Can’t afford dental care, even with insurance?

Oral health is a vital aspect of overall well-being, but the cost of dental treatment can sometimes be a barrier to accessing the care we need. Sadly, even with dental insurance coverage, out-of-pocket expenses can still be daunting – especially if you have exceeded your insurance’s annual coverage limit.

In this article, we’ll explore practical strategies for individuals who find themselves unable to afford dental treatment despite having dental insurance. Know that you still have affordable dental care options, and you can take proactive steps towards improving your oral health without compromising your financial stability.

Understand your dental insurance

First, review the details of your plan, including annual coverage limits, copayments, deductibles, and what services are covered. A typical dental insurance plan typically offers what is known as”100-80-50″ coverage. This means the plan will pay 100% of the cost of routine preventive and diagnostic care – typically two checkups with cleanings annually. It will also pay 80% of the cost of basic services such as fillings or root canals, and 50% of the cost of major procedures such as crowns and bridges.

Your deductible is the amount you must pay out of pocket for dental services before your insurance starts to cover its portion of the costs. Deductibles are typically $50 for an individual, and $150 for a family.

Many insurance plans have an annual coverage limit (also called a “yearly spending cap” or “yearly maximum”) too, usually $1,000 to $1,500 per year. After your insurer has paid that amount, you pay out-of-pocket for any additional care and procedures that you may need, until your plan resets at the beginning of the plan year (the month and day when you initially purchased your plan).

Some insurance plans may have waiting periods for specific procedures or exclude certain treatments. Being well-informed about your coverage will help you make better decisions about your dental care.

Discuss payment options with your dentist

If you’re low on funds, don’t hesitate to speak with your dentist. You are far from the only one who struggles to pay for dental care. Your dentist may be able to space out your care so that you have time to save money between treatments. If you require multiple dental treatments but cannot afford them all at once, work with your dentist to prioritize the most critical procedures. Addressing urgent issues first can prevent further complications, which could reduce the overall cost of treatment in the long run.

Your dentist may also be able to plan your treatment around your insurance’s waiting periods, annual limits or other restrictions. Your dentist may also be able to offer a payment plan that accommodates your budget. Negotiating a reasonable payment schedule can help you manage the costs of treatment while still receiving the necessary care. But remember, your dentist has their own bills to pay – rent, utilities, staff salaries and benefits, etc. So don’t feel bad if they can’t offer a payment plan.

Explore dental savings plans

Dental savings plans (also known as discount dental plans) are a trusted alternative to dental insurance that reduce the cost of dental care at more than 140,000 dentists and specialists nationwide – about 70% of dental practices in the U.S. Dental savings plan members report an average savings of 50%* on their dental care and can use their plan as often as needed.

You can save on preventive care such as checkups and cleanings, as well as restorative care – crowns, root canals, braces, dental bridges, dentures, dental implants – and even some cosmetic procedures that are not typically covered by dental insurance. And while dental insurance typically has annual maximums, deductibles and waiting periods, dental savings plans do not. Plans activate within 72 hours, and some can be used even sooner, so you can save on the care need, right away. Ask your dentist how you can coordinate the use of your insurance with a dental savings plan.

Investigate low-cost or sliding scale clinics

Community health clinics and dental schools often offer low-cost or sliding scale dental services. Dental schools provide treatments at reduced rates, overseen by experienced dental professionals. While the procedures may take longer due to the learning aspect, they can be a cost-effective option for necessary treatments.

Look into government assistance programs

Depending on your location and income level, there might be government assistance programs available to help cover dental expenses. Medicaid and the Children’s Health Insurance Program (CHIP) in the United States, for example, may provide dental benefits for eligible individuals and families. Research available programs in your area to determine if you qualify for financial assistance.

Emergency Dental Care

If you are experiencing a dental emergency, with symptoms including but not limited to severe oral pain, uncontrolled bleeding, swelling in your mouth, around the eye or your neck that is making it difficult for you to breathe, swallow or speak and/or disorientation, call your dentist, or go immediately to the nearest walk-in clinic or emergency room. You can sort out the financial issues later.

Overall, our best advice for accessing dental care even when you have insurance is to get a dental savings plan. Talk to your dentist and get their insight on how a dental savings plan can help you complete your specific treatment plan.

Curious about how much you can save with a dental savings plan? Use the calculator below to find out.

*Discount Health Program consumer and provider surveys indicate average savings of 50%. Savings may vary by provider, location, and plan.