When it comes to different forms of insurance, dental coverage is an anomaly. As anyone who has ever experienced a severe and unexpected life event can attest, health insurance and homeowners insurance are absolutely necessary, as there is a massive downside to not being prepared for when tragedy strikes.
However, dental coverage is a little bit different.
At the end of the day, dental insurance is not a necessity, as the downside to not being covered is significantly lower than other types of insurance. But, while the downside to not being covered with dental insurance is particularly low, the upside is exceptionally high. Ultimately, the decision regarding whether to get dental coverage comes down to your lifestyle, age, and needs.
The In’s & Out’s Of Dental Insurance
As with other types of insurance, dental coverage is a gamble.
In most cases, dental insurance is only required to cover cleanings, exams, and x-rays. 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 such cases, dental coverage may not be as cost-effective as you might think.
However, on occasions where your dentist may inform you that you need fillings or a root canal, dental insurance can save you a good chunk of change. Once again, the key is to choose a dental plan that works for your needs.
Why Buy Dental Insurance?
Like many other forms of insurance, dental insurance offers peace of mind. While routine visits won’t set you back too much, extensive procedures — such as filling or crowns — could cost upwards of $3,000. As such, the real benefit of dental coverage comes from not having to break the bank in case of a dental emergency like a chipped or knocked-out tooth.
What Are the Best Dental Insurance Providers for 2021?
Each dental insurance provider is different, complete with its own strengths and weaknesses. For example, in terms of family plans, UnitedHealthOne comes out on top, as demonstrated by its “A” rating from A.M. Best. Meanwhile, Delta Dental specifically offers plans designed to help families on a budget. Humana is best for those looking for discounts, and Cigna provides global coverage that is second-to-none. Finally, Ameritas offers a rewards program wherein enrollees can increase their annual maximum benefit to help pay for more expensive procedures in the future.
What Are the Benefits of Dental Insurance Plans?
While the advantages of being covered by dental insurance vary according to specific cases, at its core, a proper plan provides coverage for routine dental care, affordability, and personalized assistance. In addition, as dental care is strongly tied to your overall health, investing in dental insurance should provide you with additional peace of mind for your whole-body health.
What Are the Types of Dental Coverage?
Most dental insurance companies offer three types of coverage. DHMO plans work much like HMO health insurance plans; you’ll receive a list of providers that accept your insurance, and will need to see a dentist within your insurance company’s network. Meanwhile, PPO plans allow you to receive treatments from dentists who are both in and out of your company’s network. Finally, indemnity plans give you the freedom to select your own provider. With indemnity plans, you will pay out of pocket and submit a claim for reimbursement to the insurance company.
What Are the Three Major Differences Between Dental Insurance Plans?
While cases vary, typically, there are three primary differences between dental insurance plans; the choice of dentists available, the out-of-pocket costs, and the method of payment. When selecting your dental coverage provider, we recommend comparing these key differences.
Cost of Dental Plans Comparison
When it comes to dental insurance, different plans carry different payment methods. For example, PPO plans typically require you to reach a deductible and have a maximum. Conversely, DHMO plans rely on copayment. Finally, indemnity plans require you to pay a copayment, as well as an additional fee for the dentist.
How Dental Insurance Works
Dental plans are often difficult to understand. Still, there’s a handy trick to keep in mind in such confusing instances. According to the “100-80-50” trick, common dental insurance plans cover 100% of preventative care, 80% of fillings and root canals, and 50% of major procedures (such as bridges). While still somewhat confusing, it’s best to speak with your insurance provider about the details of their policy.
Overview of the system
In essence, choosing a private dental insurance coverage involves selecting a plan based on the providers and dentists available. If you already have a dentist and they are in the insurance company’s network, you’ll be able to opt for one of the less expensive plans. If you don’t have a dentist, you can choose from any of the dentists in the company’s network. In general, the premiums will depend on the insurance company, your location, and the plan you select.
As someone who requires dental insurance, you must always be mindful of waiting periods that sometimes accompany select dental services. If you desperately need advanced oral care, a dental plan with lengthy waiting periods might not be for you.
6 Dental Insurance Plans Without Waiting Periods
1) Delta Dental: This company offers no waiting periods for Type 1 diagnostic and preventative services, including exams and x-rays.
2) Humana: While some of Humana’s plans have no waiting period, others have a six-month wait for fillings and basic types of oral surgery.
3) Cigna: This company has no waiting period for services such as exams, x-rays, and cleanings.
4) Spirit Dental: This insurance company offers full coverage for all types of services, with no waiting period.
5) Denali Dental: Like Spirit, Denali offers a range of coverage without waiting periods.
6) Physicians Mutual: This company boasts policies with no waiting period for preventative care, and a three-month waiting period for basic services.
What Do Deductibles, Co-Pay & Co-Insurance Mean?
An insurance deductible refers to the minimum amount that must be paid before the insurance policy steps in. For example, if the deductible is $200 and the covered individual’s procedure is $179, the insurance does not kick in and the individual pays the entire amount.
