Dental care is easy to put off. However, skipping routine visits may allow small issues to develop into more complex (and more expensive) problems down the line.
One of the main reasons people delay dental care is that they’re concerned about the cost.1 Fortunately, affordable dental insurance can help make the dental care expenses easier to manage. Read on to learn what dental insurance covers and how to choose a plan that fits your needs and budget.
What is dental insurance?
Dental insurance is a type of coverage that helps lower the cost of dental care, making both routine visits and more complex treatments more affordable.
To keep your coverage active, you pay a monthly premium for the duration of your policy. In exchange, your insurance company will help cover a portion of your dental care based on your plan’s benefits.
Many dental insurance plans cover routine services at little to no cost to you. Additionally, they may offer partial coverage for more complex procedures, typically paying 50% to 80%, depending on the type of treatment.2 You’re responsible for paying the remaining balance out of pocket.
Types of dental insurance
There are many types of dental plans you can choose from. Two common options include:
- Dental Health Maintenance Organization (DHMO) plans: These plans typically require you to choose a primary dentist and stay within a specific network. They often come with lower monthly premiums and more affordable deductibles, but offer less flexibility and may require referrals for specialists.
- Dental Preferred Provider Organization (DPPO) plans: These plans offer more flexibility to see in-network and out-of-network dentists without referrals. While they provide broader coverage, they often come with higher premiums, deductibles and out-of-pocket costs.
Both types of plans provide benefits and drawbacks, making the best option a matter of personal preference.
What does dental insurance cover?
Whether you choose a DHMO or DPPO plan, dental insurance comes with varying coverage levels. However, most plans cover the following types of services:
- Preventive care: Preventive services include routine exams, cleanings and X-rays. Dental insurance often covers these services at the highest level, sometimes up to 100%. Staying consistent with your preventive care can help you catch issues early on and reduce the likelihood that you’ll need more costly treatments in the future.
- Basic procedures: Basic services include fillings, simple extractions and certain periodontal treatments. Dental insurance may cover up to 80% of the cost of these procedures, leaving you responsible for the remaining balance.
- Major procedures: Major dental work, like crowns, bridges, dentures and oral surgery, is often covered at lower levels, typically up to 50%. Even so, this coverage can significantly reduce your overall costs, as these procedures tend to be more expensive.
How much does dental insurance cost?
The cost of dental insurance depends on your plan. The main factors that influence what you’ll pay include your plan’s:
- Premium: The monthly amount you pay to keep your dental insurance coverage active
- Deductible: The amount you pay out of pocket before your insurance begins to contribute
- Copays: A fixed amount you pay for certain services, such as a dental visit or procedure
- Coinsurance: The percentage of the cost you’re responsible for after meeting your deductible
- Annual maximum: The total amount your plan will pay for covered services within a benefit period
- Waiting periods: The amount of time you must wait to receive coverage for certain services after enrolling in your plan
- Network restrictions: Limits on which dentists you can visit to receive full coverage
Understanding these factors can help you estimate your total out-of-pocket costs and determine the best dental insurance plan for your budget.
How to choose the best dental insurance plan
To find the right dental insurance plan for your needs, ask yourself the following questions:
- How often do you visit the dentist?
- Do you anticipate needing major dental work in the future?
- Do you want to visit a specific dentist?
- Is your preferred dentist in the plan’s network?
- What monthly premium fits comfortably within your budget?
- How much are you willing to pay out of pocket for care?
If you only plan to see the dentist for routine checkups, a DHMO plan with a low monthly premium may be sufficient. If you need more complex dental procedures and don’t want to deal with rigid network restrictions, a DPPO plan with comprehensive coverage may be more cost-effective in the long run. No matter which plan you choose, the right coverage can help keep your teeth, gums and smile healthy and lower your overall dental care costs.
