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What does dental insurance cover?

Chelsey Tucker graduated with a Bachelor of History degree from Metropolitan State University in 2019. She now writes about insurance with her specialty being life insurance and has been quoted...

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Dan Walker graduated with a BS in Administrative Management in 2005 and has been working in his family’s insurance agency, FCI Agency, for 15 years. He is licensed as an agent to write property and casualty insurance, including home, auto, umbrella...

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UPDATED: Mar 19, 2020

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What Does Dental Insurance CoverThere are many different dental insurance plans that offer a wide variety of benefits. In general, dental insurance covers your routine dental care (regular checkups, cleaning, and other preventive services) as well as more serious procedures such as implants and crowns.

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Many people do not worry as much about dental insurance as they do about health insurance. This is because dental issues do not have as high a chance of totally breaking your bank as do many major health problems.

Also, many dental emergencies are actually covered by health insurance (such as falling and getting your teeth knocked out).

Many employers do not automatically provide dental insurance, even when they do provide health insurance; they have either dropped dental coverage because of the general increase in the cost of healthcare, or have made the employees responsible for the premium.

Dental insurance is definitely worth thinking about, however, because while the routine care can be inexpensive (relatively speaking) there are very expensive costs associated with aspects of dental care that most people would not want to be fully responsible for.

The Typical Dental Plan

Most plans will offer a network of dentists where the individual can get care. A typical plan will offer a maximum monetary benefit somewhere between $1000 and $1350 a year. General (diagnostic) and preventive care is usually totally covered (100%) by the plan, though there may be a small co-pay, depending on the policy.

A basic policy will most often cover 80% of maintenance and cleaning visits, as well as denture repair, and will cover 50% of fillings, oral surgery (such as pulling a tooth) and root canals. There is usually a waiting period of a certain amount of months before the insurance will cover the more major work.

They  do this to make sure that people are not simply signing up for insurance just to get something serious taken care of. Sometimes this waiting period is as low as three months; sometimes the person has to wait at least twelve. The policy will not usually cover cosmetic dental work, such as braces, veneers, or teeth whitening.

Getting general care such as cleaning, check-ups, and X-rays with your policy alone can save you up to $400 a year. That might be enough to pay for the policy itself.

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What Dental Insurance Does Not Cover

You will be hard pressed to find any insurance company that covers cosmetic dental work, including braces. Why is this? Orthodontics are a huge expenditure that kids often need that costs several thousand dollars.

Insurance companies don’t cover this because the insurance policies are designed mainly to help prevent dental emergencies (in the form of routine and preventative care) and to help in the event those dental emergencies do occur. They do not usually consider orthodontics preventative care. Will they cover it if someone needs braces more for a health reason than a cosmetic reason? Possibly; you’ll need to check your individual policy.

Some companies offer supplementary orthodontics insurance, however, to help with the cost of braces. A good policy may cover half of the cost of putting on and maintaining the braces.

Things to Think About

When you are considering purchasing a new dental insurance policy, there are many things you’ll want to consider before settling on one. Here are some of the questions you may want to ask:

  • Who will be covered?
  • Will your plan cover your children who do not live in the house with you?
  • Are college aged children covered?
  • Are there in network doctors close to you?
  • What is the deductible, and is it for the entire policy or for each person named in the policy? It may or may not make sense for you if you have to pay $500 for each of the six people on your policy, or something, before you get a $1000 benefit.
  • What is the waiting period or how long do you have to wait until your policy goes into effect?
  • Will you have to switch dentists, or will your policy let you continue to visit your current dentist?
  • How many cleanings are covered yearly?
  • Does the policy cover fluoride treatments or any orthodontic care?

All policies will be slightly different and you will want to sit down and think about what are the most important things on your dental agenda. Some people view dental insurance as a way to slowly prepay for the routine annual cleanings, and that is enough motivation to get the insurance. Others require a bit (or a lot) more from their policy. Think about what is important to you!

Use the free online quote tool on this page to get the best insurance rates fast. Within minutes, you will have a good idea about what your dental insurance options are, what kind of coverage you can get, and what your rates may be.

Go to the free tool, enter your zip code and compare dental insurance quotes today!

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