Affording the dentist is a big problem for many families. Dental insurance may be a great option to ensure that you and your family always have access to the dental treatment you need.
With the rising cost of going to the dentist, many people are struggling with the decision of whether or not to purchase dental insurance. Whether you are considering buying dental insurance through your employer or independently, be sure to investigate several different plans and ask questions about the factors listed below
How dental insurance plans work
Plans typically cover preventive and basic dental care. Benefits vary by plan.
Find the right plan
Use our tools to easily find the plan for you.
We offer a broad range of plans to meet your dental needs, both big and small.
Preventive dental coverage
Regular checkups and cleanings now may prevent more serious and costly issues later.
|Dentist Choice||Out-of-Pocket Cost|
|Fewer Limitations: Not required to visit in-network dentists but DPPO in-network dentists will have lowest out-of-pocket costs.||Copayment: Pay a copayment for procedures. Require you to reach a deductible and have a maximum.|
|Very Limited: Choose one dentist or facility. Out of network procedures will not be covered.||Coinsurance: No deductibles or maximum. You pay a copayment for certain procedures. Some procedures are zero out-of-pocket costs.|
|Fewer Limitations: Large choice of dentists.||Copayment + Fee: Pay a copayment for procedures. Additional fee for the dentist since they are not reimbursed.|
|No Limitations on network||Discounted Fee: Reduced fee-for-service is completely out-of-pocket. No deductible or maximum.|
Routine dental care
Plans generally cover some or all of the costs for oral exams, cleanings, fillings, and X-rays.
Affordable dental coverage
Oral health doesn't have to be costly. Dental insurance plans start at $8.95/month*
Dental health is strongly tied to your overall health.
Need help? Our licensed agents can recommend the best dental insurance options for your situation.
The yearly maximum is the most money that the dental insurance plan will pay within one full year. The yearly maximum will automatically renew every year. If you have unused benefits, these will not roll over. Most dental insurance companies allow an average yearly maximum of $1,000.
Most independent dental insurance plans will only pay for your dental services if you go to a contracted and participating in-network dentist. Find out if you are required to go to a participating dentist.
If the plan requires that you see an In-Network Dentist, ask for a list of the dentists in your area with whom they are contracted so you can decide if they have a dentist you would consider seeing.
If you wish to stay with your current dentist, some policies allow you to see an out-of-network dentist, however, the costs covered may be significantly lowered.
Almost all dental insurance companies use what is called a Usual, Customary, and Reasonable (UCR) fee guide. This means that they set their own price that they will allow for every dental procedure that they cover. This is not based on what a dentist actually charges, but what the dental insurance company wishes to cover. For example, your dentist may charge $78 for a dental cleaning, but your insurance company will only allow $58 because that is the UCR fee that they have set.
If you are on a policy that requires you to go to a participating provider, you should not be charged the difference between these two prices. A contracted dentist generally has an agreement with the insurance company to write off the difference in charges. If the policy allows you to go to a dentist or pediatric dentist of your choice, check the insurance company’s UCR fee guide against the fees that dentist charges. You may be required to pay the difference out of your pocket, however, you cannot put a price tag on quality dental care.
A waiting period is the length of time an insurance company will make you wait after you are covered before they will pay for certain procedures. For instance, if you need a crown and the policy has a 12 month or longer waiting period, chances are you could have already paid for your crown while you have been paying your premiums and waiting.
More than 90 percent of dental insurance policies carry a “missing tooth clause” or a “replacement clause.” Many include at least one of these clauses, but most have both. A missing tooth clause protects the insurance company from paying for the replacement of a tooth that was missing before the policy was in effect. For example, if you lost a tooth before your coverage started and later decided that you would like to have a partial, bridge or implant, the insurance company would not have to pay for that service if they have a missing tooth clause in the plan. A replacement clause is similar except that the insurance company won’t pay to replace procedures such as dentures, partials or bridges until the specified time limit has passed.
Cosmetic dentistry is any type of procedure done for vanity purposes only.