What Do You Get From Having Dental Insurance?
When you avail of a health insurance plan, it covers just about everything except your teeth. If up until now, you aren’t convinced that having dental insurance can help you in the future, think about the possible expenses that you may encounter.
A crown alone will cost you around $1,500. Simple cleaning that should be regularly done every few months will likely have a price of more than $100. Even root canals have a price range of $300 up to $1,000.
The truth is that dentists aren’t cheap, which is why investing in dental insurance coverage may be one of the best decisions of your life. Keep in mind that dental health insurance plans are very varied. You have to understand how your plan is designed and how it can cater to your dental needs. Furthermore, you have to assess how it can affect out-of-pocket expenses.
A report published by the National Association of Dental Plans claimed that adults and children who have either a dental insurance plan or a dental benefits plan possess greater overall health as they regularly receive restorative dental care.
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What is the difference between an insurance plan and a benefits plan?
This is a question that doesn’t typically arise when choosing a dental insurance plan, maybe because the patient already has their heart set on investing in an insurance plan. Nevertheless, it is important to discuss the differences between these two concepts.
When you are shopping for insurance, you may have come across terms like “dental benefits plan,” which is different from dental insurance.
Keep in mind that an insurance plan is defined as something meant to absorb risks. These risks pertain to various dental incidents, such as having your tooth pulled out or knocked off by accident. Furthermore, it may also include your decision to get a root canal. Insurance plans aim to cover the necessary expenses accordingly.
On the other hand, a benefits plan tend to cover some aspects of your dental journey in full. However, the rest is partially taken care of, while some may not be even covered at all. This is meant to be helpful, but a benefits plan should not be viewed as a catch-all.
What is the cost of having dental insurance?
One of the determining factors that may push you to avail of a dental insurance plan is the cost you get to save if you invest in the right coverage.
According to a report published by the American Dental Association, dental services have an average cost of about $685 every year. However, if you compare this to a monthly payment for premiums of about $40, which comes to a total amount of $480 per year, you’ll realize that there’s so much potential in dental insurance plans.
Moreover, you also need to pay attention to the dental insurance plan’s “annual max,” which is the ceiling of what your dental insurance is willing to pay for dental work. So, if your insurance plan has an annual max of $1,500, any cost that goes beyond this amount will be covered by you.
Keep in mind that this can be both a good and bad thing. If you require services beyond the regular list of dental works, then expect that you would need to pay more. On another note, if you only need regular dental cleaning with a few additional dental services here and there, then you get to actually save money in the long run.
In the end, the best way to avoid expensive dental-related bills is to take care of your teeth.
What are the different types of dental insurance plans?
The good news is that understanding your dental insurance plan is quite similar to understanding how health insurance works. Of course, there are key differences between the two, but they are also similar in some ways.
With dental insurance plans, you’ll have the following options:
Preferred Provider Organization (PPO)
Dental insurance PPO typically comes with a list of dentists that accept the plan. You can either choose among the list provided or you can go out of network. If you do go out of network, you may have to spend more on out-of-pocket costs.
Dental Health Maintenance Organization (DHMO)
Dental insurance HMO, on the other hand, provides you with a network of dentists that accept the plan for either no fee or at a set co-pay. Do note that a co-pay is a fee that you pay every time you see a dentist.
Referral Dental Plan
Moreover, you can also opt for a referral dental plan. With this plan, you only get discounted rates on dental services from a select group of dentists. As the name suggests, this doesn’t cover any of the expenses. Rather, it gives you a discount on the services that you receive.
Dental Indemnity Plans
With dental indemnity plans, you receive higher premiums as well as co-pays as compared to PPOs and DHMOs.
What is the difference between group dental insurance and individual dental insurance?
Group Dental Insurance
About 92% of the American population gets dental insurance plans through their work. Since employers typically get a group rate for their dental insurance, this is considered as the lowest cost for dental coverage. The cheapest option may range from only $19 to about $32 on a monthly basis. That’s only $228 to $384 every year.
Individual Dental Insurance
As the name suggests, individual dental insurance is an option provided to those individuals and workers whose employers do not provide them with dental insurance plans. These plans are also considered as private dental insurance plans.
You can purchase this type of insurance plan on websites that offer dental services. This would typically cost you around $20 to about $60 on a monthly basis. While most of the rules between these two types of dental insurance plans are the same, there are certain differences when it comes to individual dental insurance plans.
