FAQ

Dental Insurance: Coverage And Cost – Forbes Advisor

The cost of dental care can be high, but dental insurance helps offset some of those expenses.

Dental insurance policies are not the same for everyone. benefits and coverage range from preventive-only plans to plans that help with major care like dentures and implants.

Reading: How much is dental insurance on average

what is dental insurance?

dental insurance provides coverage to help protect you financially from the high costs of dental care. Policies are separate from your primary health insurance, although some health insurers offer dental insurance plans.

You may be offered dental insurance as an employment benefit, or you may purchase a plan from a dental insurance company.

how does dental insurance work?

Most dental plans work like this:

  • you pay a monthly premium.
  • You may face waiting periods for some types of care, but preventive care (like cleanings) often doesn’t have a waiting period.
  • You may need a primary dentist in the insurance provider’s network.
  • There may be an out-of-pocket deductible you must meet before your plan covers a percentage of your out-of-pocket costs for care.
  • Most plans have a maximum annual allowance.
  • Your plan may require a copay for dental visits.
  • Most preventive care is covered 100% by the dental plan; this includes an annual exam, cleaning, and x-rays.
  • what does dental insurance cover?

    Dental insurance policies typically cover preventive services, but the additional amount covered varies by plan. some policies cover a percentage of the cost of basic services, while others cover part of the cost of basic and main services.

    preventive and routine services

    • generally covered at 100% of costs
    • cleanings and revisions every six months
    • annual x-rays
    • basic services

      • coverage percentage varies, but often represents 80% of costs
      • fillers
      • simple extractions
      • main services

        • coverage percentage varies, but often represents 50% of costs
        • root canals
        • bridges
        • crowns
        • false teeth
        • implants
        • what does dental insurance not cover?

          Dental insurance generally does not cover services such as:

          • cosmetic dentistry that is not medically necessary
          • bonding
          • placement of non-essential veneers
          • Dental insurance may not cover the services below. Be sure to read the fine print if you are interested in this dental work because there may be lifetime maximum benefits or waiting periods for services, even if they are covered:

            • teeth whitening
            • orthodontics (braces)
            • If your policy provides coverage for one or more of these services, it may be at a lower percentage.

              types of dental insurance plans

              Dental insurance plans are differentiated by whether you can get care out-of-network and how much the plans pay for different types of care.

              dental preferred provider organizations (dppo)

              See also: How much does car insurance cost for a teenage girl

              a dppo uses a network of dental providers to provide care for an agreed upon fee. You can also get care outside the network at a higher cost. these policies generally have higher premiums since they come with more flexibility.

              dental health maintenance organizations (dhmo)

              a dhmo offers lower cost coverage with a network of dental providers. some services are covered at 100%, while others may require you to pay a small copay. You generally must stay in a dhmo’s network to receive reimbursement for care.

              fee-for-service plans

              Fee-for-service dental plans, also known as traditional or indemnity plans, do not have provider networks. you can see any dentist.

              These plans pay a percentage for each service and you pay the rest. A fee-for-service plan doesn’t contract with dentists, which means they don’t have discounted rates like ppo or dhmo.

              dental savings or discount plans

              Discount dental plans are not actually dental insurance. instead, they offer discounts at participating discounts and you pay for treatment at the discounted rate determined by the plan.

              how much does dental insurance cost?

              The average full-coverage dental insurance policy costs $47 a month, according to Forbes Advisor’s analysis of dental insurance premiums. a preventive care plan costs an average of $26 a month.

              Factors that influence the cost of individual dental insurance include a plan’s coverage and how much it charges for out-of-pocket costs, such as deductibles, coinsurance, and annual maximums.

              This is the average monthly cost of the top rated plans from dental insurance companies reviewed by Forbes Advisor. Please note that the Humana Preventive Value Plan focuses on preventive care and does not include coverage for oral surgery, endodontics, and other major services.

              average cost of dental insurance per plan

              Employers often offer dental insurance as part of their benefits package. Those group policies are usually cheaper than getting a dental insurance policy yourself. Employer helps pay for coverage and offers more affordable dental insurance coverage by bundling coverage instead of an individual getting an individual plan.

              out-of-pocket dental insurance costs

              Here are different types of out-of-pocket costs you can expect with dental insurance:

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