Dental savings plan vs dental insurance: which is cheaper for you?

The short version

Dental insurance and dental savings plans both lower what you pay the dentist. They do it in opposite ways.

• Insurance pays part of your bill, up to a yearly limit, after you’ve paid a premium and a deductible.
• A savings plan is not insurance. It never pays your dentist. You pay a membership fee, and dentists in its network charge you a lower price.

Which one is cheaper depends on what you need, how soon you need it, and who pays the premium.

How dental insurance works

Most dental insurance has five moving parts. Check each one in the plan’s summary before you enroll.

1. Premium. What you pay for coverage, usually monthly, whether or not you see a dentist.
2. Deductible. What the ADA’s MouthHealthy site calls the amount “you will need to pay on your own before the plan begins paying benefits.” The ADA says $50 is still the most common deductible.
3. Coverage percentages. The National Association of Insurance Commissioners (NAIC) says most plans cover preventive care at 100 percent and cover major work such as crowns at the lowest percentage. Humana, an insurer, describes a common pattern after the deductible: 100% for preventive care, 80% for basic work such as fillings, and 50% for major work.
4. Annual maximum. The most the plan pays in a year. The ADA says a common maximum is $1,000 or $1,500, and some plans go to $2,000 or $3,000. After that, you pay the rest yourself until it resets.
5. Waiting periods. Time after you enroll before the plan pays for some care. Humana says fillings may wait 3 to 6 months, and major work 3 months to a year. Preventive care usually has no wait. Some plans have no waiting periods, so check yours.

Plan types differ too. With a PPO you can usually see any dentist, but you pay less in its network. With a DHMO you usually must use the plan’s dentists.

How a dental savings plan works

1. You pay a membership fee, usually once a year.
2. You see a dentist in the plan’s network. Outside the network, there’s no discount.
3. You pay the discounted price at the visit, from the plan’s fee schedule.

The National Association of Dental Plans (NADP), an industry group, puts discounts at 20 to 60 percent. The plan sellers say there’s no deductible, no annual maximum and no waiting period. DentalPlans.com says most plans activate within three business days.

For the details, see dental savings plans explained.

Side by side

	Dental insurance	Dental savings plan
Is it insurance?	Yes	No
What you pay upfront	A premium, often monthly	A membership fee, often yearly
Deductible	Often	Usually none
Who pays the dentist	The plan pays a share	You pay a lower price
Yearly limit	Often $1,000 to $1,500, some higher	Usually none
Waiting period	Some plans, for fillings and major work	Usually none
Cleanings and X-rays	Often covered in full	Discounted
Existing problems	Check the plan	Discounted like anything else

A worked example

These numbers are made up to show the math. They are not real prices or real plans. Plug in your own from a written estimate and the plan’s documents.

Say an office charges $400 a year for two checkups with cleanings and X-rays, and $1,200 for a crown.

• Insurance (illustrative): $40 a month premium ($480 a year), $50 deductible, 100% for preventive, 50% for crowns, $1,500 annual maximum.
• Savings plan (illustrative): $150 a year, 30% off the office’s fee.

What you’d pay in a year:

Your year	No coverage	Insurance	Savings plan
Checkups only	$400	$530	$430
Checkups plus a crown	$1,600	$1,130	$1,270
Checkups plus a crown, during a 12-month waiting period	$1,600	$1,730	$1,270

How the insurance column adds up for the crown year: $480 premium, plus the $50 deductible, plus half the crown ($600).

What the example shows:

• For checkups only, paying the office yourself is cheapest here. Insurance can win if your employer pays most of the premium.
• For a crown you can schedule later, insurance wins once the waiting period is over.
• For a crown you need now, the savings plan wins, because the insurance won’t pay for it yet.

In real life, in-network insurance fees are often lower than the office’s regular fee, which tilts things toward insurance. Your plan’s own numbers decide it.

To estimate your own treatment, try the dental cost estimator, or see root canal cost and crown cost.

Who each one suits

Insurance often suits you if:

• Your employer offers it and pays part of the premium.
• You mostly need checkups and want them covered in full.
• You can plan big work for after any waiting period.

A savings plan often suits you if:

• You have no insurance and need a filling, crown, root canal or extraction soon.
• You’ve used up your insurance’s annual maximum. A plan can lower the price of the rest, though you can’t use both on the same procedure.
• You have Medicare and no dental plan. NADP notes that Medicare doesn’t cover routine dental care.

Before buying either, call your dentist and ask which plans they take, by exact name. More ways to cut the bill are in dentist without insurance.

How to need less of either

• Brush twice a day with a fluoride toothpaste, for two minutes, and clean between your teeth once a day.
• Keep up with checkups so small problems get fixed while they’re small and cheap.
• Don’t wait out a sore tooth. See what to do for a toothache right now.