Paying for Dental Care
Paying for dental care is a concern of many. Not everyone can afford dental insurance and not all businesses offer dental benefits. Assistance programs vary from state to state. Locate your state on this list and contact your state dental society to find out about care in your area. Another possible source of lower-cost dental care is a dental school clinic. Generally, dental costs in school clinics are reduced and may include only partial payment for professional services covering the cost of materials and equipment. Your state society should be able to tell you if there is a clinic in your area.
For more resources, please visit the National Institute of Dental and Craniofacial Research, U.S. Department of Health and Human Services or the Association of State and Territorial Dental Directors.
Are you over 60 or the caregiver of an older adult in need of dental care? Visit Oral Health America's Tooth Wisdom for a list of the resources available in your state.
Additionally, the Children's Health Insurance Program (CHIP) provides free or low-cost health coverage for more than 7 million children up to age 19. CHIP covers U.S. citizens and eligible immigrants.
Below is a list of common questions about dental insurance:
Question: How does a dental plan work?
Answer: Almost all dental plans involve a contract between your employer and an insurance company. The amount your plan pays is agreed upon by your employer with the insurer.
Q: What does my insurance pay for?
A: What's covered by your dental plan is based on how much your employer pays into the plan. Usual, customary and reasonable charges (UCR) are the maximum amounts that your plan covers. These standards are set by your insurance company. Any portion of a dental bill not covered by your plan is your responsibility.
Q: What do I have to pay for?
A: Your dental plan may not cover conditions that existed before you enrolled in their plan, often called pre-existing conditions. Treatment may still be necessary for some conditions. Each dental benefit plan also has its own guidelines for which treatment is “dentally necessary.” If a procedure falls into this category, you may have to pay out-of-pocket. This does not mean the treatment is not necessary. It simply means your insurance provider defines it that way. There is an appeals process available should your dentist consider a procedure necessary that is not covered by your benefit plan. Although you may be tempted to decide on your dental care based on what insurance will pay, always remember that your health is more important than the price tag. The least expensive option is not always the best.
Q: How do I pick my dentist?
Q: How does financing work?
A: Your plan may want you to choose dental care from a list of preferred providers (dentists who have a contract with the dental benefit plan). “Preferred” refers to the insurance companies choices. If you choose to receive dental care from outside the preferred provider group, you may have higher out-of-pocket costs.
A: Financing may involve the use of a credit card. Make sure you understand what the monthly payment requirements will be before you decide on this option. Typically there are two types of financing offers: No Interest and Low Interest. "No Interest” payment plans are more commonly offered by healthcare credit cards. They typically give you a short time period to pay your balance (six to eighteen months). With these plans you must pay at least the monthly minimum and pay off the balance in the time offered. If you don't interest charges will be added. “Low Interest” payment plans are typically longer term, sometimes up to five years. Payments are divided into equal monthly payments and should be paid off every month. Interest charges will be placed on your account beginning on the original purchase date.
Make sure you understand how credit finance plans work before you decide on a specific plan. Only finance what you can afford, pay on time and make sure you read, fully understand and keep copies of anything you are asked to sign. Take the time to understand your options and obligations and you can improve your financial and oral health.