Next to brushing and flossing your teeth daily, visiting your dentist at least twice a year is an important part of maintaining good dental hygiene. You’ll want to be prepared for unexpected oral problems, such as gum disease and cavities, when they occur.
Dental insurance helps cover both the cost of routine visits to your dentist and major oral procedures that might become necessary later in life.
When you sign up, you’ll have the option of paying monthly or yearly. You’ll also be presented with several options for coverage.
If you want more coverage because you plan on visiting your dentist more than twice a year or need major oral surgery, expect to pay a higher premium.
If you are on the opposite end of the spectrum and only plan on seeing the dentist once a year, you might want to pass on dental insurance and pay out of pocket.
Table of Contents:
How Much Does Dental Insurance Cost?
Like all insurance, how much you pay will depend on how much coverage you want.
Though, considering the costs of medical, home, and auto insurance, dental is pretty cheap.
In fact, many dental insurance companies offer plans that are as low as $15 per month and the average American pays $360 per year in dental insurance.
What Does Dental Insurance Cover?
Dental insurance coverage falls into three specific buckets: preventive care, basic procedures, and major procedures.
Preventive care is the most common. This includes regular checkups with your dentist, allowing them to analyze your teeth and gums and provide professional advice on how to improve your dental hygiene. These check-ups involve standard dental practices, such as x-rays, cleanings, and fluoride.
The main goal of preventive care, from a dentist’s standpoint, is to identify minor oral issues that have the potential to become serious problems in the future.
Typical dental insurance policies provide 100% coverage for preventive care.
Basic procedures involve a more specific visit to the dentist’s office. They usually occur after a general check-up, where the dentist discovers an oral issue that warrants the procedure.
Examples of basic procedures are root canals, minor restorative services, denture repairs, and treatments for gum disease. Typical dental insurance policies provide 60 percent coverage for basic procedures.
So if you get your dentures repaired for $200, your insurer will pay $120 while you pay $80.
Finally, there are major procedures, which are the most serious and most expensive. This includes dental crowns, bridgework, and tooth implants.
Typical dental insurance policies will only provide 50 percent coverage for these procedures.
Common dental practices that do not fall into any of these buckets are cosmetic procedures. If you want your teeth to look more white, typical dental insurance won’t pay for a teeth-whitening procedure. You’ll have to pay for that out of your own pocket. In general, any procedure responding to something that’s not a potential health hazard won’t be covered by insurance.
It’s important to note that different insurance companies have different interpretations of which procedure falls into which bucket. A root canal, for example, is considered by some to be a major procedure, while others consider it only a basic procedure. Make sure to discuss these distinctions with your insurer before picking a plan, especially if your family has a history with specific oral issues like gum disease.
Types of Dental Insurance Plans
Dental insurance companies want to know who’ll be working on your teeth before providing coverage. Most companies have a network of pre-approved dentists. In other words, when you sign up, they’ll provide a list of dental offices in their network that are close to you.
There’ll be benefits to staying inside of the insurer’s network — but at the end of the day, It’s up to you to choose which dentist is best for you.
Like other forms of insurance, the type of dental insurance plan you end up going with will depend on a variety of factors.
- How often do you plan on going to the dentist’s office?
- How much are you willing to pay for dental insurance?
- Do you currently have good oral hygiene?
- Does your family have a history of oral cancer?
These are questions you should ask yourself before signing up for your first dental insurance plan.
Dental Indemnity Insurance
These plans allow you to pick any dentist you want, regardless of their network. It’s a traditional insurance model, in the sense that you pay your dentist for their service and then get reimbursed later by the insurance company.
This type of plan allows you the freedom to change dentists whenever you want, which is particularly beneficial for those who travel a lot. Many people complain about having to wait long periods of time to receive reimbursement from their insurer, however.
Dental PPO (Preferred Provider Organization)
These plans also allow you to pick any dentist you want, but they provide an incentive to stay within the network. The insurance company will give you a discounted fee if you become a patient at one of their preferred dentists’ offices.
This is helpful if you want to use a specialized orthodontist for a particular procedure, but are content with using any dentist for a general check-up. These plans may provide flexibility for the person seeking dental care, but they also come with higher premiums.
Dental HMO (Health Maintenance Organization)
These plans don’t allow you to receive any dental care from anyone outside of the insurance network. In other words, they’ll only provide coverage if you go to one of their pre-approved dentists.
This lack of flexibility can make things difficult depending on your geographical location and the type of care needed. But if you can make it work, you’ll enjoy lower premiums in comparison to a PPO or dental indemnity plan.
Discount Dental/Savings Plan
In a discount dental program, a select group of dentists agrees to perform services for plan owners at a discounted price and are paid that rate directly by the plan owner. This can save the shopper money, but they are still responsible for the agreed upon rate that was determined between the referring provider and the dentist.
Who Needs Dental Insurance?
Anybody who wants to protect themselves from costly oral procedures later in life should have some level of dental insurance.
Conditions such as gum disease can cause great pain, anxiety, and financial stress later in life. Plus, even if you brush your teeth three times a day, you should still have routine check-ups twice a year, which your insurance will pay for.
Dental insurance is especially important among children. Since their teeth are still developing, dentists can help children use best practices for oral health and discover issues that have the potential to create problems during adulthood.
Sadly, around 80% of children globally live with tooth decay. This has become a big problem in the US, causing certain states to consider passing laws that require parents to purchase dental insurance for their children.
Advantages to Dental Insurance
Before you start looking into different options for your dental insurance needs, here are some of the general advantages that surround dental insurance:
If you want to set your entire family up with dental insurance, most companies will present you with group plans. This can be more cost-efficient than having each member of the family pay for themselves.
You’ll have to pay a higher premium, but the cost per person will be significantly less.
Basic Dental Insurance Plans Cover Major Procedures
It’s comforting to know that if you accidentally knock one of your teeth out, your dental insurance company is going to help cover the cost of implanting a new tooth.
While they may not pay for the whole procedure if you are on one of the cheaper plans, chances are they’ll take care of at least half the bill.
Options With No Waiting Period
When you sign up for a plan, be sure to check if the policy contains a waiting period. If it does, that means the insurer will not initially cover any of your dental care. This could last anywhere from six months to a year.
Signing up with a group plan through an employer, or a PPO, is a good way to avoid waiting periods so that you can start receiving coverage immediately.
Keep Using Your Preferred Dentist
Let’s say you’ve been using the same dentist for your entire life. Perhaps they’re a close family friend. You plan on keeping them as your dentist, but you just got kicked off your family plan and are looking for new coverage.
You could sign up for a dental indemnity plan, which allows you to use any dentist you want. Though, before you do that, you should ask your dentist about which insurance network they are under, as there might be better plans available via PPO or HMO.
Should I Get Dental Insurance?
If you receive healthcare under the Affordable Care Act (ACA), you might already have dental insurance, since many of those health plans automatically come with dental. Be sure to check the details of your ACA policy before seeking dental care. It’s also important to note that you cannot purchase dental insurance form ACA without also purchasing general health care.
Most companies today provide their employees with options for dental insurance. This is usually covered by HR when you get hired. But if you’re not sure, check with your employer to see whether these benefits are available.
Before you pick a dental insurance provider, do as much research as possible. You should get quotes from several different companies and compare their different plans. Ask yourself: Which company provides the most amount of coverage? Which has the lowest premiums? Which has the best reviews online?*While we make every effort to keep our site updated, please be aware that "timely" information on this page, such as quote estimates, or pertinent details about companies, may only be accurate as of its last edit day. Huntley Wealth & Insurance Services and its representatives do not give legal or tax advice. Please consult your own legal or tax adviser.