Co-pays, which are a set dollar amount, may also be required at the time of the procedure.
Once a deductible is met, most policies only cover a percentage of the remaining cost. This is called co-insurance, and it typically ranges from 20% to 80% of the total bill.
How Does Dental Insurance Categorize and Pay for Procedures?
Most dental procedures covered by insurance policies are grouped into three broad categories; preventative, basic, and major. Most dental plans cover 100% of preventive procedures and 80% of basic procedures. Meanwhile, major procedures such as crowns and bridges are covered at a high co-payment, with the patient paying more out-of-pocket expenses. However, please note that every policy differs regarding how procedures are categorized.
What Does Dental Insurance Not Cover?
While this depends on the insurance company and provider you select, most plans do not cover cosmetic procedures.
While most medical insurance policies have yearly out-of-pocket maximums, the majority of dental policies cap the amount of annual coverage. Coverage maximums typically range from $750 to $2,000 per year. Generally speaking, the higher the monthly premium, the higher the yearly maximum. Once the yearly maximum is reached, patients must pay for 100% of any remaining dental procedures.
If you do not take full advantage of your yearly maximum, many insurance companies offer policies that roll over a portion of the unused annual maximum to the next year.
Dental Insurance Plan with No Annual Maximum
As mentioned, most dental insurance plans do come with a yearly maximum. However, providers like Humana have small one-time enrollment fees, no deductibles, and no maximums.
Apply Tax Credits for Dental Insurance
If your medical insurance policy does not include dental coverage, any leftover tax credit not used to pay for your family’s health insurance may be applied to pediatric dental insurance premiums. However, if your health insurance policy includes children’s dental coverage, you cannot use tax credits to buy an additional plan.
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, as poor health can lead to grave consequences over time. If you’re a senior without dental coverage, it is vital to weigh your options. We recommend going with a retiree health plan or a stand-alone dental benefits plan. However, if those options prove cost-prohibitive, preventative care should be sought at the very least.
Dental Insurance & You
Dental insurance may not be for you. 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, as many companies offer both dental and health coverage.
With every insurance product, you’ll need to shop around and find the best deal. Read the fine print of any policy to ensure that the plan will cover your preferred provider. Speak with the provider and ask any questions you may have before signing up for a plan. And always keep in mind that dental insurance usually costs between $20 and $60 per person, per month.
How to Get Dental Insurance
While many employers offer dental insurance as part of their benefits package, some Americans do not have that luxury. As there are limited options available on healthcare.gov, most Americans opt to obtain private dental insurance from a licensed insurance agent, or online. If you are self-employed or part of a trade association, inquire about the dental insurance coverage they may offer to members.
What to Look for from an Insurance Provider?
Naturally, this depends on your current situation and dental health. However, in most cases, those who require dental coverage from an insurance company, look for a track record of success, multiple plan options, a short waiting period, low premiums, and minimal exclusions.
How Much Is the Average Cost of Private Dental Insurance?
Private dental insurance premiums vary by provider, plan type, and coverage levels. While most subscribers pay between $20 and $60 per month for a basic dental plan, this amount may be lower or higher depending on the plan you select.
How Much Is Individual Dental Insurance Per Month for One Person?
Individual insurance policies generally cost more and are not seen as a cost-efficient option. While companies can acquire a “group discount,” individuals don’t have that luxury. Typically, individual plans entail an additional $15 more per month than those under group policies.
How Many People Have Dental Insurance?
There are about 70% of Americans with some form of dental benefits. Of the estimated 249.1 million Americans with coverage, 164.2 million people own private insurance. In 90% of these cases, the coverage is achieved through an employer.
What Percentage of Americans Don’t Have Dental Insurance?
Approximately 30% of American’s don’t have any form of dental insurance. This amounts to about 74 million people.
Best Dental Insurance Plans
1) Delta Dental Insurance
Delta Dental has been selling dental insurance for over fifty years. The company offers plans utilizing a comprehensive network of dentists and policies providing out-of-network dental coverage. The policies are open to both the public and small or large businesses.
2) 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.
3) Aetna Dental Insurance
Aetna offers affordable dental insurance to over a million Americans through PPO Plus and Aetna PPO plans, as well as a discount dental plan that varies by state. There are over 80,000 dentists in the Aetna provider pool to choose from.
4) Cigna Dental Insurance
Cigna is a health and dental insurance company that sells various PPO plans to over 15.2 million customers worldwide. A wide variety of dental procedures are accessible, and enrollees can pick from over 135,000 dentists in their network.
5) Humana Dental Insurance
Humana Health Insurance Company provides dental plans in all 50 states, Puerto Rico and the District of Columbia. Their PPO and DHMO plans can be purchased through an individual coverage policy or employer.
6) Metlife Dental Insurance
Metlife Dental is one of the top dental insurance providers in the United States. The provider’s PPO plan includes full-service coverage for retirees, and their dental network fees are generally 15-45% below community-average charges.
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.
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.