Save Money at the Dentist Whether You Have Dental Insurance or Not

Dental insurance is a separate type of insurance that is designed to help ease the financial burden of dental work, like cleanings and fillings performed by a doctor of dental surgery (DDS), more commonly known as a dentist. It can also cover specialty dental treatments like braces, root canals, and other dental surgery. Cosmetic dentistry, such as tooth whitening and veneers are typically not covered by traditional dental insurance.

People with dental insurance usually get it from their employer, who will pay a portion of the fees. Employers don't pay for everything, though. For indemnity insurance, or traditional insurance, covered employees pay a fee every month in the form of a paycheck deduction. Semi-annual teeth cleaning visits are usually "free" after that. Any other covered dental services require a co-pay at the time of the visit. A co-pay is the amount of money that the covered person needs to pay the dentist out-of-pocket at the time of service. As mentioned before, teeth whitening services are not included.

Some employers provide an HMO dental insurance with limited choices of dentists but a low co-pay, and others have a PPO insurance with more choices and a higher co-pay.

When you sign up for dental insurance during open enrollment, it's a good idea to read the policy carefully. Here are some of the terms that you need to understand so there are no surprises when the bill arrives:

Annual Maximum
This is the maximum benefit the insurance plan will pay in a single calendar year. This number reflects the amount the insurance company has paid in your behalf out of the dentists' fees. If you need more dental work than the annual maximum will pay, you will need to pay the full amount yourself.

Least Expensive Alternative Treatment Provision
Some insurance policies have what's called a "least expensive alternative treatment provision," which means that the insurance company will only reimburse you for what it would cost to go with a cheaper alternative. This could mean that your insurance company will only pay for a metal filling even though your dentist is recommending a tooth-colored filling, or the insurance company may only pay for a large filling instead of a crown. If your insurance policy has a least expensive altenative treatment provision, you're going to have to make up the difference if you go with the treatment your dentist recommends.

Pre-Existing Condition
If your insurance policy has a pre-existing condition clause, you may be denied reimbursement for a problem that existed before the dental insurance policy went into effect. This is similar to a pre-existing condition clause in medical insurance. You may still need treatment for the problem you are having, but the insurance company won't pay for it. This clause is illegal in some states, so read your policy carefully.

Usual, Customary and Reasonable (USR)
This clause can cause unpleasant surprises. Insurance companies using this clause have a list of prices for how much they think dentists "should" charge for dental care. Typically, dentists who have been in practice for many years or who have teaching credentials or other expertise charge more than dentists who are just starting out. If you visit such a dentist, or if your dentist's office has high rent, you may bump into the "usual, customary and reasonable" clause just as you're pulling out your wallet. To avoid this unpleasant surprise, try to call ahead for a price list from your dentist as well as the UCR list from the insurance company.

Search Job Listings