For one, this type of insurance plan has a 12-month minimum contract and a 6-month to about 8-month waiting periods before the patient is asked to pay for any serious procedures. These regulations are made so as to discourage people from only availing of dental insurance when they are in need of treatment. Learn more about dental insurance no waiting period for major services & pre existing conditions.
How do you choose a dental insurance plan that is perfect for you?
When you review and compare dental insurance plans, you must consider the following items so that you’ll be able to effectively discern which among the plans can satisfy your dental care needs.
With that in mind, try answering some of the questions below before you say “yes” to a particular dental insurance plan:
- Who gets to control the treatment decisions in the plan? There are some dental insurance coverages that require dentists to follow what is known as the “least expensive treatment option” approach.
- Stemming from the previous point, does the dental insurance plan give you enough freedom to avail a dentist of your choosing? Pay attention to plans that restrict you to only a list of dentists that are specifically selected by the insurance company. Moreover, if you have a particular dentist in mind, are they included on this panel?
- What does the dental insurance plan cover? Does it cover preventive, diagnostic, and dental emergency services? If so, up to what extent?
- What are some of the major dental care services included in the plan?
- How much of these costs will you have to cover?
- What are some of the limitations and exclusions of the dental insurance plan?
- Is it possible for you to visit the dentist at times of emergencies? Furthermore, are you able to schedule appointments at times that are convenient for you?
- Who are those that are considered eligible for your dental insurance coverage? Furthermore, when does it go into effect?
Keep in mind that your dentist may not be able to answer all of these questions, especially those that are very specific toward the coverage of your dental insurance plan. The details to your plan may vary depending on what has been agreed upon.
Should you have any questions about the coverage, it is best to seek the assistance of your employer's benefits department, the third-party payer of your dental insurance plan, or the actual dental insurance company of your plan.
How often should you visit your dentist?
The frequency and timing of your dental visits can affect your decision in taking up a dental insurance plan offer. Experts would claim that every individual should at least see their dentist twice in one year. Even though the wording may differ, you can find ample support of this claim from dental benefits policies.
As explained, you have to understand your policy and know how it works. This will help you schedule your appointments. Furthermore, if you aim to avail of a particular dental service, you have to consider the time period required for that particular dental work.
What should you do before a dental procedure?
Now that you have settled on a dental insurance plan and have gotten everything sorted out, it’s now time to avail the dental services offered by your plan. With that in mind, there are a few reminders that you should pay attention to before a procedure.
For one, you have to make sure that you have read and understood your dental insurance policies. Don’t hesitate to call your insurance company should you have any questions. During major dental procedures, please be reminded that your dentist should provide a pre-treatment estimate. This will help you assess how much you’ll owe them after any deductibles.
What are the limitations of dental insurance plans?
Of course, in order to truly understand your dental insurance plan, you have to be familiar with its limitations. With that in mind, the majority of the dental insurance plans aims to control its cost by limiting how much the insured can reimburse. In some cases, they limit how much money is given per year.
There are also some plans that exclude certain dental services to lower costs. By knowing what your dental plan covers and excludes, you’ll be in a better place to make a sound and practical decision.
On another note, there are certain exclusions and limitations in dental insurance plans that are made for the purposes of keeping the dentistry’s expenses from increasing without having the need to penalize the patient. Experimental procedures are typically excluded from plans or are performed under the supervision of a dentist.
Nevertheless, it is always good practice to read and understand the conditions stated in your dental insurance plan so as to avoid any confusions and unnecessary costs.
Are there any alternatives to dental insurance plans?
At this point, you may have wondered whether or not there are alternative options to dental insurance plans. To answer simply, there are alternatives to dental insurance plans, one of which is a dental discount card.
Dental discount cards are made available to patients who are looking for ways to reduce the cost of dental procedures. By using this card, you are given a network of dentist to choose from. Much like a dental insurance plan, choosing a dentist outside of that network will entail a higher cost.
While a dental discount card is a great way to lower your dental bills, this does not provide you with the same list of benefits as that of a dental insurance plan. Furthermore, in choosing between these two options, you have to carefully assess which decision can help you meet your dental needs.
The bottom line is that whether you opt to go for an individual dental insurance or a group dental insurance that is provided to you by your employer, it will still be more cost-effective as compared to not having any financial plan for your yearly dental expenses.
