Dental insurance vs. discount plans | Business

When I left my full-time reporting job on Sept. 15, I lost my dental insurance plan, which covered me and my wife for $20.82 per week. Here’s what I’ve learned about getting dental coverage:

The first thing I did was to contact United Healthcare, my medical insurer through Medicare, and add the dental plan at $36 per month for me so I would be covered at least for my scheduled cleaning last week with my current dentist in Glastonbury. (It doesn’t cover my wife, who’s not old enough for Medicare.)

I learned at the office that my dentist had retired the week before. As I paid my $113 bill, I mentioned that I may not stay with the new dentist and may find one closer to home who’s less expensive. She gave me a brochure for the Vantage One dental discount plan, costing $48 per year for one and $72 for two, an alternative to my UnitedHealthcare insurance. My insurance offers good discounts and free oral exams, X-rays, and cleanings but has a $100 deductible for restorative work and $1,000 maximum payout per calendar year.  

I did not know about dental discount plans, which can be much cheaper than insurance. So I did some research and found dozens. These discount plans are not insurance, with almost all providing no annual payout limit and no pre-condition exclusion.

Here are a few plans with typical annual fees for one person and for a family, in contrast to my insurance for one at $432 per year:

Aetna (which has several plans): $112, $144; Cigna (also several plans): $96, $136; Alliance: $120, $160; United Concordia: $96, $136; Uni-Care: $108, $144; Aon: $84, $128. All have discounts ranging from 20 percent to 60 percent and more, with most at 50 percent.

Here are, in order, are the average amounts a customer would pay for eight common procedures based on the 80th percentile of the 2016 National Dental Advisory Service Comprehensive Fee Report; average discount dental plan fees from my research of about a dozen representative plans, many of which have differing fees; the fees under my dentist’s Vantage One plan; then fees under my UnitedHealthcare dental plan:

Oral exam: $75, $27, $30, 0.

Cleaning: $110, $49, $57, 0.

Fillings: $198-$214, $55-$69, $93-$172, $41-$80 (20 percent).

Crowns: $1,452, $700, $1,161, $725 (50 percent).

Root canal: $1,045-$1,478, $443-$637, $836-$1,182, $500-$700 (50 percent).

Extractions for impacted wisdom teeth: $360, $191, $288, $180 (50 percent.)

Now I have to decide whether to keep my insurance or drop it and go with one of the dental discount plans.

According to an article on Policy Genius Inc.’s website, “If you have healthy teeth and don’t expect any serious trouble, a basic dental insurance policy will likely suffice, because (of) the small savings you might see from a good discount plan. … If you require an expensive dental procedure immediately the right discount plan could save you hundreds of dollars.”

I called my dentist’s office, and Jessica reviewed my record. I am in good shape and don’t need any restorative work, just preventive (three cleanings and related items), so Vantage One at $48 per year is better than my insurance at $432 per year. However, if I need major restorative work, my insurance is cheaper — but after $1,000 it’s out of pocket.

Balancing the risks I think I’ll stick with insurance to cover my next cleaning in January and see if any work is needed after that. If not, then I’ll drop it for the Vantage One plan.

Note: Don’t pick a plan that’s not licensed by the state Insurance Department.

Here’s the best advice: Take care of your teeth every day.

Leave a Reply