lack of coverage, the dentist’s office will have to pursue payment for the entire amount from you.
On the other hand, discount dental plans do not require dentist's offices to file claims. As long as you’re a member of a discount plan, the dentist will receive compensation for his services.
As you can see, there are significant differences between dental plans and dental insurance. Which one you choose depends on your particular needs. It’s important to consider the pros and cons of each plan before making a selection.
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