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Financing Dental Treatment
The Problem:
"Even if I could somehow work up the courage to see a dentist, I wouldn't be able to afford dental treatment."
There is no doubt that the cost of dental treatment can be a major deterrent from seeking help. Usually, there are a variety of treatment options available to fit different budgets. Financing options vary from country to country - this page covers the U.S. and U.K. only. If anyone would like to add guides to other countries, please contact us!
Financing Dental Treatment in the UK
NHS
Well, there is the NHS. Though if you can afford it, we recommend you go private. The advantages are that more time can be spent with you to get to know you and your fears, and you can avail of better treatments and materials. The NHS dental service in England and Wales has been cut back to a very basic standard of care. As a result, few dentists who want to give their patients the care they deserve participate in it.
Find out more about free and paid NHS treatment here:
Denplan or Dental Insurance
This may be the best option. Here is some advice from someone who has researched these options extensively:
I started with Boots dental insurance as they offered a very good deal a few years ago. When they changed their terms and conditions I went with the HSA, but recently they have also changed the terms and conditions so that it wasn't such a good deal. Tesco, in my opinion, now offer the best cover, but who knows, once they have suckered the punters in, they will probably reduce the benefits too. It's hard keeping the best deal, but as with any other insurance it's worth shopping around.
The 3 policies I've had, Boots, HSA, and Tesco have not had any conditions as to prior dental health whatsoever. The Denplan type of policy which is sold by private dentists, relies on the dentist assessing the patient's dental condition, and then putting them into payment bands. I believe that is called a 'capitation' plan, and you have to have treatment with the dentist who has registered you on the plan. With the insurance I have you are free to go to any dentist of your choice.
Usually with dental insurance you have to sign up for a year. After all, they're not going to let you claim for treatment if you've only paid a few monthly premiums and then decide to cancel . Depending on the policy, after a year it's generally on a monthly basis. Also, with some policies you can't claim during the first 3 months apart from maintenance or accidents.
There's a comprehensive explanation of dental insurance on the excellent Money Saving Expert site:
Community Dental Service
If you suffer with extreme dental phobia, you may be able to avail of the Community Dental Service. Community Dental Officers cater to special needs patients and, in most areas, to dental phobic patients as well. This service is not available in all areas, and waiting times may be long. You can find out more by contacting your local PCT/NHS trust or your local Citizens Advice Bureau:
You can also try contacting your local PALS (Patient Advice Liaison Service). Feedback on PALS with regard to dental queries has been mixed, ranging from "extremely helpful" to "very unhelpful".
You can find more information on our Special Needs and Dental Care page.
Financing Dental Treatment in the US
CareCredit and Payment Plans
Care Credit specializes in loans for medical/dental care. If you can repay the entire cost of your treatment within a year, you do not have to pay *any* interest.
You still have to make a relatively small payment each month. If you do not pay the loan back in full in the 12th month, interest for the entire year is tacked on, and the interest can be very hefty! So this option will only work if you can save up enough money within the year to repay in full.
Initially you must be referred by the trreating dentist (in order to establih an account), but most dentists are glad to do that, because the company pays them immediately for the work.
The good thing about this option is that you can save money to pay for treatment over the course of a year, rather than having to pay upon completion of treatment.
If you are upfront with the dentist and tell him/her about your financial situation, you may discover that the dental office offers patients a payment plan. It is always worth asking about this!
Dental Schools
If finances are tight, you may want to look into local dental schools. You will be treated by dental students, who perform the treatment closely supervised by their instructors. Expect to pay about 20% - 60% of what you'd pay for the same treatment by a private dentist. On average, it's about a third to half the cost, but this varies quite a lot from state to state. Some dental schools have a graduated program based on the patient's income - ask for their fee schedule to find out more.
Pros:
- Generally inexpensive.
- Quality of treatment is generally excellent to superior, with the student getting checks at various points in the treatment.
- Patients appear to be generally very happy with chairside manner.
- You can get free consultations with every dental specialty.
Cons:
- Each appointment takes much longer because of the instructor checks, and because it takes practice to become fast at dentistry.
- There can be long waiting lists. Treatment may be very drawn out, over several years.
- The students at times stand in line waiting for an instructor.
- You can't choose your dental student.
- You may be treated by more than one person.
- Your mouth may be looked at by a dozen different people.
To find out how happy patients at your local dentist school are with their treatment, you could schedule a consult (with the dental school), find out where the patient waiting area is and start asking questions of the patients that are being treated there.
To locate and get more info about dental schools near you, try the American Dental Education Association's website.
Dental Insurance (Dental Benefit Plans)
Usually, dental benefit plans (dental insurance) are based on a contract between your employer (or your partner's employer) and a dental insurance company. Coverage is limited, usually to around $1000 per year. You can take one out yourself, but it's not worth it. Here is why:
"No insurance company will allow an individual to buy a decent dental plan out-of-pocket. Why not? They are not in business to lose money. They will lose plenty if a patient needs say $1,000 worth of dental care for each of five years, but only pays $300 premium per year. And who would pay $300 a year and not go to the dentist? No one. That is why they sell to large corporations where the odds are 10% of the population has dentures and won't go to the dentist, 20% are too scared to ever go to the dentist, 30% are too busy to really take serious advantage of it, another 10% will balk at paying a co-pay, often being 50% of the cost of a crown, and yes, 20% will exceed their premium."
