How Does the Dentist I Choose Affect How Much I Pay?

a woman shaking hands with her new dentist

When choosing your dentist, it is important to be well informed so you can make the best choice for you and your family. Many patients start their search with recommendations from family members, friends, co-workers or trusted acquaintances. If you still need help, start your search with our ADA Find-a-Dentist tool. You’ll be able to compare dentists who practice near you, learn about their specialties and find out which types of benefit plans they accept. 

Many dentists accept dental benefit plans. They will file a claim with your plan on your behalf so you can receive your benefit dollars. Here are a few other things to consider when choosing your dentist: 

What Does It Mean If a Dentist Is “In Network”?

Many dentists are “in network” with certain dental benefit plans. This means these dentists (also known as participating dentists) have signed a contract with the dental plan carrier agreeing to accept that plan’s set fees as payment for services. A part of the agreed-upon fee is paid by the carrier, and you often pay a portion of it with your deductible and co-insurance for the plan. 

What Does It Mean If a Dentist Is Not “In Network”?

While dental plan carriers may encourage you to see a network dentist, your choice of dentist should depend more on how well the dentist fits your dental care needs than how it fits your dental plan. You may prefer a dentist that is not in your plan’s network.

Read your plan carefully to see if it restricts you to seeing a network dentist, and check with your preferred dentist’s office about how your plan would work with his or her office. Capitation programs (which include dental health maintenance organization (DHMO) plans) and some highly restrictive PPO plans (known as exclusive provider organization [EPO] plans) do not provide any benefit coverage for treatment by "non-participating" dentists.  There are, however, plans that allow you the right and freedom to choose your own preferred dentist.  

What Are Your Dental Care Needs?

If you have simple dental care needs, think about if you need to purchase a dental benefit plan at all. You might be surprised to find out your total costs, including the premiums you pay, may end up being more than the amount your plan pays in benefits. If you decide you don’t need a dental benefits plan, you can always see the dentist of your choice.

More Dental Benefits FAQ >>