Is it good to pay out of pocket to get dental care services?

What is Special Dental Billing Consultation?
June 17, 2021
Billing Guidelines for Traditional and Preferred Dental
June 24, 2021

Everyone wants to take care of their teeth. However, there are many individuals who choose to pay out of pocket to get dental care services, which means they either do not have any active dental insurance plan that offers low-cost dental care or they are willing to choose the dentist who does not have a contract with their insurance provider. Choosing out of pocket to get dental care services means that the patient is responsible for the bill of the services they have availed.

Dental care can be expensive especially if patients prefer to take regular visits to the dental Office by paying out of pocket. This can also be possible that a dentist can charge whatever they wish because they do not have a contract to charge the amount fixed with your insurance provider. Another difficult aspect of paying out of pocket for dental services is that dental offices want to get the full payment at the time they have provided the services instead of getting it in installments. 

In cases, when a patient wants dental care unexpectedly for a chipped tooth or other situations then it can be difficult for a patient to pay out of pocket for the cost of services in a short time. Moreover, having a family and paying out of pocket can multiply the out-of-pocket cost.

Why opt for insurance coverage instead of choosing to pay out of pocket for dental care?

The fee required for dental care has been increasing day by day. These dental care costs are more when you pay for multiple dental procedures availed by your family. At the same time, skipping dental care can put a person at serious oral health risks and even lead to other health issues. However, choosing to pay out of pocket can lead to unwanted high costs for dental services and be an extra burden on finances. Thus, dental insurance becomes important and as most health plans do not provide dental coverage so dental insurance needs to be purchased separately.

Like all health insurance plans, dental insurance plans also have both in and out network dentists. If individuals prefer to pay in the network, then they need to pay less as dental insurance covers most of the charges. However, if the person prefers to avail services from a dentist who is out of network then they need to pay a little higher cost. Depending upon the dentist you choose, your dental care office may need to take pre-approval for the dental services they are offering to you. Also, many dental offices prefer to charge differently for preventative, basic, and major services so get all information before you choose a dentist from in-network or out network.

Why do patients need to pay out of pocket to get dental services?

Usually, when an individual is covered by a health insurance plan, then they should use it to see their dentists. However, there are some instances when a patient pays for dental care out of pocket to get dental services such as:

  • You have a long time to pay for the deductible. After having dental coverage, still some patients prefer to pay out of pocket. Deductible means patients need to contribute some amount every year before starting to pay for the dental care costs. However, if a patient has a long way to pay the deductible then they prefer to pay for out of pocket. Paying out of pocket sometimes charges less than deductible costs. However, it should be noted that paying for out of pocket does not mean paying a deductible and thus it can even cost more when you pay deductible after some time. Thus, it is best to pay the deductible once a year and go for dental care services covered under in-network.
  • Some patients want to avail dental care services that are not covered under in-network. However, the best way is to ask your dental care provider to offer you some discounts that can save some of your money.
  • Sometimes, the patient has already hit the annual maximum amount, and still, they want some dental care services this year. Many dental insurance programs have set the maximum dollar amount that they provide on a yearly basis and for the rest, you need to pay for the rest of the services. Once the yearly plan resets, your services will be re-covered by your dental care provider.

With an insurance plan, you get a comprehensive package covering both routine preventive care and other important dental treatments. Also, the dental insurance plan can motivate some to get their regular dental care and get treatment services, after all the dental insurance plan will pay for it. A good dental insurance plan can even save you in the long run. Thus, it is best to have active insurance coverage instead of paying out of pocket to get dental services.