Your dentist may allow you to use your discount dental plan to reduce the cost of your dental visit once you have reached your annual maximum for your dental insurance plan, or before your benefits kick in. This means that they can’t be used on the same dental visit; however, owning both plans could benefit you in a number of ways.
Reasons I Might Need a Dental Insurance Plan and a Discount Dental Plan
If you have a dental insurance plan already, you might think it’s pointless to have a discount plan, too. There are some instances in which a discount dental plan is a good supplement to your current dental insurance plan, or a good alternative.
Below is a list of possible scenarios in which having a discount dental plan along with your dental insurance plan could be helpful:
1. Waiting Periods
Many dental insurance plans have waiting periods of some kind.
What is a waiting period?
A waiting period is the time that must pass after you’ve purchased a plan before you can receive the full benefits of that plan.
These waiting periods vary. They can be anywhere from a few months to as long as a whole year (but that’s getting a little crazy).
They might also vary by procedure. Some procedures may have a waiting period while others don’t. Talk to your plan provider or examine your benefits’ package to find out more.
Why do dental insurance plans have waiting periods?
Most dental insurance plans have waiting periods to protect themselves from individuals signing up for their plan just for a costly dental procedure and promote long-term use of the plan.
While this makes some sense, there are a few caveats to waiting periods if you’re a member. Not only are you not able to receive the full benefits of your plan right away, but you end up spending many months paying high premiums for your plan without getting to use its full benefits until much later.
How can a discount plan help during dental insurance waiting periods?
Discount dental plans can be used immediately. While you wait for your dental insurance to activate, or for certain benefits to apply, you can use a discount dental plan for work you need now. Or, if the waiting period seems too long, you could purchase a discount plan instead.
2. Annual Maximums
When you reach your annual maximum, you pay the full price of your dental work for the rest of that plan year. A discount dental plan can offer you discounts off those out-of-pocket costs.
What is an annual maximum?
This is the maximum dollar amount a dental insurance plan will pay toward the cost of dental care within a specific timeframe (usually a year). Once this amount is reached, the insured member is responsible for paying the full price on any additional dental work.
How can a discount plan help when you reach your annual maximum?
Start using your discount dental plan once you’ve reached your annual maximum with your dental insurance. It will give you significant discounts off the full cost of those dental treatments and procedures so you don’t have to pay full price.
3. Cosmetic Work
Dental insurance doesn’t usually cover cosmetic work, but many discount dental plans offer a discount of 15-20%!
What is considered cosmetic dental work?
Cosmetic dental work generally refers to work that improves the appearance of teeth, gums or a person’s bite but is not medically necessary. This often includes:
- Teeth Whitening
- Cosmetic Bonding
- Tooth Implants
- Tooth Contouring/Reshaping
There are services that can improve the appearance of your smile and are medically necessary. These include:
- Defective fillings that need to be replaced
- Crooked teeth that affect your ability to bite and chew
- Discolored teeth that have been weakened due to large restorations and need a couple of crowns to restore and strengthen the teeth
Call your dental plan provider and see what procedures and treatments are covered under your specific plan.
How can a discount dental plan help with cosmetic dental work?
If there is a cosmetic procedure you need that is not covered by your dental insurance policy, use a discount dental plan to get 15-20% off, or more. It might not seem like a lot, but if you have a procedure that would cost $2,000, a 20% discount would save you $400 immediately. Imagine what you could do with that money!
4. Price Comparison
Check with your dentist at the start of your visit to find out which plan can save you the most money. Many dentists are willing to do this for you. There may be certain procedures or treatments that your dental insurance plan may not cover, or only covers a fraction of the cost (say 20%), whereas, your dental plan may offer you 15-60% off the treatment cost.
How can a discount plan offer greater savings at your dental visit?
Use your discount dental plan instead of your insurance plan when it offers greater savings at your dental visit! Your dentist can check to see which plan saves you the most.
Here’s How You Can Use Your Dental Insurance and Discount Plan at the Same Visit
There is one rare instance in which you can use your discount dental plan and dental insurance at the same dental visit.
If your insurance company accepts reimbursement claim forms, you can…
- show your membership card to an in-network provider/dentist (use our mobile app!)
- pay the discounted fees for your dental work at the time of your visit
- ask your dentist for a copy of your bill
- file the claim with your insurance company to reimburse you for what you spent
This will reduce your out-of-pocket costs and stretch your dollar a bit further so you can reach your insurance plan’s maximums more slowly.
Word of Caution: Keep in mind that submitting reimbursement claim forms to dental insurance companies isn’t always easy and, in this case, there is a chance it might not work. It may not be worth the risk.
This article is very helpful for me and very informative. This definitely gives me more information about Dental Insurance and a Discount Dental Plan. I think that I will be able to avoid problems regarding it with the help of this article.
Okay,so I went to see an endodontist,and they said that I can’t use my dental plan, since I have a dental insurance. I told them, that I don’t want to use my dental insurance, cuz I still have a bridge prosedure and it cost more than the root canal. So,instead of my insurance, I want to use, the dental plan discount, for my root canal, but then the dentist told me, that I cant use my dental discount, cuz then it’s considered an insurance fraud….. I don’t get and don’t understand, why this is an insurance fraud？？？？
Hi Lynn. Thank you for reaching out to us. Using one plan or the other is not insurance fraud – as long as you aren’t trying to get the discount AND then use insurance on the same procedure. Choosing one of the plans to use by procedure is fine, as long as it’s not on the same procedure.
You may want to ask for clarification as to why they think switching from insurance to a discount dental plan is fraud. They can call our Provider Relations line at (800-441-0382 xt 8) to clarify what they should and should not do if they have questions.
If you need help finding a different specialist in your area, please reach out to us at 800-372-7615 so we can help!
Great & useful information to share. Thanks!
Do you accept Care Credit?
That will depend on the dentist you visit. If you find a dentist nearby who accepts our dental savings plan, you can ask them if they also accept Care Credit. Some dental offices do.
Could more clarity be provided to the “may not work.” In terms of using your discount card and then self-claiming for reimbursement? Is it based on the procedure? I plan to go over my max out of coverage this year and would really like to get as much taken care of as possible.
You should be able to use your discount plan and dental insurance on different dental visits (you’ll just need to check with your dentist); you just won’t be able to use it on the same dental visit.
So which dental insurance company offer the best deals on say bonding and other mAjor works?
Do I still have insurance?
Hi Patricia. Wanting to clarify your question: Do you still have dental insurance through another provider when you purchase a discount dental plan or are you asking if you still have a discount dental plan with us?
Great article explaining the difference between dental insurance and dental discount plans (also referred to as In-House Dental Insurance). It’s important to understand the qualifying parts to both options. Thanks so much!!!
Yes, it is possible but it depends on the terms and conditions of the insurance company. So while applying for dental insurance and discount dental plan you should be aware on that.