Dental insurance is significantly different from other forms of insurance. With health insurance or homeowners insurance – there is a massive downside to not being insured. If you get seriously injured and require surgery, your medical bills will be astronomical without the right type of health insurance. If your home burns down without homeowners insurance, you will be in a world of hurt from a financial perspective. You almost have to have these types of insurance; health insurance is even required by law now.

However, dental coverage is a bit different. You don’t necessarily have to have dental insurance. The downside to not having dental coverage is significantly lower than other forms of coverage, like health or homeowners’ coverage. And while the downside with dental coverage is low, the upside is about the same. Ultimately, the decision to get dental coverage or not comes down to your lifestyle, age, and needs.

The In’s & Out’s Of Dental Insurance

During most years, you may only need cleanings, exams, and x-rays. These services are usually considered preventative care and wholly covered by most dental plans. If you were only to require these types of services throughout the year, you would pay more in dental premiums than the services would cost out-of-pocket. In years where your dentist may inform you that you need fillings, a root canal or a crown – dental insurance can save you a good chunk of change. The key is choosing a dental plan that works for your needs.

Why Buy Dental Insurance

Just like many forms of insurance, dental insurance offers peace of mind. While routine visits won’t set you back too much, an extensive procedure, such as filling or crowns, could cost upwards of $3,000. The real benefit of dental coverage comes from not having to break the bank in case of a dental emergency for a chipped or knocked-out tooth.

How Dental Insurance Works

Dental plans are often a bit tricky to understand. This is because most dental coverages work in the opposite manner of health insurance. You receive a certain amount of coverage, and after that, you have to pick up the bill or wait until next year. This coverage usually correlates directly to the “100-80-50” plan. One-hundred percent of preventative care is taken care of. Eighty percent of fillings and root canals are covered. While only 50% of major procedures, such as bridges, are covered by the plan. While somewhat confusing, it’s best to speak with providers about the details of any policy.

Waiting Periods

While not every individual needs a dental plan, dental coverage can offer a great benefit to many. Surprisingly, a majority of Americans do not have dental coverage. However, some groups should look into dental coverage if they are not insured already. You don’t want to be stuck paying thousands of dollars for dental work that could have been covered with a small plan.

Larger families should strongly consider dental insurance. The more individuals in your household, the higher the likelihood someone in your household will need a basic or major dental procedure at least once a year. Active individuals who play contact sports must have dental insurance. Contact sports significantly increase the chance of a tooth getting chipped, knocked out or worse. 

Lastly, all seniors should have some form of dental coverage. Just like the rest of the body, your teeth and mouth will require more attention as you age – and the cost of dentures isn’t cheap.

Medicare & Dental

Medicare and dental coverage are tricky topics. Technically, Medicare does not cover dental services. However, a majority of Medicare Advantage programs do offer some form of dental insurance. The original plan, Medicare Parts A and B, do not cover dental services. Medicare Advantage programs often include a wide range of dental benefits.

Dental Insurance For Seniors

Dental benefits are essential for seniors because poor oral health can lead to grave health consequences as an individual ages. If you’re a senior who does not have dental coverage, it’s important to weigh your options. You will want to look into a retiree health plan or a stand-alone dental benefits plan. If those options prove cost-prohibitive, you’ll need to at least seek preventative care. As well, if a dental problem does begin to persist – you need to handle the problem quickly. The longer you let a dental problem persist, the more expensive it will become.

Dental Insurance & You

Dental insurance may not be for you. You may not have a need for coverage. However, many individuals will do themselves a service by looking into a few dental plans. Check with your employer to see if dental coverage is available for you and your family. Often, companies offer dental alongside health coverage. If not, you’ll want to look around for dental coverage.

With every insurance product, you’ll need to shop around and find the best deal. Read the fine print of any policy you’re interested in and make sure the policy will cover your preferred dental benefits provider. Speak with the provider and ask any questions you may have before signing up for a plan. Dental insurance should usually cost between $12 and $50 per person, per month.

How to Get Dental Insurance 

While many employers offer dental insurance as part of their benefits package, or as a voluntary benefit, some Americans do not have that luxury. 

