How does dental insurance work?

Dental insurance provides a benefit payment for a designated set of covered procedures related to teeth and gums, as outlined in your plan’s Schedule of Benefits. Reviewing your Schedule of Benefits enables you to plan how and when to receive care by showing:

  • What services are covered
  • What your out-of-pocket costs will be
  • Whether benefits vary based on selecting an in-network or out-of-network provider

Depending on the plan you select, your policy may include:

  • Annual maximum – the maximum amount your plan will pay towards covered services in a calendar year
  • Co-pay – a fixed amount you pay each time you visit your dental provider
  • Co-insurance – the portion of each covered service for which you are responsible to pay
  • Deductible – the amount you must pay before the plan provides payment for covered services
  • Waiting period – the amount of time you must wait before your plan will pay for diagnostic, basic and/or major dental procedures. Waiting periods vary by state.

Note that routine preventive services, such as exams and cleanings, may not be subject to your plan’s deductible. Learn more about how dental insurance works.