dental cost calculator can add up quickly. That’s why it’s important for patients to understand how much they will pay for a specific procedure.
Dental insurance typically covers 100% of preventive services and 80% of basic care such as fillings, but policies may also have annual maximums, deductibles or waiting periods.
Insurance
Dental insurance helps mitigate the cost of many procedures. It pays a percentage of a procedure’s fee after the patient meets a deductible and reaches a policy maximum, such as a per-year or calendar-year limit. However, not all dental plans cover the same services and fees. In addition, each plan is different, and a patient should carefully examine their coverage details before enrolling.
For example, one type of dental coverage is a preferred provider organization (PPO). These plans have a network of dentists that accept a predetermined fee. Typically, a PPO will pay 100% of a preventive exam or 80% of the cost for basic restorative treatments like fillings. However, it will likely only pay 50% of the price for major restorative treatments, such as a root canal or crowns.
Another type of dental insurance is a health maintenance organization (HMO) or a dental health maintenance organization (DHMO). These plans have a predetermined list of dentists that will accept the plan’s fee, and patients usually have to stay within the plan’s network to avoid paying higher out-of-pocket costs.
It is also important to note that some Medicare Advantage plans require a monthly premium for dental coverage, and this can add to the overall cost of the plan. Those who choose to pay this additional premium will need to consider how it affects their annual maximum and other out-of-pocket expenses.
Procedures
There are a lot of factors that go into why the cost of a dental procedure can vary from one location to another. But the bottom line is that quality healthcare — whether it’s medical or dental — is expensive. There are a few multi-char practices and dentists around the world that offer cheap dentistry, but those are often not sustainable businesses and they tend to have lower patient satisfaction ratings than their competitors.
In the end, it’s all about what patients feel is a good value for the services they receive. This is why it’s so important for dental offices to properly calculate patients’ estimated out-of-pocket costs. Giving patients a wrong number can put them in the dark about how their insurance works, how they should divide up their visit, and if they are going to be hit with a surprise bill.
To help our members better understand how to estimate out-of-pocket costs for dental procedures, MetLife has developed a Procedure Fee Tool. This tool identifies the approximate fees that most participating dental service providers who offer the procedure in their office will charge for each individual treatment option. The Tool also displays the amount that MetLife will pay for the procedure and the patient’s out-of-pocket responsibility based on their dental plan coverage. This information will help you make an informed decision about your choice of dental provider.
Materials
The materials used for a dental procedure will also affect the total cost. For example, if you are getting single or multiple tooth implants, the type of implant and crown will determine how long and strong the prosthetics are. Some dentists advertise a cheap price but they may use entry-level materials and not top brand products that will last longer. The same is true for dentures and other teeth replacements. Ask about the quality of the materials being used.
Labor
Unlike materials and insurance costs, which are fairly consistent across dental practices, labor can vary widely. It can be influenced by many factors, including location, overhead and employee salaries. Dentists must take these factors into account when setting their fees for services and determining the best ways to reduce costs and increase profitability.
For example, some dentists find that offering bonus pay for hygienists and assistants who hit production benchmarks helps control their labor costs. Additionally, some practices have found that using software that allows them to compare real-time prices and accelerates the request-approve process when ordering supplies can save thousands of dollars a year.
In addition, some dental practices are trying to cut their expenses by reducing staff levels. However, this can have a negative impact on patient care. For instance, if a practice doesn’t have enough staffers to handle the volume of patients, it could lead to missed appointments and longer wait times for patients.
Similarly, some practices are trying to lower their expenses by cutting back on lab costs. While this can save money, it may not be sustainable in the long run. For example, if a practice’s lab is not providing the right quality of work for fee-for-service patients, it should consider switching labs to maintain its profitability. It’s also important for dental practices to keep in mind that they must pay their rent, utilities and taxes.