You have a dental problem that needs attention, but you’re not sure how to pay for your trip to the dentist. Take a deep breath – it’s okay. There are several ways you can afford quality dental care without putting yourself in a financial tailspin.
This guide will help you understand the options you’ll have when budgeting for a dental procedure. We’ll cover expected costs for common procedures. We’ll look at what to do if you don’t have insurance. And we’ll go over the basics of dental financing, dental credit cards, HSAs/FSAs, dental savings plans and dental insurance.
Because every situation is different, we recommend working closely with your dentist and insurance provider (if applicable) to make a plan that fits your needs and budget. But a general understanding of what’s out there will help you ask the right questions.
Let’s get started.
The cost of common dental procedures
To start, here’s a look at the typical costs you can expect for common types of dental work.
If you need a dental procedure but you’re not sure how you can afford it, start by talking to someone at your dental clinic. (Do you still need to choose a dental clinic? You can find one through your dental insurer’s website or your state’s dental society.) Dental clinics have experience making treatment practical for patients on a limited budget. If you do have insurance, your dentist’s front-desk staff can give you an idea of what you’ll be responsible for paying out-of-pocket.
How do I pay for a dental procedure without insurance?
If you don’t have insurance, someone at your dental clinic can help you estimate costs of treatment and describe financing options. Consider dental financing or a dental savings plan to help pay for a major procedure.
Dental credit cards vs. dental financing
Dentists know that patients are more likely to get the treatment they need if they can spread out payment over months or even years. Most dental clinics partner with third-party creditors who simplify the process for the clinic; some clinics even offer in-house financing. Most payment plans, however, go through a third party and have some kind of interest baked into their contracts.
Most of these arrangements are unsecured loans, although there are dental credit cards that serve a similar purpose. Your clinic may work with more than one financing partner – and they may agree to work with another financing company of your choosing. Don’t be afraid to do a little shopping to find a payment plan that works for you.
Pitfalls of dental credit cards and dental financing
There are a couple of common characteristics between dental credit cards and dental payment plans. The first common feature is an interest-free period, which may be 6, 12 or 24 months. The other similarity is a high interest rate that kicks in if you don’t pay off your entire balance by the end of the intro period. Once the introductory period has passed, what once was an interest-free loan can be subject to back-interest at rates as high as 27%, as was the case with CareCredit.
Before you lock into a payment plan, be sure you can make your payments every month without depleting your emergency savings. It’s also important to fully understand the terms of your financing before you sign. Clinic staff shouldn’t make you feel rushed. Ask questions and take your time to research your options before committing.
FSAs and HSAs
If you don’t have dental insurance but you do have health insurance through your work, an FSA (flexible spending account) might be an option. You can use your FSA contributions to pay for eligible treatments with a tax advantage. (FSA contributions are pre-tax, meaning they reduce your taxable income.) The max you can contribute to an FSA in 2017 is $2,600. The caveats are: unused FSA contributions don’t roll over to the next calendar year, and you can only adjust your contribution amount during special open enrollment periods.
If you have an HSA (health savings account) or if your employer’s health coverage offers an HSA option, you could also pay for your dental work with tax-advantaged income. (HSA contributions are also pre-tax.) HSA contributions do roll over to the next year – though they’re only available to people who have a qualifying high-deductible health plan (HDHP). Max HSA contributions for 2017 are $3,400 for an individual and $6,750 for a family.
For more on HSAs and FSAs, read up on Health Savings Accounts vs Flexible Savings Accounts.
Dental savings plans
The term “dental savings plan” may be misleading. Sometimes called “reduced-fee dental plans” or “discount dental plans,” these programs are really loyalty networks. Patients with dental savings plans pay for care out-of-pocket but at a discounted rate. Dental care providers lose some of their profit margin in exchange for securing more patients. Dental savings plans are not insurance, nor are they savings accounts; they are paid memberships to networks of dentists who’ve agreed to discount their fees for members.
Benefits of dental savings plans
Dental savings plans, unlike individual insurance, allow you to take advantage of their discounts immediately. Some plans may also cover cosmetic procedures not deemed medically necessary by insurance, such as braces or veneers.
Risks of dental savings plans
Dental savings plans have fee schedules with specific costs for each procedure. Your treatment must be on the schedule, or you’ll be responsible for your clinic’s normal rate. Be sure that you understand if you’re agreeing to any treatment options or upgrades beyond those listed in your plan’s fee schedule.
Not all dental clinics participate in dental savings programs. You’ll want to make sure the plan you’re shopping for includes your home dentist (if you have one) or a dentist that you feel comfortable with.
Dental insurance overview
Dental insurance is different than other types of insurance. It rarely covers 100% of major dental procedures. In addition, most dental plans have a relatively low maximum yearly benefit. Depending on your plan, your coverage may max out after your insurer pays for $1000 or $1500 of your dental care in a year. Dental insurance is similar to other insurance in that you will likely have to meet an out-of-pocket deductible before your coverage kicks in. That could be something like $50 or as much as hundreds of dollars depending on your plan’s coverage.
Drawbacks aside, dental insurance doesn’t have to be expensive. Many decent plans cost less than $20 a month. Those with dental insurance can find further help in paying for the remaining cost of treatment by using some of the other means covered in this article.