And unfortunately, there are limited options available on healthcare.gov, or your state’s marketplace. Often, you only have the opportunity to purchase dental insurance on the ACA marketplaces if you had bought your healthcare plan there! So, if you don’t qualify for ACA grants, or don’t choose the dental insurance on the Marketplace, you can obtain private dental insurance from a licensed insurance agent, or online.

If you are self-employed and are a part of a trade organization or association, inquire about any group rate dental insurance coverage they may offer to members.

Is there an open enrollment period for dental insurance?

If you’re purchasing from the private market, you can buy dental insurance plans 365 days a year. But, if you’re purchasing dental insurance through a Medicare Advantage plan, you need to wait for the open enrollment period. Same goes for the ACA plan; you’ll have to do so during the open enrollment, or prove that you qualify for a “Special Enrollment Period.” If you’re buying a group plan, there’s a chance that you’ll have to purchase during a specific period.

How much is dental insurance?

An employer-sponsored dental insurance plan premium can be valued at $14 and $30.50 per month, or $168 to $366 per year. Family coverage costs an average of $27.00 to $56.00 per month or $325 to $680 per year.

How much is individual dental insurance per month for one person?

Individual insurance policies generally cost more and are not seen as a very affordable dental insurance option. While companies can acquire a “group discount,” individuals don’t have that luxury. Typically, individual plans are an additional $15 more per month than those under group policies. In some extreme cases, some have seen dental insurance plans average an extra $46 per month.

How many people have dental insurance?

There are about 77% of Americans with some form of dental benefits, an increase of 20% over the last 20 years. Of the estimated, 249.1 million Americans with coverage, 164.2 million people own private insurance. In 90% of the cases, the coverage is bought through their employer.

What percentage of Americans don’t have dental insurance?

Approximately 35% (74 million) of American’s don’t have any form of dental insurance. 

What is PPO dental insurance? 

The most common dental plan is PPO. Preferred Provider Organization plans usually provide a type of stability between lower costs and dentist choice. PPO dentists opt to join in the network, allowing negotiated fees as payment in full, as opposed to their usual fee with the PPO. Among PPO plans, 50% have a maximum yearly benefit of $1,500. The other half is less than $1,500.

Best Dental Insurance Plans

Delta Dental Insurance

Delta Dental Insurance has been selling dental insurance for over fifty years. The company offers plans utilizing a comprehensive network of dentists, over 140,000, with many plans providing out-of-network dental coverage. The policies are open to both the public and small or large businesses. Delta Dental plans are not available in every state. Types of Dental Plans include Dental PPO Plans, Dental HMO or prepaid plans, fee-for-service programs, and discount policies.

Guardian Dental Insurance

Guardian sells dental insurance plans to individuals, companies, and groups. The company offers accessible solutions for obtaining high-quality and affordable dental coverage, saving approximately 35% for their customers.

Guardian offers several policies through PPO and DHMO plans. While they’re not available in every state, an extensive national network, 114,000 providers at over 319,000 locations, provide comprehensive dental coverage to many. Guardian claims to pay its claims in less than two days, which is a bonus!

Aetna Dental Insurance

Aetna offers over a million Americans affordable dental insurance through PPO Plus and Aetna PPO plans, as well as a discount dental plan that varies by state. Aetna generally provides group dental insurance through employers, though if you live in Alaska, Arizona, Delaware, Illinois, and Pennsylvania, you can buy it separately. There are over 80,000 dentists in the Atena provider pool to choose from. 

Cigna Dental Insurance

Cigna is a health and dental insurance company and sells several different PPO dental plans to over 15.2 million medical customers worldwide. There are over 135,000 dentists nationwide within their network. A wide variety of dental procedures are accessible, and enrollees can pick from a wide range of dentists within their PPO network. 

Humana Dental Insurance

Humana Health Insurance Company provides dental plans in all 50 states, Puerto Rico and the District of Columbia and is one of the biggest providers of dental insurance in the country. Coverage through their PPO and DHMO plans can be purchased through an individual coverage policy or your employer. Humana also provides full coverage dental insurance to Americans as well. 

Metlife Dental Insurance

Metlife Dental provides dental insurance for groups and is a top provider in the nation. Their Dental PPO plan includes full-service coverage for retirees, and Metlife network dental fees are generally 15-45% below community-average charges.