Important Steps for Choosing Dental Insurance

Like health insurance, homeowner’s insurance and auto insurance, you should take some time to compare dental insurance plans before you enroll in a policy. 

Our guide will introduce you to a few of the key considerations you need to make before selecting a policy.    

Step 1: Understand Your Dental Needs.

Everyone has different dental needs. A young, single person with no prior history of dental issues will need less coverage and will pay less than a family of 3 with a history of gum disease. A family with young children also has to worry about all the complications that can come with growth, such as the need for braces.

In order to understand your dental needs, it’s best to make a list of you and your family’s dental history. This includes past, present and future (professionally predicted) needs. You’ll also want to take a look at what you’ve paid for previous dental visits and issues, which will give you an idea of your cost desires and requirements.   

Step 2: Review Your Insurance Options

You can get dental coverage using 1 of 2 plan types: a comprehensive health insurance plan that includes dental coverage or through an independent dental insurance plan. 

Insurance companies sometimes include dental coverage through health plans that you get through your work, but others do not. Find out whether dental is covered through the health plan you can get through your employer. 

Step 3: Compare Dental Insurance Plans

An insurance plan that is provided through an employer or association is a group plan. An individual plan is insurance that you buy on your own. 

Let’s take a look at a few more details you can use to decide which type of plan is best for you. 

Group Dental Insurance 

Group insurance plans are usually a dental plan that you get through your workplace. With group insurance, you’ll have a limited choice of plans to choose from, and you usually won’t be able to shop around between competing companies. 

However, your employer will pay for some or all of your premiums or deduct your share of your premium from your paycheck when you’re enrolled on a group plan. 

Individual Dental Insurance 

You can buy individual dental insurance if you do not get health insurance through your employer or if your employer doesn’t offer dental coverage. You’ll be able to shop around and choose the plan you want for yourself and your family when you choose to independently sign onto a dental insurance policy. 

Though you’ll usually pay more for coverage with an independent plan, these plans provide you with more options and allow you to more easily customize your coverage. 

Step 4: Review a List of Dentists Included in the Coverage

Each dental insurance plan will have a different network. A dental insurance network is made up of all the dentists in a given area that are willing to accept the dental insurance plan that you’ve chosen. 

If you have a dentist that you’ve previously gone to, check whether he or she is inside or outside of your new network. If they are not in your network, you will likely have to pay more money out-of-pocket to continue seeing them.

You will be able to choose between any of the dentists that the insurer has in the network who are accepting new patients. You should consider doing some research on the dentists that are included in the coverage you are considering. If there are limited options in your area, you might want to consider choosing a different insurance plan.

Step 5: Check Coverage

Knowing what type of dental insurance plan you have will help you choose a dentist, keep your costs low and understand exactly what is and isn’t covered by your insurance. There are a few different types of plans that will provide different coverages.

• Preferred Provider Organizations (PPO). A PPO doesn’t have a list of dentists in-network that you must see. Though you’ll usually save money when you work with an in-network dentist, you can still use your insurance benefits with dentists who aren’t within your network.  
• Dental Health Maintenance Organization (DHMO). DHMO plans have a set network of dentists that accept your insurance, and you must see an in-network dentist to use your benefits. HMO plans afford you less freedom to choose your insurance provider but are usually less expensive than PPO plans.
• Discount plans. While technically not an insurance plan, a discount plan provides you with lowered costs on major dental procedures and check-ups in exchange for a monthly fee.  

Each of these plan options offer coverage for different circumstances, as well as different premiums and fees. If you aren’t sure what’s covered on the plan you’ve chosen, contact your insurance provider. 

Dental Insurance Benefits

The benefits you receive are dependent on the dental plan you choose. Some possible benefits may include:

• Preventive care. This covers routine oral exams, teeth cleanings, fluoride treatments and routine x-rays.
• Basic restorative services. Usually includes fillings, root canals and other types of regular, routine treatments.
• Major restorative services. Crowns, dentures, implants and some oral surgeries are usually considered to be major services.

The benefits can vary from company to company, so make sure you fully understand what benefits you will receive with the plan you choose before you sign a contract. 

What is the Real Value of Dental Insurance?

The cost of dental insurance will vary state to state. The cost will also be heavily dependent on your income, where you live, your age and the amount of people that are getting coverage on the policy. 

You can pay as little as $15 a month if you’re an individual, but these rates may drastically increase as you add family members to your plan. Your policy will also have a maximum cap on the total dollar amount of benefits that you can claim.

The monthly cost of dental insurance pales in comparison to what you’ll need to spend in the event that you must seek emergency dental treatments. The average cost of a dental crown in the United States is between $500 and $3,000, while dental implants may cost you up to $4,500. 

Even routine cleanings may cost between $75 and $200 without insurance, while you’ll usually pay $0 for preventive care when you’re enrolled on an insurance plan. If you have little in savings or a long history of familial dental issues, you may be able to save hundreds or even thousands of dollars by enrolling in a dental insurance policy. 

How does Dental Insurance Work?

If you have health insurance or a supplemental insurance plan, you’re likely already familiar with the dental insurance process. First, you’ll choose a dental insurance plan and review your options for service providers. After choosing a dental service provider and receiving treatment, your dental office will review your insurance coverage and ensure that the services you received are covered under your plan.

From here, you’ll be responsible for paying your plan’s coinsurance percentage. If your plan has a deductible, you’ll also need to meet the deductible before your insurance will help you cover the cost of your treatments. While preventive care will usually cost you $0 with dental insurance, you may be required to pay up to 50% of the cost of major restorative services like crowns and bridges.

Dental Insurance Waiting Period and Coverage Limits

Most dental insurance plans have a waiting period that you must go through before you can use your plan’s benefits. While the majority of dental insurance plans have no waiting periods for preventive care, you may need to wait up to 3 months before you can use your insurance for major services.

Your dental insurance plan will also include a limit on the total amount of benefits that you can claim from your plan. Once you reach your annual limit, you cannot continue to claim benefits from your insurance plan provider. 

Best Dental Insurance Companies

Not sure where to begin your search for dental insurance? Consider starting off with a few of our favorite dental insurance providers below. 

Start Shopping for Insurance Now

Don’t wait until you have a major dental emergency to begin shopping for dental insurance plans. Your dental insurance plan will have a waiting period that prevents you from using your benefits for up to a few months after you’re approved for a policy. The best time to start shopping for insurance is now — before you need a major dental treatment.  

Frequently Asked Questions