Just like smiles, no two dental plans are exactly alike. So which dental insurance plan is right for you? Here's exactly what to look for.
Whether you’re self-employed, between jobs, or your employer doesn’t offer dental insurance as a benefit, there are a few different cost-effective dental insurance choices out there for you and your family. Because let’s face it — dental work is expensive, and sometimes, your daily brushing and flossing just isn’t enough to make sure your teeth are in top shape. (In other words, you should be visiting a dentist regularly!)
But if you’ve ever shopped for dental insurance in the past, you’ve probably noticed that no two plans are exactly alike. With so many options (and lots of acronyms), it can be a bit difficult to figure out the best dental plan for your needs.
Ahead, we’re breaking down the different kinds of dental insurance plans, so you know what to look for, what everything means, and ultimately which dental insurance plan is right for you.
How dental insurance works
Many employers will offer dental insurance as a benefit, but some do not. And if you’re self-employed or currently unemployed, you’re tasked with finding the right insurance plans on your own. If that’s you, you might be wondering: how does dental insurance work? Is it similar to health insurance?
Individual and family dental insurance plans provide coverage in two main forms: preventive care and restorative care. When using your plan, you need to find a dentist in your plan's network so you can get the most out of your insurance policy.
In most cases, dental insurance plans cover various classes of dental work. Typically, cosmetic procedures, dental implants, and veneers aren’t covered — though this can vary. Most dental plans cover 100% of preventive care, including cleanings, x-rays, oral examinations, and fluoride treatments.
Restorative care services, such as palliative treatment, periodontal treatments, and x-rays, are covered up to 80%. Other restorative services such as fillings, root canals, crowns, extractions, and dental surgery are partially covered at 50%.
Though you can get dental insurance at any point in the calendar year, you will likely notice that a waiting period might be required. A dental insurance waiting period is a time frame needed to receive coverage for certain dental procedures. So if you’ve been holding out on dental coverage until that back molar starts to bother you — it might be best to start searching for plans now.
Different types of dental insurance
Dental insurance exists in various forms, including Dental Preferred Provider Organizations (PPOs), Dental Health Maintenance Organizations (HMOs), and indemnity plans.
Dental PPOs are among the most common plans provided by dental insurance companies. With a Dental PPO, you can choose the dentist you would like to see. If you’re getting a preventive care service and the dentist is in-network, you can expect it to be 100% covered. But if you end up visiting an out-of-network dentist, you might have to pay a copay for the service. These plans have an annual deductible and coinsurance, which will vary based on your budget and overall needs.
Dental HMOs are known to be a more affordable option and are ideal for those who always keep floss on hand and are cavity-free. There isn’t a deductible for these plans — usually only set fees for non-preventive dental services. You are required to choose a primary care dentist from a list provided to you as you’re enrolling, though. (And if you go out-of-network for care, your insurance will not provide any coverage.) If you need specialty care, your primary care dentist will refer you to another in-network provider.
Dental indemnity plans are “fee-for-service" plans that usually have no network. You will have an annual deductible for your dental care like a Dental PPO. Under this plan, the amount you pay for services is determined as usual, customary, and reasonable — in other words, the amount that other providers in the area are charging for a similar service.
No matter which type you choose, dental insurance premiums vary depending on the kind of plan you need, where you live, and level of coverage. The average cost of dental insurance premiums range between $15 to $50 a month and remains a fixed amount for typically one year.
How to determine the best type of dental insurance for you and your family
Choosing a dental insurance plan can be difficult, especially if you’re not familiar with dental insurance. But with the right information and good strategy, choosing a dental insurance plan can be easy.
First, you need to identify your dental needs, including your dental health expectations in the future. If you’ve walked out of every dentist visit with zero cavities and a glowing review from your dentist, you might be able to get away with a lower premium cost and a higher deductible, like a Dental HMO or a high deductible Dental PPO.
Not to wipe off your pearly-white smile, but keep in mind that dental work can not only be expensive — it can be extremely unexpected, too. So next, determine the unexpected costs you might incur during your routine dental visits. If your tooth suddenly cracked, how much would you be comfortable paying for dental care? Consider the amount of premium you can pay comfortably per month and determine whether your current dentist is in-network. Once you consider the mentioned factors, conduct an online search on the available dental insurance plan to find one that meets your needs.
When you are shopping for a dental insurance plan, there are a few small but mighty factors that you need to single out. These factors are common with top-rated dental plans. They include:
Network of dentists: top-rated dental insurance plans work through a dentist network. Make sure your current dentist is in-network on your short list of insurance plans if you’d rather not switch providers.
Full coverage: to help you get the most out of any dental insurance plan you choose, make sure your preventive care is fully covered. Because if two routine cleanings a year cost a cool $0 (and you might be able to score a new toothbrush at the end, too), why wouldn’t you go? It’s the best way to stay proactive with your dental care and ultimately keep costs low.
Deductible amounts: these are always the amounts paid out-of-pocket before making claims, which can impact your budget if something comes up. It’s important to crunch some numbers ahead of time before picking your dental plan.
If you’re still not sure what to look for, help is here. Signing up for a dental insurance plan through Kasasa Care means that you have access to expert assistance through KindHealth. Their Licensed Advisors can help sift through your options, offer recommendations, and answer all your questions. You don’t have to go through this alone!
Expected costs of dental insurance
Nearly 56% of Americans skip their routine visits, according to the American Dental Association. Why?
It’s not because people are scared of the dentist — it’s actually to avoid the cost of dental care. It can be a burden on your finances, especially to an individual or family with a history of dental health complications. But that’s where dental insurance can help.
If you’re ready to take a proactive step towards a healthier smile (and an overall healthier lifestyle), a dental insurance plan can help you get there — and save you money. But there’s still a lot of uncertainties of how much plans and services will cost.
Out-of-pocket payments for dental procedures vary depending on the dentist and the facilities. On average, dentists charge between $90 to $200 for routine dental procedures such as dental examinations. Services such as professional teeth cleaning might cost higher, with some dentists charging up to $1,000. Extensive dental procedures such as dental implants, bridges, root canal treatments, and crowns might cost higher than $2,000.
With dental insurance, you can expect most plans to follow the 100-80-50 coverage structure previously mentioned. A dental crown usually could set you back $1,000+, for example, but with a dental plan, your out-of-pocket cost would only be $500.
When considering your monthly premium cost, there are two things that can play a role:
The type of dental plan: there are different dental coverage plans, ranging from basic to high premium plans. The basic plans will cost you relatively less since they only cover minor dental services such as cleaning and flossing. On the other hand, if you have a high-premium dental insurance plan, you will be forced to pay more as full coverage plans cover more extensive dental care services.
Your location: when it comes to health insurance, a geographical area does play a factor when determining the cost of an insurance policy. Mostly, insurance providers consider the cost of living, the state regulations governing insurance policies such as Medicare, and competing companies. If you live in an area with high competition, you will likely pay lower premiums as companies compete to attract insurance policy consumers.
From preventive care to restorative services, dental insurance helps cover various dental procedures that could be otherwise costly if you pay entirely out-of-pocket. If you’re considering getting a dental insurance plan for yourself or your family, take some time to understand the different plans available to you.
Just like smiles, no two dental plans are exactly alike, so be sure to do your research and find the one that makes the most sense for your needs and budget. Because saving money is worth smiling about!