Dental insurance is available in many forms, such as group plans for employees through their employer, family plans intended to cover multiple people, and individual plans. Depending on the plan, the insurance benefits will wholly or partially cover dental treatments and services.
Individual dental insurance plans have different options. According to America's Health Insurance Plans (AHIP), dental coverage is divided into three types:
Under a DHMO plan, you'll choose a dentist in the plan's network for your primary provider. DHMO will typically cover visits to your primary provider or treatments from a specialist once your primary provider makes a referral.
You don't have to choose a primary provider under a PPO plan. As long as you select a dentist or specialist within the plan's network, your care is covered. You can still visit a dentist outside the network, but the visit could cost more.
You're free to use any dentist you choose under an indemnity plan. These plans are sometimes called "fee-for-service" plans. You will pay a co-pay and a premium, and then the plan will cover a certain percentage of the cost of treatment.
According to the American Dental Association, most dental insurance plans will cover the costs for preventive care. Preventive care procedures include dental hygiene treatment, some X-rays, exams, and sealants. Dental insurance will often also cover some percentage of the expenses related to non-routine procedures like fillings, teeth replacement, other cavity treatments, and root canals. Coverage for cosmetic treatments like teeth whitening and orthodontics for adults will vary.
Before choosing an individual dental plan, here are some definitions for standard terms you will find in the details of dental insurance plans:
You can find dental insurance plans easily online. Employer-provided programs typically have cheaper monthly premiums, better co-pays, and other benefits.
As you compare individual plans, here are some questions to consider:
Dental insurance coverage depends on the terms of the plan. Many basic dental insurance policies include yearly or bi-yearly examinations, x-rays, dental hygiene treatment, fillings, root canals, and preventive care such as dental sealants and fluoride therapy. Other plans may cover special treatments like crowns or braces. Young people, such as college students, often only use their coverage for preventive care, so students can keep their teeth strong and healthy and avoid needing more serious dental care.
Although you might think dental insurance is only needed for extensive dental procedures, taking advantage of all preventive and cosmetic dental work benefits is a great idea. Keeping your preventative care appointments twice a year is typically affordable. It ensures that oral health problems are prevented and treated early, saving you time and money.
Oral Care Center articles are reviewed by an oral health medical professional. This information is for educational purposes only. This content is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your dentist, physician or other qualified healthcare provider.
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