Dental Insurance 101
- Dental insurance will typically cover issues related to your teeth and gums, as well as preventative care such as yearly cleanings
- Not all procedures will be covered. For example, cosmetic procedures such as whitening and crowns, generally will not be.
- Deductibles, copays and coinsurance most always apply, and many policies have annual coverage maximums that are relatively low.
A good dental plan can not only benefit your smile – it can help your wallet too. Many major dental procedures can cost thousands. Even routine preventive cleanings can be more than $100 at a time. Add X-rays or fluoride treatment to the tab, and a routine dental visit can quickly cost hundreds of dollars.
Cue dental insurance: Like health insurance, dental insurance provides you with benefits that help pay for dental costs. And whether you need a longer-term dental plan or short-term dental insurance option to fill gaps in coverage, know that you have plenty of flexible options to choose from.
Picking the right dental plan can help curb expensive health care costs. But before you shop around for the best dental plan for your pearly whites, let’s cover some common questions so you know the basics.
How does dental insurance work?
Dental insurance can pay for things like annual cleanings, minor oral health fixes, or big-dollar dental claims for crowns and bridges. In general, dental coverage is broken out by preventive, basic and major services:
- Preventive dental care includes diagnostic and preventive services like regular oral exams, teeth cleaning, and x-rays. It may also include fluoride treatments and sealants (plastic tooth covering to prevent decay). In many cases, dental plans include 100% of the cost of preventive care.
- Basic dental care includes office visits, extractions, fillings, periodontal treatment (gum disease), and root canals. Your insurance company might pay anywhere from 60 to 80% of the cost for these services, with you covering the rest of the cost. But if you’re paying a lower percentage of the costs, you may have a high-dollar copay.
- Major dental care covers crowns, bridges, dentures, and inlays. Inlays are something between a filling and a crown: Your tooth might have extensive decay and need a more substantial filling, but it may not be in bad enough shape to require a crown. Meanwhile, crowns completely cover the tooth. Some dental insurance plans include root canals under “major” dental care, while others categorize them as “basic.” The cost of major dental care is higher, and most insurance plans cover about 50% of the fee.
There are two main types of dental insurance plans:
PPO dental plans
Dental Preferred Provider Organization (PPO) dental plans provide dental care for a fixed monthly premium. This type of plan allows you to visit any dentist within the PPO network for reduced service fees. You may go outside of the approved system, but your out-of-pocket costs will increase. This plan works well for those who want to see any dentist who takes their PPO plan.
DMO dental plans
Dental Maintenance Organization (DMO) plans allow you to see any dentist within the approved network for no fees or for a reduced cost. In some cases, the prices for a DMO dental plan are lower than a PPO plan. However, you can’t go outside of the network to receive dental care. This plan works well if you have a preferred dentist within the DMO network and want a lower fixed monthly premium.
Dental insurance coverage can vary, so it’s a good idea to compare different plans to choose what’s right for you.
What do dental insurance plans offer?
Dental plans typically cover some level (if not all) of cleanings, X-rays, and a percentage of basic services like fillings and major services like root canals. Many dental insurance plans also offer extra non-insurance wellness benefits to increase the value of the plan.
Who is dental insurance good for?
The choice to get dental insurance is ultimately up to you and your budget. But even if your mouth is healthy, dental insurance that covers preventive care at 100% can be valuable to have, especially when unexpected issues arise like filling a cavity or fixing a chipped tooth.
Dental insurance may be right for you if you:
- Have missed the annual open enrollment period through your employer
- Are on Medicare and don’t have a dental plan
- Are in-between jobs or have been laid off.
- Are a part-time or temporary worker and your employer does not offer dental benefits.
- Are a student, a recent graduate, or have aged out of your parent’s dental plan.
- Do not have a dental benefit through your employer
How much is dental insurance?
The cost to have dental insurance varies based on your coverage, where you live, and other factors such as:
- Is it an individual or family policy?
- Is the dental insurance provided through an employer?
- What are the annual maximums?
- What are the annual deductible and the copays?
Affordable dental insurance plans might pay for preventive care but may not pay as high of a percentage for major services. If you need thousands of dollars of work done for crowns or a bridge, a higher-cost dental plan might pay for itself.
Overall, monthly premiums range between $39 per month for an individual to $139 per month for a family (for the most part).
How much does the dentist cost if I don’t have insurance?
Dental services can get pretty pricey if you don’t have insurance:
- A single filling can cost up to $300 on average.
- A standard dental cleaning can cost up to $200.
- An X-ray can range from $20 to $250.
- A dental crown can range from $500 to $1,500.
Can I get dental insurance without a job?
Yes. You don’t need a job to have dental insurance. As an example, dental insurance for college students is one way someone without traditional employee benefits can keep their oral hygiene in check.
Not all employers offer dental insurance, but you can easily buy a dental insurance plan for yourself if you’re a freelancer or part of the gig economy.
Anyone can shop around and sign up for dental insurance plans online – typically within minutes.
Can you get dental insurance anytime?
Yes. There is no open enrollment period like there is for health insurance. You can buy dental insurance any time of the year, and coverage typically starts within days of submitting your application.
Note: There may be a waiting period for major services, so it’s smart to review any dental plan you’re interested in to confirm the waiting and coverage periods.
Can I cancel dental insurance anytime?
Absolutely. Dental insurance premiums are paid on a monthly basis, so you can cancel at any time. That means you can purchase dental coverage for a set period of time and cancel it with no penalty.
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