As you may have already known, dental services are expensive. Moreover, these expenses may pertain to services that are unexpected. Dental emergencies can truly hurt your wallet and bank account. Thus, having a dental insurance plan that meets your needs is a practical decision to make.
On another note, a dental insurance plan can also be considered a waste of money if your plan does not match your dental needs. This is why it is important for every patient to pay attention to dental insurance plans that can provide them with a wide array of benefits.
With that in mind, it is your duty to read and understand what is included and excluded in the policy, and if there are any limitations. Remember, no one insurance plan is the same, which is enough reason to be more critical about it.
General Dental Insurance Questions
This section covers general questions you might have about dental insurance.
What is the best dental insurance?
That depends on your particular needs. You should check the different dental insurance options available on your state health care exchange and see which product most closely matches your requirements.
How to get medical insurance to pay for dental work?
It can be tricky to get medical insurance to pay for dental work. You’ll need to talk to your insurance provider and dentist to see what your options are.
Can I use 2 dental insurance plans?
Yes, this is known as having dual coverage. One plan will be a primary plan, and the other will pick up costs not covered by your primary plan.
How do I get dental insurance?
The easiest way to get dental insurance is to sign up for it on your state’s healthcare exchange marketplace during the open enrollment period.
How do I find out my dental insurance?
You’ll need to ask your employer what dental insurance you have. You can also check your bank statements to see what dental insurance company you’ve been paying.
How long can I stay on my parents dental insurance?
You can stay on your parent’s dental insurance until you’re 24 years old, according to recent health care laws.
How to get dental insurance for free?
It’s going to be difficult to get dental insurance for free. Your best bet is to get a job that provides dental insurance.
What is a PPO dental plan?
A PPO dental plan attempts to balance lower costs with a network of providers. The PPO network dentists accept lower fees rather than full fees from the insurance company.
What is a DMO dental plan?
A DMO is a Dental Maintenance Organization plan that lets you pick a primary dentist to see for most things. If you need a specialist, then you’ll have to get a referral.
Are dental plans a scam?
No, dental plans are not a scam. They provide a way to get important health care access that can literally save your life at a fraction of the cost.
What to look for in dental insurance plans?
The thing to look for in dental insurance plans depends on your needs. If you expect a lot of dental work, then you’ll want a lower deductible, higher premium plan. If you’re just going for routine checkups, then a low premium high deductible plan is good.
How do dental discount plans work?
Dental discount plans work by the dentist agreeing to provide services for network members at a reduced cost.
What does DHMO dental plan mean?
A DHMO plan is one that contains a network of dentists that agrees to provide services at low or no cost for members of the DHMO.
What is a PDP dental plan?
A PDP is a Preferred Dental Provider Plan, where there’s a network of preferred providers you can choose from at the time of treatment to get your dental plan benefits.
What is an indemnity dental plan?
This type of dental insurance plan lets you see any dentist you wish. However, you pay the full cost upfront and submit a claim for reimbursement to the insurance company.
Can I have 3 dental insurance plans?
That depends on your specific dental plans. Many plans have a non-duplication of benefits clause that prevents you from accessing benefits that are covered by another plan.
What is standalone dental plan?
A standalone dental plan is one that’s not tied to a specific healthcare plan. Some health insurance plans come with dental coverage included, while others don’t, requiring a stand-alone dental plan.
What is the difference between HMO and PPO dental plans?
The difference between and HMO and PPO dental plan is that a PPO plan will give you better benefits but at a higher monthly premium cost.
What is a dental discount plan?
A dental discount plan gives you access to lower prices at participating providers. You usually get the procedure for 10-60% of the normal price.
Dental Insurance and Procedures Pricing
We’ll answer your questions about dental insurance pricing and dental procedures pricing in this section.
How much does dental insurance cost?
That depends on lots of factors, like where you live, what kind of dental plan you’re considering, and more. You can usually get dental insurance for between $10 and $50 per month.
How much is a dental cleaning without insurance?
If you don’t have dental insurance then you can expect to pay between $80 to $175 for a dental cleaning.
How much does a dental bridge cost with insurance?
Dental bridges without insurance can get very expensive. Depending on other factors, the cost ranges from $300 to $1,000 per tooth.
How much are dental x rays without insurance?
A single tooth X-Ray can cost between $15 and $25. Bitewing x-rays can cost between $50 and $100, and a full mouth series will cost between $100 and $200.
How much is a dental filling without insurance?
A dental filling with the cheapest filling material will cost about $150 for a single tooth and tooth surface.
