Truth About Dental Insurance

What Makes Discount Dental Plans Any Different?

Dental insurance plays a role in helping people obtain dental treatment. Here are some myths and facts about dental insurance:

Myth #1
Dental insurance is meant to be a PAY-ALL.
Dental insurance is meant to be an aid.
Myth #2  
Plans pay up to 80% or 100%.
In spite of what you're told, most plans cover about 40% to 50% of an average fee. Some plans pay more, some pay less. The amount your plan pays is determined by how much your employer paid for the plan. The less they paid for insurance, the less insurance you'll receive.
Myth #3  
The insurance company will pay the fees that the dentist charges.
It has been the experience of many dentists that some insurance companies tell their customers that "fees are above the usual and customary fees" rather than saying to them that "our benefits are low". Remember you get back only what your employer puts in less the profits of the insurance company.
Myth #4  
All services are covered by insurance.
Many routine dental services are NOT covered by carriers.
Myth #5  
Insurance over the years has kept up with inflation.


When dental insurance first came on the scene in the 1960's there was an average yearly maximum coverage of $1,000 per year. Now 40 years later, the average yearly maximum is still $1,000. Using the annual Consumer Price Index (CPI) for just the past 27 years – the yearly maximum should be over $5,000 now in 2006 !

What Makes Discount Dental Plans Any Different?

  1. Dental Plans are not insurance, so they don't pay claims

    This is a very important point to understand. With dental insurance---or any insurance for that matter, the goal of the insurance company is to get their money from you up front so that when you actually use the plan and they have to pay, you've already paid for it many times over. This is the basic principle on which insurance companies make their money.

    Dental Plans, on the other hand, don't have to worry about getting money up front from you because they don't pay claims, they simply give you a great discount. They are able to negotiate these discounts because they have the power of thousands (sometimes even millions) of members. That is a LOT of buying power, and doctors and retail outlets are willing to give the members of these plans a good discount in turn for being referred to other members in the local area and prefer receiving payment at the time of the service.

    Because of this, dental plans can afford to charge a small, easily affordable membership fee as opposed to an expensive insurance premium.

  2. Dental Plans offer many things that insurance does not
  3. Because they have little to no liability attached, dental plans are able to offer discounts for things like ongoing problems, cosmetic dentistry, orthodontics, and specialists, which are where most people incur the bulk of their dental expenses.

    What's the use of paying a high insurance premium if you must pay the entire bill for $2,500.00 of specialist work or $5,000.00 worth of cosmetic orthodontics?

    Remember, dental plans don't pay claims so they aren't concerned with getting as much money out of you up front as possible. Their primary concern is getting more and more members so that they can negotiate better and better discounts and keep their membership price affordable.

  4. While traditional insurance is often limited, dental plans are unlimited

    Once again, since they must get all of the money that they can get from you before having to pay a claim, traditional dental insurance generally has several limits that come with it:

    • Waiting periods
    • Annual limits
    • Number of people who can be covered on one plan

    None of the above are concerns to dental plans. They don't want your high premium payments, they just want lots of people paying their low, affordable membership fee.

    Because of this, you generally can get the care you need right away without having to deal with waiting periods. There is generally no annual limit. And finally, the best plans will allow you to have an unlimited number of people in your home included on their dental plan. It just gives you more incentive to join, AND its more people who they can say are members, which means they can continue to negotiate the best discounts for their membership.


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