10 Differences between Dental Insurances and Medical Insurances

A blog by Buford Affordable Dentist, Lake Lanier Smiles

1. WHAT IS INSURANCE

Insurance is an arrangement where you pay a premium payment and in return you will get guarantee of compensation for a loss or eventuality. Medical insurance is a real insurance where you pay a premium and if any major illness happens then you would be covered of all the expenses irrespective of amount. But dental insurance shouldn't be even called as insurance because it doesn't cover everything and instead it covers some preventive and certain annual amount. So imagine someone gets a car accident and the same year they unfortunately got diagnosed with cancer, medical insurance will cover both the catastrophic events. Unlike in dental insurance, you got a broken tooth and get an implant and same year you fell down and broke another tooth, then there will not be enough benefits so you have to wait till next year. Weird right!

2. BENEFITS

Dental benefits are mostly used for preventive services like dental cleanings, fluoride and dental exams. On the other hand most of the medical benefits are put towards the injury or illness after they occur.

3. YEARLY LIMITATIONS ON BENEFITS

All Most all of the dental insurances have a yearly maximums. Average yearly dental benefits are around $1500. To cut the costs, the dental insurance companies limit the dollar amount of coverage in a calendar year. But with medical insurance there is no annual limitations so you can get one, two or as many procedures as needed. For example if you need two root canals and crowns, then all the dental benefits will be exhausted and you can't get any benefits for any other procedures even as small as filling or a sealant unlike with medical insurance you can get all necessary procedures.

4. EXPENDITURE

Well dental care expense in 2002 was about $500 and the same year medical expenses were about $3000. It shows how much difference is there in the two systems and that's why the two systems operate quite differently. 

5. DENTISTS AND DOCTORS

80% of dentists are general dentists and on the other side 80% of doctors are specialists. You might get most of the treatment in the same location by the same dentist and referred out very little in dentistry unlike medicine. These factors separate medical care and dental care.

6. NATURE OF DISEASE

Medical conditions can be life threatening and need a doctor consult immediately but most of the dental conditions are non-life threatening so you have the leisure to find a dentist or ask your friends or family for a referral. But it doesn’t mean you can delay dental care.

7. IMPORTANCE OF INSURANCE

It is very important to have a medical insurance but on the other hand not that important to have a dental insurance as many dentists are providing the dental care by giving in house dental savings or discount plans. Please contact us at 770-831-0559 for more information or an appointment.

8. PRE-EXISTING CONDITIONS

Since 2014 you can’t be denied medical insurance because of any pre-existing conditions. But believe it or not dental insurance still have pre-existing clauses. For example if you are missing a tooth and wants to get it replaced with a partial denture or implant or a bridge, dental insurance will deny the claim due to pre-existing condition, here it is missing tooth. Note that cavities or broken teeth don’t fall under the pre-existing conditions.

9. WAIT PERIODS

It is unimaginable to have wait period with medical insurances because if you have any illness or injury you can’t wait until the wait period is done. Well with dental insurances you generally have to wait about 6 months to a year for full benefits. So until wait period is done with dental insurance, you are not covered for certain procedures like fillings, crowns or surgery.

10. DEDUCTIBLES

Deductibles are the dollars out of your pocket for health care before insurance begins to pay. Dental Insurance is better in the deductibles because most of the deductibles fall in the range of $50 - $100. Most of the medical insurance deductibles are over $1500. Once deductibles are met, the cost of the treatment is shared based on your insurance coverage.

Hope this article explained the common myths and questions about dental insurance and the differences between medical and dental insurances. If you have any questions about dental insurance, please don’t hesitate to call Lake Lanier Smiles insurance coordinator at 770-831-0559.

If you have any questions about your Oral Health or to make an appointment to see us, Call us at 770-831-0559 or visit us at WWW. LAKELANIERSMILES.COM for Valuable Coupons and Specials. Our prices are 30-50 % Off Regular Prices. Call Us before Noon and we will see you the Same Day. We accept most insurances. We are conveniently located just off I-985 at 4965 Lanier Islands Parkway, Suite 105, Buford, Ga- 30418. LAKE LANIER SMILES provides Affordable dental care with outstanding customer service to patients in Buford, Sugar Hill, Suwanee, Cumming, Flowery Branch and surrounding areas.