The short answer
Dental insurance pays part of your bill. A dental savings plan gives you lower prices at the visit, but it does not pay anything. You still pay the discounted price yourself.
Insurance tends to win when you expect regular care and want help with the bill. A savings plan tends to win when you need care soon, have no insurance and want to skip waiting periods. Let's look at each one.
How dental insurance works
You pay a monthly premium. In return, the plan pays a share of your dental bills. Most plans follow a pattern of 100% for preventive care, 80% for basic care and 50% for major care, after a deductible. That is what Consumer Reports and many insurers describe.
There are limits. Plans have a yearly maximum, which is the most they will pay in a year. Many also have waiting periods before they pay for bigger work, and rules about how often they pay for the same thing. Consumer Reports reports that individual plans cost about $20 to $80 per month, with annual maximums of $1,000 to $2,000, and a middle maximum of $1,500 according to the National Association of Dental Plans.
How a dental savings plan works
A dental savings plan is also called a discount plan. You pay a yearly fee, and you get reduced prices at dentists who joined the plan. There is no claim, and the plan does not pay the dentist. You pay the lower price when you get care.
Consumer Reports puts savings plan fees at about $80 to $200 per year. Other sources give different numbers, so check current offers. The sites that sell these plans point out that there are usually no waiting periods, no deductible and no yearly cap. That means you can use the discount the first week you join.
One thing to remember is that these plans work only with the dentists in their list. Ask if your dentist takes the plan, and ask what the discount is for the treatment you need. Discounts are not the same for every service or every office.
Where each one wins
Each one has a clear best-use case. Here is a plain way to see it.
- Regular cleanings and exams: insurance often pays 100%, so insurance usually wins.
- A big surprise bill soon: a savings plan has no waiting period, so it may win.
- A lot of work in one year: a savings plan has no cap, but insurance may pay more of each bill up to its limit. Run the numbers.
- Very little care needed: both may cost more than the care itself. Think about paying out of pocket.
- Employer plan available: employers often pay part of the premium, so take it.
Where the money goes, and why insurance is not always worth it
It helps to know what you are paying for. With insurance, part of your premium covers the risk that you might need costly care, and part covers the plan's costs. If you stay healthy, you may pay more than you get back. If you need big work, you may get back much more than you paid.
With a savings plan, you are buying a lower price list. You pay a small fee, and it works best when you will use it. If you do not visit the dentist, the fee is wasted. If you need several treatments, the discounts can add up.
Consumer Reports points out something that surprises people. If you only need basic care, you may pay more in premiums than the care would cost. The article lists typical 2018 prices of $73 to $130 for a cleaning and $108 to $246 for a filling. Those prices are older now, but the logic holds. Two cleanings a year can cost less than a full year of premiums.
The article's advice is to take a plan if your employer offers one, because employers often pay much of the premium. If you buy a plan on your own, compare the yearly premium against the care you expect to use. Insurance makes more sense when it helps you see the dentist more often, since small problems are cheaper to fix early.
Run your numbers, and ask the right questions
Take 10 minutes and do this. Write down the care you expect in the next 12 months: exams, cleanings, X-rays and any work your dentist already told you about. Ask your dentist's office what each costs.
Then, for insurance, add the yearly premium and the part of each bill you pay yourself. Remember the waiting period and the yearly maximum. For a savings plan, add the yearly fee and the discounted prices. Compare the totals.
Here is a made-up example. Say a plan costs $400 a year and pays 100% of two cleanings that cost $300 together. You paid $400 to save $300, so you lost $100 on cleanings alone. But if you also need a $1,200 crown and the plan pays half after the wait, you save $600 and come out ahead. Your real numbers will differ.
Savings plans vary, so ask these before you pay the fee:
- Is my dentist in the plan's network today, and will they still be next year?
- What is the exact discount for the treatment I need, not just an average?
- Can I see the fee list in writing?
- Is the fee charged once a year, and can I cancel for a refund?
- Does the plan cover specialists, such as a gum doctor or an oral surgeon?
- Does the discount apply right away, with no waiting period?
Can you use both?
Some people do. A savings plan may help with services your insurance does not cover, or after you hit your yearly limit. But rules vary, and many insurance plans have contract terms that affect what a dentist can charge. Ask the dental office and both companies before you rely on this.
Also ask if your office has its own membership plan. Some offices offer one for people without insurance. The American Dental Association has said it supports in-office membership plans as an option. Ask for the terms in writing.
Paying for care at KDA
At Kendall Dental Associates (KDA), we accept most dental insurance plans, and financing is available. We also take credit cards, debit cards and NFC mobile payments. If you have a savings plan or are not sure what you have, call us and we will talk it through before you book.
Call 305-271-1421 or visit 8833 SW 107th Ave, Miami, in the Kendall Mall. We are open Monday to Friday, 8:00 AM to 5:00 PM. Whatever plan you choose, regular visits are the best way to keep your costs down over time.
Common questions
Is a dental savings plan the same as insurance?
No. Insurance pays part of your bill. A savings plan gives you lower prices at the visit, and you pay the discounted price yourself.
Are there waiting periods on dental savings plans?
Plan sellers say usually not, so the discount can start right away. Always read the terms of the plan you pick.
How much does a dental savings plan cost?
Consumer Reports lists about $80 to $200 a year. Other sources give different numbers, so check current prices.
Is dental insurance worth it?
It can be if your employer pays part of the premium or if you expect regular care. For very light care, the premium can cost more than the visits.
Can I use a savings plan if I need work done now?
Often yes, since there are usually no waiting periods. Check that your dentist takes the plan and ask what the discount is for your treatment.
This article is general information, not medical advice. Your dentist will confirm what is right for you at your exam. General information checked against: consumerreports.org, mutualofomaha.com, dentalplans.com, ada.org.