CF1 Is Insurance Required for Preventative Dental Care?

Is Insurance Required for Preventative Dental Care?

With about 23% of Americans lacking dental insurance according to a recent article in The Guardian, preventative dental care is often avoided because of high out-of-pocket costs. Fortunately, there are a wide range of options for making preventative care, which is critical for oral and overall health, affordable and accessible to all.

As with any financial decision, it is essential to be educated about your choices when it comes to seeking dental care without insurance. From healthcare financing programs to in-office payment plans at practices like Dentist of West Covina in Southern California, we will share the many ways to access preventative dental care without dental insurance.

What Is Preventative Dental Care?

Dental care services vary from preventative to restorative to cosmetic. Investing in preventative care can help you avoid later restorative and cosmetic treatments, which are expensive whether you have dental insurance or not.

In dentistry, the term “preventative care” includes in-office services like twice-annual cleanings, most X-rays, and dental exams. Fluoride treatments and sealants are also considered preventative care for children.

Preventative dentistry also includes good daily habits practiced at home, like brushing, flossing, and using mouthwash, as well as wearing a mouthguard for teeth grinding and for sports.

What Does Insurance Cover When It Comes to Preventative Dental Care?

If you’re considering all your options for paying for your preventative dental care, it’s important to know what is covered by dental insurance.

The in-office procedures mentioned above are generally 80-100% covered by dental insurance. This coverage will often have limits, such as two cleanings and exams per year, or only a certain number or type of X-rays. Treatments like fluoride and sealant application are usually covered as preventative care for children, but would be considered elective for adults.

You may also have a copay for the office visit, and that cost may vary based on whether your dentist is in- or out-of-network with your insurance provider. You should be able to search for dentists in your insurance company's network on their website, as well as find the coverage and copay details for your policy.

But while having dental insurance can greatly limit your out-of-pocket expenses, it is not mandatory for seeking preventative dental care, and it is not the only way to make it affordable.

Dental Care Without Insurance

With so many lacking dental insurance, it's more important than ever for dentists to inform patients of ways that preventative care can be within reach financially so that they face fewer major dental issues down the road.

One such means is paying fully out-of-pocket. While more cost-effective options are available, they are not strictly necessary. Insurance coverage is not required for any kind of dental care, and it’s possible to pay for the full cost of preventative care visits yourself at the time of service.

For most folks, though, it is well worth the time to explore non-insurance options for assistance paying for your preventative care. Given that millions of Americans are without dental insurance, several ways of making preventative dental care more affordable have become available.

Options for People With Medical but Not Dental Insurance

If you have certain types of medical insurance, you may be able to pay for your preventative dental care with special savings accounts.

One such account is an HSA, or a health savings account. This is a tax-free, interest-earning account that can be used with a qualifying high-deductible medical insurance plan. It can also be set up with certain banks if you have a high-deductible plan that does not offer its own HSA program. HSAs can be used with employment-based or marketplace-based medical insurance, and they have a high contribution limit.

Another option for those with medical insurance is an FSA – a flexible spending account. These accounts are available only through employment-based medical insurance. They have a lower contribution limit than an HSA, and your contributions will not carry over year-to-year. However, FSAs are not limited to high-deductible insurance plans, and it is possible that your employer may contribute to the account.

Because the income going in or out of these types of accounts is never taxed, you can end up with significant savings on dental care spending. All preventative care, as well as non-cosmetic treatments, are eligible under the rules of HSA and FSA accounts.

Self-Insuring for Preventative Dental Care

If an FSA or HSA is not available to you, another way to put preventative dental care within reach is by setting aside money each month into a personal savings account. You can then use those savings to cover preventative care, rather than spending it on dental insurance premiums. This strategy can be used in combination with the following options as well.

Dental Savings Plans

Dental savings plans, also known as dental discount plans, can be purchased through most major insurance companies, as well as other reputable organizations. A dental savings plan is a program with a low annual or monthly membership fee, no deductible, no delay in coverage, and no annual maximum coverage.

With a dental savings plan, you will get a discount, usually between 10% and 60% off, on a wide range of preventative, restorative, and cosmetic services. You will need to make sure your dentist participates in your plan’s network before your visit.

Financing and Payment Plans for Dental Care

When financing or creating a payment plan with your dentist, you'll still end up paying the full price for your treatment (unless combined with insurance or a savings plan). The advantage is that rather than a prohibitively high up-front cost, you can instead pay smaller, manageable amounts over the course of several months.

Financing options include dental loans, available from companies like iCare Financial and OrthoBanc, as well as CareCredit, which offers a widely-accepted credit card specifically for health and dental services. Dentist of West Covina offers in-house payment plans and third-party financing to our patients to help you manage the cost of dental care, with or without insurance.

As you can see, affordable preventative care can be within reach even without insurance coverage. Take the time to explore these options and talk to your dental care provider to find the best payment option for you. Your dentist wants you to have healthy teeth and should be willing to be flexible and creative in making that goal fit with your budget.

Where Can I Get Preventative Dental Care Without Insurance in the Los Angeles Area?

At Dentist of West Covina, we are committed to getting you the best care at the most affordable price. We will inform you of all your options, working with insurance, discount programs, payment plans, and financing to make sure that you can afford a healthy smile without any surprise out-of-pocket costs.

Looking for preventative care without insurance in the Los Angeles area? Contact us at Dentist of West Covina to make an appointment and discuss the payment option that is right for you at (626) 605-6601.

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