Dental Insurance

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Dental Discount Plans Vs Dental Insurance What's Right for You?

Entering “dental plan” into a search engine yields a seemingly endless list of options. The page 1 results may seem like your best bet. However, upon closer inspection, you will notice that many of these top-ranked listings are for dental discount plans, not dental insurance plans.

While both may offer savings, is important to realize these are not interchangeable terms. Understanding their differences will help you choose the best option for you and your family.


A dental discount plan is not an insurance plan. It is exactly what it sounds like—a way to receive dental care at a reduced rate. You pay for all services, from cleanings to root canals, directly and out of your pocket.

Participation costs – Enrollment fee, annual fee

What’s included – Discounted rates for participating providers, which typically range from 25 to 50 percent off select services

Who pays for services – You pay the dentist directly for services

Calendar-year maximum - No


Like health insurance, dental insurance covers a portion of your billed treatment charges depending on the coverage you select.

Participation costs – Monthly premium, deductible, copay

Who pays for services – The insurance company pays the dental provider directly. You are responsible for paying applicable copays and deductibles out of pocket.

What’s included – Typically, insurance plans cover two cleaning and exam visits annually. Depending on the coverage you select, the cost for services will be shared by the insurance company.

For example, additional preventive and diagnostic care may be covered at 80 percent, leaving you to pay 20 percent coinsurance, and major services such as a root canal may be covered at 50 percent.

Calendar-year maximum – Yes. Most dental insurance plans include an annual maximum benefit, once this amount has been exceeded, you must pay for any additional charges.

So how do you choose between the two? Consider what care you and your family require annually, and crunch the numbers. If you decided to go with a discount plan, make sure you are setting aside enough funds for regular checkups and cleanings. Visit’s Dental Cost Calculator to find the average pricing of dental treatment and care in your area.

Remember: Knowing how you will pay for health care means knowing how you will pay for dental services, too. Recent reports from the Pew Center on the States and PBS regarding dental disparities found that many without insurance seek treatment in hospital ERs where charges can be 10 times that of a dentist. Oftentimes, an ER visit only temporarily addresses the problem. The Pew report cited a study of low-income patients with toothaches and found that among those who sought treatment at the ER, 80 percent needed subsequent care from a dentist. While some of these cases result from “dental deserts” and others from Medicaid coverage issues, others are individuals without the means to pay for dental care.

Take time to plan, leave room for the unexpected, and remember that preventive care helps keep costs and problems low.

Read “Purchasing the Perfect Plan” for tips on shopping for dental insurance plans.

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