Are there payment plans for dental implants?
That depends on the provider. Many providers will set up a payment plan for expensive procedures like dental implants if your insurance doesn’t cover it or you lack insurance.
Dental Insurance Coverage and Benefits
We’ll answer questions about dental insurance coverage and benefits in this section.
Are dental implants covered by insurance?
That depends on your specific situation. If there’s a medical reason you can’t get dentures and must get implants, then your insurance may cover them.
Does dental insurance cover wisdom teeth removal?
In most cases, yes. You’ll need to show the removal is medically necessary. Your insurance will cover about half the cost.
How to get dental implants covered by insurance?
To get dental implants covered by insurance you’ll need a reason why cheaper alternatives like dentures aren’t an option for you and a reason why dental implants are medically necessary.
Is oral surgery covered by medical or dental insurance?
That depends on the specific operation and the reason for the operation. You’ll need to talk to your health care provider and insurance company to find out what’s covered by whom.
Are veneers covered by dental insurance?
Most dental insurance plans consider veneers to be a cosmetic procedure and thus, won’t cover them. You can get partially covered if the veneers are needed for restorative purposes.
Does dental insurance cover night guards?
That depends on your specific dental insurance plan. Many plans cover night guards at some percentage, but some don’t.
How much does dental insurance cover?
The amount that dental insurance covers depends on your specific dental insurance plan. You can find information about your plan limits on your insurance card or by contacting your provider.
Is Invisalign covered by dental insurance?
Lots of dental insurance plans will cover Invisalign treatment. However, many of them only provide partial coverage.
Does dental insurance cover teeth whitening?
Not in most cases. Teeth whitening is usually considered to be a cosmetic procedure not covered by dental insurance.
Do any dental plans cover braces?
Almost every dental plan covers braces for children. Adult braces may or may not be covered, depending on the specific circumstances involved.
What dental plans cover orthodontics?
Delta, Humana, Cigna, and many other dental insurance plans cover orthodontics. You’ll need to check with your health care provider to see what insurance plans they accept.
Questions about Specific Dental Insurance Plans
This section answers your questions about specific dental insurance plans.
Does Kaiser offer dental insurance in California?
Kaiser dental plans are administered by Delta Dental of California in that state.
What Medicare plan covers dental and vision?
Some Medicare Advantage Plans (Part C) will offer benefits like dental and vision. You’ll need to check with specific plans for more information. If not then we recommend places to get the cheapest contact lenses or other vision needs.
What does my MetLife dental plan cover?
The MetLife dental plan covers more than 400,000 providers across the country. It gives free or discounted services based on your specific plan.
Does AARP Medicare supplement plan f cover dental?
No, Medicare Supplement Plan F doesn’t cover dental work. You’ll need to pay out of pocket or get additional Medicare coverage.
What does my Cigna dental plan cover?
The details of what your Cigna dental plan covers depends on your specific dental plan. However, you get annual exams, routine x-rays, and cleanings for free when you visit a Cigna provider.
What does my Humana dental plan cover?
The specifics of what your plan covers depends on your particular plan. But you can count on free routine checkups, cleanings, and x-rays.
What is the best FEDVIP dental plan?
As of 2019, there is only one dental program available, the Federal Employees Dental and Vision Insurance Program.
Does Maricopa health plan cover dental for adults?
It may cover up to $1,000 in emergency dental care, but it is unlikely to cover things like checkups and cleanings.
Does COBRA cover dental plans?
Yes, but you can only continue a dental plan on COBRA if you got one while you were employed.
Does plan f cover dental?
No, Medicare Plan F doesn’t cover dental work. Medicare Plan C does cover some dental work, but you’ll need to check if it works for your situation.
Is Careington a good dental plan?
The reviews for Careington are mixed. You can save an average of 20-60% on most dental care, but there may be a better option for you.
Does Delta insurance cover dental implants?
It depends on the nature of your situation. Your doctor must fill out a pre-treatment estimate for you to see how much your insurance will cover and how much you’ll have to pay out of pocket.
Other Dental Insurance Questions
We’ll cover dental insurance questions that don’t fit into our other categories in this section.
How to verify dental insurance benefits?
The best way to verify your dental insurance benefits is to log on to your account with your insurance company.
Are dental discount plans better than insurance?
That depends on your situation. Many people find that insurance is better, as it assures them 100% coverage for the most common dental procedures.