Dental Insurance comes in two basic flavors:
- Dental Managed Care Plans - comes in two subflavor: DHMO and PPO
- Dental Fee-for-Service Plans (Direct Reimbursement)
Fee-for-Service plans are best! They allow you to choose any dentist and you get reimbursed according to dollars spent on dental care. This means that treatment decisions are not influenced by the dental plan - unlike Dental Managed Care Plans.
Dental Managed Care Plans come in two subtypes: DHMO (short for "Dental Health Maintenance Organization", and also know as DMO or dental HMO) and PPO (short for "Preferred Provider Organization").
With DHMO (capitation) plans, contracted dentists are paid a fixed amount (usually on a monthly basis) per enrolled family or individual. The dentists in turn provide some types of treatment to the patient at no charge, while for other treatments, a co-payment is required. Disadvantages of DHMO plans are:
- you can't freely choose your dentist.
- it may encourage undertreatment (ignoring problems), because the dentist gets paid regardless, and it doesn't make financial sense to perform (or put much effort into) treatments that are covered (such as simple fillings and prophy).
- treatments which require co-payment may be encouraged even though they are not indicated (e. g. crowns), because - that's where the money is.
The above is not to say that "HMO dentists are bad" - merely that the system may encourage both under- or overtreatment.
PPO programs are better than DHMO. These are plans under which patients select a dentist from a list of providers who have agreed, by contract, to discount their fees. In PPOs that allow you to choose a non-participating dentist, you will be penalized with higher deductibles and co-payments. If you have a PPO plan which allows you to freely choose your dentist, you shouldn't base your decision on who's on the list. Pick someone you think is right for you - if s/he happens to be a provider, all the better - the difference in what you'll save is usually minimal.
Be aware that some services may be either poorly covered or not covered at all by your insurance company, and every insurance plan has its own exceptions, limitations, maximums, and fee schedules. For example, very few insurance companies cover implants, even though implants are often a more conservative and better option than bridges. Let your dentist explain the pros and cons of your options, and try and base your decision on what's best for you in the long run (as long as you can afford it), rather than on what's covered by insurance. This may mean having to space treatment out a bit.
Dental Discount Plans
Dental discount plans are also known as "referral plans" (that is, referral through the dental plan provider). You pay 100% of the rates negotiated by the dental plan company directly to your dentist - these discounted fees are about 10% to 60% lower than what a dentist normally charges, depending on the procedure and materials in question.
The dentist gets paid 10% to 60% less than they normally would, and the difference goes to the dental plan provider, for acting as the referral agent.
To make up for the losses, dentists who accept these plans usually need to do one of the following:
- run a production line, where they're chasing from patient to patient, to make up for the losses through sheer volume.
- recommend more expensive and/or more extensive procedures than necessary. That's the rumor, anyway. The net result could be that you pay more than you would've done otherwise.
Some dentists who accept discount plans may bait-and-switch you to non-covered procedures. They may cut corners to get their overhead costs lower. Some do not have enough patients to pay all their bills and will do anything to get warm bodies in the door. Some take discount plan patients hoping they will refer their next-door neighbors at full fee. A few offices participate out of generosity.
With the exception of the last two scenarios, most offices will not provide the highest level of care under discount plans.
Dental plans come with a membership card and a complete list of all dental procedures covered and what the discounted price will be. Unlike with dental insurance benefits, there are no claim forms, pre-existing condition checks, or paperwork hassles.
Be aware that some of these plans don't give you the list of participating dentists until you have signed up. If you decide you'd like a discount plan, you should choose it based on which plans the dentist of your choice accepts, NOT the other way round (i.e. take out a discount plan and then see what dentists partner with that plan).
Offering Services or Skills
Got a skill or service you can barter with? Tell or write to dentists in your area what you can provide in return for dental treatment, or as a part payment. Examples might include landscape design/gardening, website design, building, or anything else that would otherwise cost big bucks.
Borrowing Money of Relatives
There may be family members who are willing and able to lend you the money, or offer you a part time job.
Your Own Savings Account
You may want to open a savings account and draw out what you need to pay your dentist. He or she may even give you a percentage off for paying in full at the time of your appointment.
You can work out a treatment plan with your dentist which allows you to space out treatment over a considerable period of time, and pay as you go along. The same goes for some of the other options on this page.
Fee Reduction
Dentists may offer fee reductions (usually about 5%) for payment in advance or at the time of treatment, if you ask them.
Charitable or Religious Organizations
You can check with your state dental board if you are eligible for any programs in your area. For example, for victims of domestic violence there's a scheme called "Give Back a Smile". You can find a list of state dental societies here.
You can also do a Google search for "donated dental services" in your state or area.
If you are elderly, disabled, or medically compromised, try the National Foundation of Dentistry for the Handicapped (NFDH) website, where you can find contact numbers and addresses for donated dental services in your area. More detailed information is available on our Special Needs and Dental Care page.
Low-cost Neighborhood Clinics, Public Health Services, and Other Community Resources
Some communities have low-cost health clinics or similar whose services also include dental care for people with limited resources. The Bureau of Primary Health Care, part of the Health Resources and Services Administration, has federally funded community health centers that provide dental care. A call to your local health department might give you additional leads.