The National Association of Dental Plans reports that in 2012, more than 40 percent of Americans lacked dental coverage. The Affordable Care Act now requires that all individual and small group market plans cover pediatric oral health services but not adult oral health.
Even for those who do have dental coverage, most plans only cover up to $1,000 per year – a maximum that hasn’t increased since the 1970s, according to Matt Messina, a dentist in Cleveland, Ohio. “Even though the cost of care has increased, [the maximum] hasn’t changed,” he says. “In the 1970s, that would generally take care of anything other than a massive injury.” Nowadays, a single crown could easily max out those benefits, potentially requiring you to make up the difference out of pocket.
These seven tips could help you take a bite out of dental costs.
1. Commit to preventive care. If you don’t have dental coverage, paying out of pocket for cleanings could save you money down the line. Barring that, make sure you’re still brushing and flossing carefully. “The absolute cheapest way to make your own dental experience better is to commit to brushing, flossing your teeth and eating a healthy diet,” Messina says. “Those are pennies a day that breed dollars of savings later on. The cheapest cavity is the one you never get.”
[Read: 5 Ways to Cut Medical Costs.]
2. Ask about discounts. Some dentists offer services on a sliding scale for patients with financial need or discounts for upfront payment in full. Kendra Lawyer, office manager for Carothers Parkway General Dentistry in Franklin, Tennessee, says her office offers a 20 percent discount for patients without insurance who pay cash upfront. If you have multiple children who need braces, talk to your orthodontist about possible discounts for multiple patients. David Osherow, an orthodontist in Darien, Connecticut, says he even gave a discount when he treated triplets and quadruplets who needed braces.
3. Look into financing. Some dentists offer low- or no-interest financing plans. Osherow’s office, for instance, lets patients create a budget plan and pay over 15 to 20 months instead of covering orthodontia all at once. Even if there’s no interest, make sure you can realistically afford the payments, as missed payments may trigger a higher interest rate.
4. Get a treatment plan in writing. Unlike a restaurant, where you can see the prices listed on a menu, dental care doesn’t have the same level of transparency. Ask for a treatment plan in writing with an itemized list of costs so you know what to expect, and talk through these costs with your dentist or orthodontist to see if there might be less-expensive options. Orthodontists now offer many types of braces with differing costs. Braces hidden behind the teeth are the most expensive option, followed by Invisalign and ceramic braces, Osherow says. “You can save money by going with traditional metal brackets,” he explains. Materials for fillings or crowns may have different associated costs as well.
5. Visit a dental school. If you live near a dental school, find out if it offers free or inexpensive cleanings to the public. Messina says students perform work “under the supervision of licensed dentists, so you’ll get a high quality of dental work done.” However, the cleaning may take several hours (or even multiple visits), because students are expected to take their time and check every inch of your mouth carefully. “You’re trading time for money,” Messina explains.
6. Use flexible spending dollars. If your employer offers a flexible spending account, you can fund the account with pretax dollars to pay for out-of-pocket medical costs like dental work. However, you need to predict your costs for the year in advance so that you don’t overfund the account and wind up losing unused money unless your employer offers a grace period or carry-over option. Patients with FSAs may especially benefit from treatment plans, Messina says. “If we can look at long-term planning, people can fund their FSAs and prepare in advance,” he says.
7. Time elective procedures. FSAs max out at $2,500 for the year, and most dental plans max out at $1,000. For pricey dental procedures that require multiple steps, you may be able to space out the steps over several months to max out dental coverage and FSA dollars. As Lawyer points out, most benefits reset at the beginning of the calendar year, which works out for some procedures. “We could place implants in the summer or fall,” Lawyer says. “Those need time to heal and integrate, so most oral surgeons are fine if you wait until January [to place the permanent crown].”
Finally, here are two strategies that many dentists don’t recommend: dental tourism and Groupon vouchers. Traveling overseas could save you money on pricey procedures like implants, but it carries some additional risks (not to mention the added travel costs). “If you are going abroad for major surgical procedures, what happens if you have a complication while you’re there?” Messina asks. “Or worse, when you get back?” Although many countries do have highly qualified dentists, he also points out that American standards governing dentists don’t extend beyond the U.S. border, so you may not have much recourse in court if things go wrong.
Coupon websites like Groupon have been controversial in medical and dental circles because of ethical concerns around fee-splitting between the company and dentist. Also, if you jump from dentist to dentist based on who’s offering a Groupon to new patients, you won’t get the same continuity and level of care you’d get from a dentist who knows you and your teeth. Plus, there’s the concern that a bargain-basement provider might be cutting corners. “You don’t want to be looking for bargains on parachutes,” Osherow says. “I wouldn’t be looking for one in orthodontics, either.”