Types of dental insurance
The first and most basic classification for dental insurance is whether it’s through an employer or is an individual policy. Most people with dental insurance are covered through their employer (also called a group policy), either as a default condition of their job or by opting into the plan.
Individual coverage vs. employer-provided coverage
If you have an immediate need for a procedure but don’t already have dental insurance, then an individual policy might not be the best option. Most individual dental insurance policies have waiting periods for different procedures. For example, you may have to wait 6 months from sign-up to be covered for a routine cleaning. Major procedures like root canals or crowns could have waiting periods of a year and a half or more.
If you enroll during open enrollment, individual dental insurance is available as part of some health insurance plans or as stand-alone insurance through the Health Insurance Marketplace. Marketplace open enrollment for 2018 runs from November 1, 2017 to December 15, 2017.
On the other hand, employer-provided coverage is available for dental work, often without the same waiting periods. You may, however, have to wait the length of your employer’s probationary period before you can use dental coverage if you just started your job. If you don’t have dental coverage, but it is available through your employer, check with your human resources manager about signing up.
Closed vs. open network
The second classification for dental insurance has to do with the way the plan pays benefits to your dental clinic. Most plans use the PPO (Preferred Provider Organization) model, though some plans use the indemnity model. We’ll touch on some of the other models as well, but the most important thing to know is whether a plan uses a closed network or an open network.
PPO plans use a closed network of dental care providers. (Plans that use a closed network are also called “managed care” insurance). This model offers better rates for preferred providers – that means lower out-of-pocket costs when you stay within the network. PPOs also cover out-of-network providers (just at less favorable rates for the patient).
PPO plans typically have three tiers of coverage rates, and many use a 100-80-50 structure. Preventive maintenance procedures make up the top tier and are covered at 100% of the cost. Basic restorative procedures, like fillings, are the next tier. They’re typically covered at 80%. The bottom tier includes major restorative procedures like crowns, root canals, dental implants and other surgeries. Even though these are the most expensive procedures, they’ll often qualify for the lowest rates of coverage—around 50% of the total cost. Check your plan’s schedule of benefits to find specific percentages for each tier and the procedures covered under them.
Other, less-common plan types that use closed networks are HMOs and EPOs. Neither HMOs nor EPOs cover treatment by out-of-network providers.
Indemnity plans use open networks. They are the oldest style of insurance. With indemnity coverage, you can go to any dental care provider, and the plan will pay for a percentage of the total cost.
Indemnity plans, like PPOs, usually have a tiered schedule of benefits that covers minor treatments at more favorable rates than major ones. Check the schedule of benefits for your particular plan to know what’s covered at which rates.
You should talk with your dental clinic and insurance company to get pre-authorization before scheduling a dental procedure. This process can take a few weeks, but it can be helpful to have an idea of what your financial responsibility will be beforehand. Pre-authorization is routine for dental clinics and a required service for insurance companies.
What about cosmetic dentistry?
A nice smile goes a long way. If you want to make yours look a little nicer, there are a few ways you can make your cosmetic dentistry more affordable.
What is cosmetic dentistry?
Cosmetic dentistry is dental work done solely to improve appearance. Examples of cosmetic dentistry include veneers, dental contouring and reshaping, whitening, some types of braces, all-porcelain crowns, bonding (filling or attaching artificial material to the surface of teeth) and extruding (lengthening) of teeth. Cosmetic procedures are those not considered medically necessary and are usually not covered by insurance.
Note: some types of dental work improve both the health and appearance of your teeth. Such treatments are usually at least partially covered by dental insurance.
How can I afford cosmetic dentistry?
Although dental insurance usually won’t cover cosmetic procedures, you may be able to find discounts through a dental savings plan. You can also ease the cost burden by spacing out procedures or by distributing your payments with dental financing. Better yet, consider starting a personal savings plan to save up the money needed for a cosmetic procedure.
Other budgeting tips
If you have the cash on hand, consider paying for your procedure in one lump sum to avoid the extra cost of interest from a loan or credit card.
Save up for emergencies
It’s not a bad idea to have a savings account just for dental, medical and car emergencies. A good way to start saving is to set up an automatic transfer to move money from your checking account to savings account each month. Building up an emergency fund before you need it can take some of the stress out of surprise dental issues in the future.
Prioritize your treatments
Take care of the most pressing problems immediately to prevent future expense. Then you can space out less time-sensitive procedures to ease the impact on your finances. Ask your dentist for help developing a long-term, prioritized treatment plan.
Don’t wait to take care of your teeth
As the saying goes, “an ounce of prevention is worth a pound of cure.” Preventive maintenance is cheaper, better-covered and less painful than a major restorative procedure. Consider the following strategies to keep your teeth healthy – and avoid costly procedures in the future:
- Visit your dentist twice a year for exams and cleanings, and be sure to take care of cavities quickly.
- Seek treatment for missing teeth to avoid jawbone loss.
- Ask your dentist about a fitted mouth guard if you grind your teeth at night, as grinding can cause cracked molars that will later require crowns or implants.
- Avoid chewing ice.
- Brush your twice daily and floss once daily.
Good daily habits go a long way toward reducing costly dental issues in the future. By prioritizing dental health and knowing your options for financing issues that do arise, you can keep your teeth and your budget in good condition. Now that’s something to smile about!