Is an Individual Dental Insurance Plan Right for You?
If you and your family do not have access to dental insurance through an employer,
you might consider buying your own coverage. This article provides the basics when
it comes to understanding individual dental insurance.
What is individual dental insurance?
We purchase health insurance to help pay for preventive health care as well as unexpected
medical expenses. Dental insurance serves a similar purpose. It helps individuals
and families with the cost of dental care—the routine and the unplanned alike.
For a monthly fee, which is known as a premium, you gain access to benefits for
oral health services such as exams, cleanings, fillings, and so on. As with health
insurance, you will be responsible for meeting a deductible before certain benefits
kick in—preventive care benefits, such as routine exams and cleanings, are not typically
subject to the deductible. You may also be responsible for an office visit copay,
coinsurance, and any charges not covered by your dental plan.
Be sure to note that dental insurance and dental discount plans are not the same
thing. Click here to learn the difference.
What benefits do dental plans include?
Dental insurance focuses heavily on preventive care. Most basic plans cover two
routine oral exams and professional cleanings per calendar year, as well as one
topical fluoride application annually for children under 19, at 100 percent. Some
even cover sealants and diagnostic care such as intraoral occlusal film and X-rays
100 percent at certain intervals.
Additional benefits for basic care (e.g., extractions, fillings, denture maintenance)
and major care (e.g., crowns, bridges, dentures, oral surgery) are typically subject
to coinsurance. Your plan will pay a certain percentage of costs, and you will owe
the remainder. For instance, if your bill is $100 and the services you received
are covered at 80 percent, your plan will pay $80 and you will owe the remaining
$20. This percentage varies depending on the plan you select and the type of services
(e.g. basic or major) received.
Dental insurance does not usually include benefits for specialty care such as orthodontics.
However, some carriers may offer related discount programs, which can be added on
to your coverage for a small charge.
Depending on the carrier and plan, your coverage may come with extras such as vision
care discounts and discount prescription drug cards. To fully understand the benefits
of dental insurance you are considering or coverage you already have, read the plan
information carefully and be sure to ask questions.
How much do individual dental plans cost?
Dental insurance plans range in price, depending the benefits you select. At sites
such as dentalinsurance.org, monthly premium rates may be as low as $15 per month.
Again, you will also be responsible for a deductible, any applicable office visit
copays, the amount due after coinsurance for services not covered at 100 percent,
and the full amount for any services not covered at all.
Basic dental plans usually translate into lower monthly premiums and higher out-of-pocket expenses. More robust coverage will often result in a higher monthly premium and lower out-of-pocket expenses.
Who should buy dental insurance coverage?
Practically anyone who does not have access to coverage through an employer. Dental
insurance is a primary indicator of access to dental care in the United States,
according to findings from the Centers for Disease Control and Prevention’s 2008 National Health Interview Survey. In other words, people
who have it are more likely to visit the dentist. Professional dental exams and
cleanings, in addition to brushing and flossing, are an important part of maintaining
healthy teeth and gums.
Individual and family dental insurance plans can be a smart option for those who
- Employed part-time and don’t have access to employer benefits
- In college
Where can I buy dental coverage?
Under the Affordable Care Act, pediatric dental and vision benefits are considered
essential health benefits that must be included in health insurance plans. This
benefit is available on and off the exchange in one of three ways—embedded in a
health insurance plan, bundled with a health insurance plan, or offered as standalone
coverage. Read “How Obamacare Will Impact Kids’ Dental Access,” to learn
Depending on where you live, your state’s health insurance exchange may offer dental
insurance plans for adults as well. You may also buy coverage directly from a carrier
(e.g., IHC Dental, Delta Dental), through an insurance agent or broker, or by using
a website designed to help you find plans and obtain quotes from multiple carriers
It is important to consider the dental needs of everyone who will be covered under
the policy and not base your decision on monthly premium alone. To learn more about
shopping for affordable coverage, read “How to Find Dental Insurance as Low as $15 per Month.”
Get a free quote in seconds—no contact information required until you apply—at dentalinsurance.org
. Need help choosing the right
dental insurance plan? Talk to a dental insurance advisor at