Ways to pay for dental work.

- An overview of the types of options and plans a patient typically has. / Advantages and disadvantages of each. / Features to look for in a good dental plan.

When it comes to finding help in affording the dental work you need, you'll generally find the following options as possible alternatives.

  1. Traditional dental insurance (Indemnity policies). - This is an arrangement where a policy is issued by an insurance company. And per its terms and conditions (wait-periods, pre-existing conditions, benefit maximums, etc ...), it pays for a portion of the dental treatment you receive from your dentist.
  2. Managed care insurance policies. (HMO's, PPO's) - These plans are a type of insurance but your care is provided by a specific set of providers (a dental clinic or list of "participating" dentists). Procedures are provided to members at a reduced rate, although restrictions and conditions similar to traditional policies frequently exist.

  1. Discount (Referral) plans. - These types of programs are often confused with dental insurance but really aren't. They're simply the situation where a dentist has entered into a contract with the company selling the plan to discount their fees for its plan members.

    Limitations like yearly maximums, wait-periods, pre-existing conditions typically don't exist.

  2. Financing your treatment. - Just like when you buy any type of consumer item, lenders exist that are in the business of financing the cost of dental work too.
  3. Direct financial arrangements. (Cash discounts, Payment plans) - Don't overlook the fact that if you have funds available, or at least some amount of funds on a regular basis, you may be able to negotiate a deal directly with your dentist whose terms are advantageous for both of you.

Just as you might expect, each of the methods listed above has its own distinct advantages and disadvantages. The following section explains what they are, and provides links you can follow for more information about them.

a) Dental insurance.

A primary difficulty with dental insurance is that it can be difficult for an individual (or individual family) to find coverage on the open market. That's because the companies that sell these types of plans (Traditional, PPO or HMO policies) to groups as opposed to individuals.

Here's why:
  • An individual purchasing a policy on their own often has an immediate need and will likely make use of their coverage.
  • Covered groups are more likely to include people who have no pressing needs or aren't so likely to utilize their policy benefits.
  • An insurance company is more likely to make money covering the latter group. Premiums are paid in but fewer benefits are typically paid out (due to policy underutilization by some members).

For this reason, most people who participate in an insurance program get it through their place of employment or an organization to which they belong.

Individual dental insurance policies.

It is possible for individuals (single people or families) to find coverage for themselves on their own. But these policies are often shackled with pre-existing and wait-period clauses. Depending upon what the insured's immediate dental needs are, this may or may not present a problem.

Dental options with Obamacare.

Dental policies are offered as a part of the Affordable Healthcare Act (Obamacare). In fact, dental coverage must be available as part of a health plan for children 18 years and younger (although it does not have to be purchased).

For adults, coverage is available too. Although stand-alone policies (dental plans that are not part of an associated health policy) can only be purchased if you've enrolled in a health plan through the exchange also.

b) Discount plans.

They frequently seem better than they really are.

Discount (Referral) dental plans typically have an open enrollment (anyone can join at any time) and seemingly few benefit restrictions. But to the knowledgeable eye, their terms aren't always quite as advantageous as they seem on the surface.

These plans may be suitable for some. But especially in the case where extensive work is required, you'll benefit from reading our discussion (use link above) so you are aware of the types of pitfalls you may encounter.

One underlying problem.

Especially in the case where deep fee reductions are involved, you need to keep in mind that no dentist can afford to heavily discount their fees and remain in business for long. (Office overhead expenses for a dental practice usually run on the order of 60%.)

In situations where a plan's fee schedule seems too good to be true, you have to remain aware of the fact that loss-leader or bait-and-switch tactics may be involved.

c) 3rd-party dental financing.

It's usually easy to get but may have some catches.

Financing dental expenses is another way to manage treatment costs. And some third-party plans offered through dental offices can be a decent deal for some patients. But as our pages explain, for those who can't comply with their strict repayment conditions, doing so may prove to be a costly choice.

Something to watch out for.

Don't let your relationship with your dentist, or a plan's endorsement by some type of dental association, cause your guard to drop. Entering into a 3rd-party financing agreement is strictly a business deal.

It may or may not be a good deal for you. But it must be for someone (your dentist, the finance company) or else it wouldn't be offered.

Generally speaking these agreements are not unlike the type offered by the big-box store down the street and this can be a very expensive type of debt (an unsecured personal loan) to take on. Our advice, consider the suggestions we make on our pages (see link above) as to other, less costly, methods of arranging financing for dental work.

d) Negotiating directly with your dentist.

This may work out exceptionally well for both of you.

Working out some type of creative financial arrangement (cash discount, payment plan) with your dentist can be a great way to reduce or stretch out your expenses.

As our pages explain, as far-fetched as this idea may seem, there are some very grounded reasons why this type of set up might be a good deal for both of you.

Situations when this might work out.

Finding a dentist who will, or can, agree to this type of arrangement may be the difficult part. For example, nowadays many dentists are simply employees and therefore have limited authority to enter into creative financial arrangements.

But in some cases, especially when you've had a long-standing, positive relationship with your dentist, this may be the easiest decision of their day.

Features to look for in dental insurance plans.

When looking at a traditional insurance, HMO or PPO plan, here are the kind of benefits you should look for, and why.

a) Generous benefits for Preventive dental services.

A fundamental characteristic of a good dental plan is that it provides for regular and on going diagnostic and preventive care.

Most of the dental problems that a person will experience during their lifetime will be those that could have been avoided or significantly minimized if they were just diagnosed and dealt with at an early stage.

Unlike a medical policy whose primary purpose is to provide protection against catastrophic expenses, the goal of dental coverage is prevention and/or treating an issue early while the amount of time, money, and effort needed to correct it are small.

Use this link for details about what's ideal, or at least customary, in regard to coverage for Preventive services (what procedures are included, coverage levels, utilization frequencies).

b) Reasonable benefits for Basic dental services.

Once a problem has been identified, it's always best to have the treatment that's needed to correct it performed in a timely fashion.

While it's unrealistic to expect that a plan would necessarily pay the entire cost of this service (although some may), it should provide enough assistance that the care is easily within the individual's financial reach.

Use this link for details about ideal/customary coverage for Basic services (included procedures, benefit rates).

c) The more coverage it provides for Major dental services the better.

By structuring a plan so it provides generous benefits for prevention and the early detection and correction of problems, hopefully only a minimal amount of Major dental care will ever be needed. When it is required, however, a plan's benefits should provide enough assistance so that obtaining it is possible.

Use this link for details about ideal/customary coverage for Major services (included procedures, benefit rates).



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