HDHP + HSA vs PPO
Compare your HDHP with an HSA against a PPO plan across low, expected, and worst-case medical bills. Counts payroll premiums and HSA tax savings.
Net annual dental insurance savings
-$24.40/yr
Insured ($618.40/yr) vs Cash pay ($594.00/yr) on $660 retail workExample calculationNear break-even: Paying cash saves $24.40/yr
With $660 in retail dental work, your $618.40 insured cost and $594.00 cash-pay cost are within $75/yr. Cleanings-only years favor cash (-$162.00/yr), while a major crown year favors insurance (+$625.60/yr).
Total insured annual cost
$618.40/yr
Premium $540.00 + $78.40 copaysTotal cash-pay annual cost
$594.00/yr
$660 retail - $66.00 discountRoutine year (cleanings only)
-$162.00/yr
Insured $540.00 vs Cash $378.00Major crown year (+$1,300)
+$625.60/yr
Insured $1,138.40 vs Cash $1,764.00Annual cost breakdown: Dental insurance vs paying cash
| Cost component | With Dental Insurance | Paying Cash | Insurance advantage |
|---|---|---|---|
| Allowed network charges vs discounted cash bill | $528.00 | $594.00 | +$66.00 |
| Annual dental insurance premiums (12 months) | $540.00 | $0.00 | -$540.00 |
| Insurer benefit payout (capped at annual maximum) | -$449.60 | $0.00 | +$449.60 |
| Patient out-of-pocket at dentist office | $78.40 | $594.00 | +$515.60 |
| Total all-in annual cost | $618.40 | $594.00 | -$24.40 |
Scenario comparison: Routine year vs Planned year vs Crown year
How dental insurance math differs from medical insurance
Unlike medical insurance, which caps your out-of-pocket risk in a worst-case hospital year, most standalone dental insurance policies cap what the insurer will pay (typically $1,000 to $2,000 per year). Once your cleanings, fillings, and crowns use up that annual benefit maximum, every remaining dollar of dental work comes out of your pocket. If your employer subsidizes most of the monthly premium, dental insurance almost always pays; if you buy an unsubsidized individual or retiree plan at $40 to $60 per month, you generally need either basic restorative work plus network fee discounts or periodic major work to beat a 10% cash-pay discount.
A planning estimate based on your inputs and the assumptions shown. Actual dental fees, network discounts, waiting periods on major work, and coverage exclusions vary by policy and provider.
Benchmark sources and dates
Starting assumptions are example benchmarks, not binding quotes. Change any input to match your own bills or offers.
| Assumption / Input | Starting value | Source | Checked |
|---|---|---|---|
| Retail dental fees for cleanings, fillings, and crowns | `$420` preventive (2 visits), `$240` filling, `$1,300` crown | American Dental Association Health Policy Institute Survey of Dental Fees | 2026-10-14 |
| Dental insurance premium, deductible, 100/80/50 tiers, and annual benefit cap | `$45/mo` premium, `$50` deductible, `100%/80%/50%` coverage, `$1,500` annual cap | National Association of Dental Plans Dental Benefits Report | 2026-10-14 |
| Original Medicare routine dental exclusion | Excluded from Part A & Part B | Medicare.gov Dental Services Coverage Rules | 2026-10-14 |