Dental Insurance FAQ
Dental insurance is insurance that provides coverage for services relating to the care and treatment of your teeth and gums.
Typically, it provides coverage for some or all of the following dental services:
- Diagnostic procedures
- Semiannual checkups (including cleanings) and periodic x-rays
- Procedures that restore teeth
- Oral and maxillofacial surgery (teeth extraction and oral surgery)
- Periodontics (treatment of bone and gum diseases)
- Prosthodontics (fillings, dentures, bridges, and crowns)
- Orthodontics (repositioning of the teeth)
- Oral surgery
- Root canal therapy
What does dental insurance cost?
Dental insurance is typically inexpensive. For most people, the cost is less than you spend eating at McDonald’s over the course of a year (depending, of course, on your affinity for Big Macs). If you have employer-sponsored dental insurance, the cost to you will be even less because your employer probably pays all or most of the premium. Dental insurance is generally very affordable for the average consumer.
How does dental insurance work?
Dental insurance may provide direct payment to the dentist for the dental care and treatment you receive. Or you may be required to cover the applicable charges out-of-pocket at the time of service, and then file a claim for reimbursement. It depends on the specific plan.
With group dental insurance, deductible and co-payment features usually come into play, often with a separate co-insurance percentage for orthodontia and other specified procedures. Often the deductible does not apply to routine cleaning and oral examinations. Most plans also place a limit on the total amount of dental benefits you can receive each year. Finally, if you've just enrolled in a dental plan, be aware that there may be a waiting period before dental benefits kick in.
Where do you get dental insurance?
Dental insurance has become more common in recent years. Of the roughly 55 percent of Americans who have dental insurance, most receive their coverage through their employer. Employer-sponsored dental insurance may take the form of a health insurance plan that includes dental coverage, a separate dental plan, or a benefit choice within a cafeteria plan.
Unfortunately, if you don’t have access to employer-sponsored coverage, you may have a difficult time finding dental insurance. Despite the variety of dental plans available, plans for individuals are few and far between. And dental coverage is seldom found in individual health insurance policies either, except coverage for accidental dental injuries.
This doesn't mean you’re out of luck if you’re looking for individual coverage, but it does mean that your options may be limited. Availability rather than cost is often the major hurdle faced by individuals in search of dental insurance. In fact, one of the few types of plans that’s readily available to individuals is what’s known as a dental discount plan, which isn’t even a true "insurance" policy.
Who should have dental insurance and who shouldn’t?
If your employer offers dental insurance, you should almost always enroll in the plan because the coverage will probably cost you little or nothing. If coverage is not available through your employer, you should weigh your options carefully.
On the other hand, buying your own dental insurance might be a good idea if you’ve had a history of dental problems and expect to have more, if you smoke (which can cause yellowing and/or decay), or if you’re over 40 (age-related decay). If any of these applies to you, make a point of seeking out individual dental coverage.