The True Cost of Dental Insurance

“Do you take my insurance,” is, for many people, the first question asked of their dental provider. This is asked prior to services provided, location, and even the doctor’s education and experience. With that, you may be shocked to find that dental insurance isn’t always the best financial option for your care.

Doesn’t dental insurance cover all my dental care?

In reality, dental insurance is not insurance, but a dental plan and differs in many ways from traditional health insurance; Health insurance sets limits as to how much the policyholder must pay out of pocket, whereas dental insurance is designed to limit what the insurance company pays. As noted by Guardian Direct, “typically defined as a type of health insurance and may on occasion be referred to as a dental plan. This coverage is designed to help pay a percentage of associated dental care costs…”.

Should I have dental insurance?

In many cases, individuals pay more for their dental plan than for dental care. If your plan allowed maximum is $1000 and your treatment is more, they don’t cover the remainder and will also have a say in how your treatment is planned. For patients who need a dental implant, for example, the plan allowed maximum will be less than the cost of the implant and the monies paid to the company.

You might be wondering then, what is the point of dental insurance, and is it worth the cost? In some cases, it is when:

  • your employer is paying the full plan fee
  • you have a large family
  • your children are covered for orthodontics.

However, if that doesn’t apply to you, you may be paying more for your plan than your dental care. Over the last few years, dental plans began covering fewer services and reimbursement rates have decreased. In addition, dental plans have created roadblocks to covering your services. For example, when a procedure can be completed in one visit, they stipulate that it should be completed in two appointments.

When that is unnecessary and both the patient and the doctor agree that one visit is applicable, the plan will not cover the procedure. In addition, as plans only cover a specific dollar amount each year, many individuals choose to wait until the following year when plans renew. The true cost here is, in many cases, your dental health when care is delayed.

With that, many dentists have become out-of-network providers.

What are the benefits of using a non-insurance-based dentist?

There are many benefits to working with a dentist who is considered out-of-network or non-insurance-based. This means that they are not bound to the stipulations of the companies’ dental plans that have requirements to approve treatment such as:

  • Additional and unnecessary x-rays
  • Additional and unnecessary appointments
  • Additional and unnecessary procedures

This becomes a benefit to the patient in both time and money.

In addition, your treatment is being developed between you and your trained dentist, who assesses your dental records, such as x-rays, photos, and health history as well as who listens to your personal issues. You may be surprised how often treatment is denied by a dental plan individual, who in most cases, does not have any dental training and does not know your specific clinical needs.

Note that most out-of-network dentists exceed expectations in order to give you a phenomenal experience. They may:

  • offer a variety of in-office payment options, many without interest.
  • help find alternative dental financing solutions.
  • submit insurance information to your plan provider for your maximum reimbursement.

For more details, call Smileboston Cosmetic & Implant Dentistry at Smileboston Cosmetic and Implant Dentistry office Phone Number 617-277-4100 or visit our website at

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Call us: 617-277-4100