2003-12-21
What is the difference between Dental Insurance and a Dental Discount Program?
Hal Cline
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| Key Differences |
Dental Insurance |
Dental Discount Programs |
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| Who pays for services |
You pay monthly premiums, deductible and co-pay/coinsurance (see below); the insurance company pays dentist directly for remainder of charges.
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You must pay the dentist directly at the time dental services are rendered. The Discount Program does not pay any money to the provider. You also pay a monthly membership fee to the discount program in exchange for discounted rates at participating dental providers.
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| Discounted Rates at Selected Providers |
PPO plans have pre-negotiated discounted rates with selected providers.
Indemnity plans allow you to see any dentist, and, as such, do not have discounted rates at selected providers.
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Dental discount programs offer discounted rates at participating dental providers.
Note: Dental discount programs can be used in conjunction with Dental Insurance Indemnity plans.
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| Deductible |
Typically has a deductible, i.e., insurance company may not start paying for services until your dental expenses reach a certain dollar amount.
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No deductible -- discounts are available at first visit to dentist.
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| Co-Pay/Coinsurance |
After deductible is met, you may need to pay a nominal amount (e.g., $10) per office visit or a percentage (e.g. 20%) of the cost of a larger procedure. Insurance company typically pays for remainder of charges.
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Not applicable to Dental Discount Programs. For a given service, participating dentists will charge you the contracted discounted rate that has been pre-negotiated with the discount program.
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| Waiting Period |
Many dental insurance plans require you to be a policyholder for 6 to 18 months before paying for major dental services.
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No waiting periods apply.
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| Annual Maximum Benefit |
Most dental insurance plans will only cover up to certain amount per member per year (e.g., $1,000). After that cap is reached, you are responsible for all dental expenses.
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Not applicable to Dental Discount Programs. You and your family members can use your discount program membership as often as you need.
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