Dental insurance is not the same as medical insurance

Dental insurance is very different from conventional medical insurance, and sometimes we aren’t able to distinguish between them. We’re going to break it down for you –

There is a tremendous difference between the way medical insurance and dental insurance cover costs, charge for procedures, and provide leads. Most dental insurance plans cover up to $3,000 a year, which is equivalent to the cost of a single dental implant; while on the other hand, most medical insurance plans do not have a cap on the maximum amount they cover, rather a maximum cap on the amount one has to spend out of pocket.

This model works in a way to prevent one from going bankrupt for when they are in need of a procedure that can cost thousands. And due to its high unpredictability, medical insurance is not as profitable as dental. Effectively, dental insurances are able to take advantage of the predictability of costs and (typically) charge beyond of the $3000 cap for unnecessary procedures. Medical insurance companies can face hefty claims, and so they make sure to scrutinize each claim and ensure the procedure is necessary and not overcharged, while dental insurance companies don’t.

Additionally, for certain dental insurance companies, dentists agree to become in-network providers to guarantee their patient flow by paying the insurance company per person – usually $8. For instance, if an insurance company sends over 1,000 patients in month to a dentist, the dentist would pay $8,000 a month to the insurance company for the leads. This puts the insurance companies at the top of the ladder with dentists and patients at the bottom; insurance companies charge for leads, dentists barely profit, and patients are overcharged.

Next time you google ‘dental care near me’, try choosing a dentist that’s not in-network and not using your dental insurance to partially cover your cost. You’ll notice how much more you can save than you would expect, while also receiving quality dental care from a dentist who isn’t part of a dental insurance mill and genuinely cares about you.

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