Traditional Dental Insurance vs. Discount Dental Plans
Traditional Dental Insurance	Dental Discount Dental Plan
Typically expensive (up to or over $100 for family)	Inexpensive (the cheapest dental plan starts at $6.95 a month - save up to $85 a month in premiums)
Deductibles	No Deductibles
Maximums ($1000 to $1500 annually)	No Maximums (use as much as you need)
Rate Increases typical - up to 10% to 15% a year	No Foreseeable Rate Increases
Claim Forms	No Claim Forms
Dentists are starting to reject insurance because of long lag time in payments	The Percentage of Providers Joining Discount Dental Plans is Growing every year!

Dental Indemnity Insurance

This is the oldest form of traditional dental insurance. This type of insurance is also the most expensive. The Insurer gambles that they will collect more in premiums than they will pay in claims. The odds are in the insurer's favor because they have control of what, how much, if and when a claim gets paid. Until recently indemnity insurance was available only for groups. Due to the large number of enrollees in the groups, the income to claim ratios is easily kept in the favor of the insurance company.

Indemnity dental insurance is now available to individuals. It is also the most expensive type of dental coverage. You can choose any dentist and the dentist submits their usual and customary fees to the insurance company for payment. Most all dentists will accept indemnity insurance plans because they are able to charge full price!

Keep in mind there are waiting periods (sometimes very long), deductibles, exclusions (procedures that are not covered at all) and yearly limits on benefits. Most insurance plans have a deductible of $50 to $100, pay only a specified percentage for each type of treatment, and have a yearly maximum amount of funds available for dental care.

An example of the typical insurance coverage is: preventive care, cleanings, check-ups, protective dental sealants, x-rays, and fluoride treatment at 80-100%. Basic care, including root canal therapy, extractions, and fillings are usually covered at 60-80%. Major care such as crowns (caps), permanent bridgework, and full and partial dentures as well as periodontal (gum) care are often covered at 50%.

If you get nothing more out of this page, PLEASE UNDERSTAND THIS: Insurance companies are in the business of collecting premiums NOT paying claims. Insurance companies ALWAYS look to make a profit. They will always collect more money in premiums then they will pay in claims. If too many claims are submitted, their profits will decrease, to offset the decreases in profits premiums are increased and/or benefits reduced.

An article by Dr. Jerry Gordon on howstuffworks.com, titled "Digesting the alphabet soup of dental insurance," notes:

Many insurance companies have a yearly maximum between $750. and $1500. Dental insurance is not cumulative, so if you don't use it, you lose it. It is interesting to note that when dental insurance companies became common in the early 1970's, the yearly maximum was the same ($750. to $1500.) as it is today, even though the cost of delivering dental care has nearly tripled since then.

Why Dental Insurance is a Waste of Money

Dental insurance is the most expensive type of dental coverage. Because insurance companies pay claims, they must charge more in premiums than they pay out. According to "Dental Plans," an article on bizjournals.com, "

...many people who have dental insurance waste their premium, as 60% of those who are insured, do not make a claim or visit a dentist in a year." Below, we will discuss several reasons that dental insurance is a waste of money.

DEDUCTIBLES
- Called by some the "hidden cost" of dental insurance and some PPO's and HMO's, deductibles add to the actual cost of your plan. A deductible is the amount you pay every calendar year before the insurance company's benefits begin. Deductibles can vary - some as low as $50.00 per person per year, some $150 or more.
CEILINGS or MAXIMUMS

Two types of "ceilings" can limit the benefit you can receive from dental insurance and some PPO's and HMO's.

First, potentially unrealistic yearly maximums limit what you can claim in a year. An article by Dr. Jerry Gordon on howstuffworks.com, titled "Digesting the alphabet soup of dental insurance," notes:

Many insurance companies have a yearly maximum of a $1000. Dental insurance is not cumulative, so if you don't use it, you lose it. It is interesting, and disappointing, to note that when dental insurance companies became common in the early 1970's, the yearly maximum in many was the same $1000 it is today, even though the cost of delivering dental care has nearly tripled since then.

It is also important to note that this maximum can be based on the claim amount (the total cost of work performed) rather than the amount paid by the insurance company. Ceilings can range from as low as $750.00 per person per calendar year to as high as $2,000.00.

Second, coverage may be limited to the "UCR" (Usual, Customary & Reasonable) Fee - "...an arbitrary fee ceiling at which the insurance company will stop reimbursement." (dentist.net, "What is Dental Insurance") If the dentist you like happens to charge more then the UCR, you are required to make up the difference.

WAITING PERIODS
- After joining a dental insurance plan, some or all procedures may not be covered for a period of time called the "waiting period." It is not uncommon for an insurance plan to have waiting periods as long as 24 months for major work; however, some plans have waiting periods for even preventative care, such as cleanings and examinations, of up to three months, and basic care, like X-rays, extractions and fillings of 6 - 12 months. Also, the percent of coverage may vary depending on waiting periods.
LIMITED COVERAGE
- While many insurance companies boast about covering preventative care at 80% to 100%, more expensive work (the kind you wanted the insurance to protect yourself against) is often only covered 50% or less, after a waiting period of up to 2 years. Some procedures, like Cosmetic Dentistry, are not covered at all. This tends to vary quite a bit by the individual plan, but we have compiled typical coverage below.
  
  1.        PREVENTIVE CARE: Cleanings, check-ups, protective dental sealants (if covered), and fluoride treatment at 80-100%. The waiting period is usually 0 to 3 months.
  
  2.        BASIC CARE: X-rays, extractions, and fillings are usually covered at 60 to 80%. The waiting period is usually 6 to 12 months.
  
  3.        MAJOR CARE: Root canal therapy, crowns (caps), permanent bridgework, oral surgery and full and partial dentures as well as periodontal (gum) care are often covered at 50%. The waiting period is usually 12 to 18 months.
HIGH PREMIUMS

Monthly or annual premiums for dental insurance are higher than any other option. Ranging from averages around $180.00 per year for an individual to over $1,400.00 for a family, premiums can vary greatly and depend on the type of plan, the maximum annual benefit and deductibles. Lower deductibles and higher maximums will result in higher premiums.

DECLINING CREDIBILITY

It used to be that most dentists accepted indemnity insurance plans, because, since most people couldn't afford to pay the full cost of treatment, this was the only other option available. Recently, however, we have seen more and more dentists phasing out insurance in favor of dental plans, because dental plans do not require the paperwork, pre-authorizations for treatment and delays involved receiving payment from insurance companies.

IN SUMMARY...

PLEASE UNDERSTAND THIS: Insurance companies are in the business of collecting premiums, NOT paying claims. Insurance companies MUST make a profit, or they go bankrupt. They will always collect more money in premiums then they will pay in claims. If too many claims are submitted, their profits will decrease, to offset the decreases in profits, premiums are increased and/or benefits reduced.