This won’t be complicated, we promise! We know how frustrating it is to be in the dark when it comes to the costs of healthcare. At Austin Dental, our dentists and team strive to be transparent about pricing and the cost of treatment.

Believe it or not, having dental insurance tends to make things more confusing. Let’s take a closer look at the downsides of dental insurance.

Before we get started, here’s how things work at Austin Dental

Our office is “non-contracted” with all insurance companies. As long as your dental insurance allows you the freedom to pick the provider you want to see, we can help!

Our expert front office team will work with you to file your claim and make sure you get the most out of your dental insurance. However, if you don’t have dental insurance, we also accept a variety of payment methods.

We even offer pre-payment discounts and financing through CareCredit and LendingClub. Call 512-835-1924 to learn more.

Dental insurance is not the same as your auto insurance, homeowners insurance, or even your medical insurance.

Here’s what our Financial Coordinator Sam Watson has to say about dental insurance,

“I’ve been in dentistry for 23 years, and let me tell you, dental insurance is not the end all be all that people expect it to be. Individual insurance plans often times have high premiums and long waiting periods. I find with self-insured plans, you get more value for your dollar putting it directly toward your dental treatment. Now, if your employer provides you with a dental insurance plan, it’s going to help you to a certain extent, more so on routine care than major treatment. Dental insurance companies have not raised their maximums since the 1960s, that should tell you a lot about how willing they are to help with the cost of your dental health.”

Even the very “best” dental insurance plans are little more than discount cards that allow you to save some money on the dental care you want and need. Yes, some dental insurances allow you to pay $0 out of pocket for preventive care like exams and cleanings. But for fillings, implants, and other restorative procedures, you’ll likely find that most insurances aren’t offering what you might expect.

Here’s how most dental insurance plans work:

  • You or your employer pays a monthly premium for your insurance
  • You start each year with a set “cap” — the maximum amount your insurer will contribute toward the cost of your care. Usually, this amount is shockingly low, often as little as $1,000 or $1,500.
  • When you need treatment, the amount your insurance will pay is covered in your plan’s benefits. You’ll pay a percentage of the cost yourself. Your insurance plan will pay the rest — until you hit your yearly limit. Then you pay the rest.

Let’s say you need a crown and you’ve already hit your yearly maximum. You’ll be responsible for paying the full cost of the crown and either you or your employer will keep paying your monthly premiums for the rest of the year. It’s almost like you’re paying for nothing. What sense does this make?

The worst part about this is that the yearly cap hasn’t gone up much over the past 40 or so years since dental insurance became commonplace. The price of everything has gone up over the past 40 years. Why hasn’t dental insurance kept up?

The drawbacks of dental insurance

Insurance is frustrating and hard to understand. That’s by design. Insurance companies don’t always play fair and honestly, their policies and regulations don’t make much sense to us either.

“At least I get to see whatever dentist I want, right?”

Wrong. Many policies force you to choose from a pre-selected list of providers to get the most out of your benefits. You may be able to see an “out-of-network” provider, but you’ll pay more or your visit won’t be covered at all.

“If I need a procedure, it’ll be covered right?”

Not always. Most dental insurance provides the greatest benefits for preventive care, including exams, cleanings, and x-rays. You may even pay $0 out of pocket for those kinds of visits. Restorative care like implants, root canals, and fillings are often covered at a much lower rate. Some high-tech procedures or procedures that are considered “cosmetic” might not be covered at all.

Plus, remember: even if a treatment is “covered” by dental insurance, you’ll still have to pay for some (or even all of it) out of your own pocket. 

“Can I put off my visit to the dentist because I know I’ve already hit my yearly max?”

Unfortunately, many people allow their insurance benefits to dictate their care. They skip visits to the dentist or put them off to “get the most out of their insurance.” In the long run, this is a dangerous game that can result in small problems getting bigger. It can often be cheaper to just get treated now instead of trying to save money by putting off your appointments.

“Do I need dental insurance?”

Many people do find dental insurance to be beneficial. However, you don’t need it. Think of dental insurance as something that can sometimes reduce the cost of your dental care.

If you don’t have dental insurance (or even if you do) there are options for making your dental care more affordable.

“Should I shop around for the least expensive dentist?”

No! You should find a dentist you trust and who has your health and wellness in mind. Lower expense dentistry can come at a cost to both your experience at the dentist and your lifelong health and wellness.

“Will dental insurance always save me money?”

No! There are so many limits and exclusions in most insurance policies. You’ll usually save money, particularly on preventive care, but you won’t always save money.

Come see us at Austin Dental

Our process is simple:

  1. Schedule your appointment
  2. Relax in your chair
  3. Love your smile!

Read more about what to expect at your first visit to our office, including more about how we can help you make sense of your insurance (or what to do if you don’t have insurance). We can’t wait to see you!