Dental Insurance vs. Dental Savings Plans

By the GWAAR Legal Services Team

If you or someone you love is looking to save money on the high cost of dental care, two available options include dental insurance and dental savings plans. These may sound similar, but they offer different types of benefits and have different limitations. There are pros and cons of each. It is important to know the difference between the two and choose a plan that is right for your individual dental care needs.

 Dental Insurance

Dental insurance is like health insurance. You pay premiums to the company, and then, the dental insurance company pays the dental provider on your be-half. These insurance plans will typically require co-pays and deductibles. They will oftentimes have a provider network that works much like an HMO or PPO health insurance plan.

It is important to note that some dental insurance plans have an annual maximum amount that they will pay on your behalf (sometimes referred to as a “benefit cap.”) Sometimes, this maximum amount will be around $1,000 or $1,500. If you need a lot of dental work in a one-year period, this could mean your insurance benefits are used up rather quickly. It may also mean that more expensive items or services may not be fully covered. However, some plans do have negotiated discounted prices that you pay the provider after you reach your annual benefit cap.

Another drawback to dental insurance is that they sometimes require a waiting period before a particular service is covered. One benefit to dental insurance is that sometimes they will cover preventative care with no co-pays. Most importantly, keep in mind that each plan is different, and you should compare multiple plans to choose the right one for your needs.

Dental Savings Plans

Dental savings plans are not insurance (although sometimes they may be administered by insurance companies such as Aetna.)  With a dental savings plan, you pay the provider directly, but those charges are discounted in accordance with your plan. Also, you must choose a dentist who participates in the plan.

With a dental savings plan, there are generally no deductibles, no waiting periods, and no annual maxi-mums. However, most often, the discounted price you pay for these services is higher than the copay amount you would pay with dental insurance. Notably, some services that are not typically covered by dental insurance, such as cosmetic services, may be discounted through a dental savings plan.

 It is often possible to have both a dental insurance plan and a dental savings plan. For example, if you reach your annual benefit cap with your dental insurance plan, you can then start paying discounted rates through the dental savings plan, or you can pay dis-counted rates for items or services that dental insurance does not cover. If you chose this option, you will want to make sure your dentist is in-network for the insurance plan and participates in the savings plan.

Finally, and most importantly, when choosing a dental insurance plan, dental savings plan, or both, you should weigh the pros, cons, and total costs of each option. To do this, it is helpful if you have an idea of your expected dental needs. Then, you can estimate what your total dental care cost will be under each plan considering copays, deductibles, benefit caps, covered services, and discounts.

Copyright 2019, GWAAR, Greater Wisconsin Area Aging Resources