Dental Insurance

 

Good oral health is important for your overall health – dental insurance can help!

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A dental insurance plan can be a good way to avoid paying out of pocket for a major dental procedure, such as a root canal.

While costs vary depending on where you live and your specific circumstances, expect to pay anywhere from $300 to $2,500 when trying to anticipate the costs of a major procedure like a root canal and filling.[1]

Dental Coverage is an ACA-Mandated Essential Health Benefit for Kids

Pediatric services, including oral and vision care, are part of the 10 essential health benefits for children 18 years of age and under.

Adults, however, must obtain dental insurance if they want coverage and don’t have it through an employer.

Quote and enroll now to compare dental health insurance plans and costs.

What Does Dental Insurance Cover?

Dental plans typically cover four categories of services: preventive, diagnostic, basic and major care.

The list below includes examples and is not a complete list of coverages, exclusions and limitations.

Individual plans vary, so you’ll want to read the plan details closely to validate the coverage and benefits you’ve selected and limitations and exclusions that apply.

 
What Dental Insurance Covers
  • Cleanings + checkups

  • Extractions

  • X-rays

  • Fillings

  • Crowns, bridges + root canals

What Dental Insurance Does Not Cover
  • Anything after the plan’s annual maximum benefit amount has been reached

  • Elective cosmetic procedures (e.g., tooth-whitening)

  • Orthodontics (e.g., braces)

  • Implants

  • Prosthodontics (dental prostheses)

  • Oral care related to a medical condition (e.g., TMJ)

  • Prescription drugs + analgesia pre-medication

Have a specific coverage question?

Contact us speak with an advisor now

Pros and Cons of Dental Insurance

 
Dental Insurance Pros
  • Guaranteed issue – All applicants aged 18 to 99 are accepted regardless of health history (however, rates are based on age and location).

  • Covers pre-existing conditions – With the exception of missing teeth in some cases.

  • Apply year-round – There is no official open enrollment period and, in most cases, coverage begins the next day after you enroll online.

  • Flexibility – An indemnity plan affords you more provider options. A PPO plan can help lower your out-of-pocket expenses by using an in-network provider. Either way, it’s your choice.

  • Options for every budget – Varying amounts of coverage range from 50% to 100%, which means you can find a plan with the level of coverage you need at the right monthly premium rate for your budget.

  • Low deductibles – With annual deductibles generally under $200[2], most people will be able to access their dental plan’s full benefits without paying a significant amount out of pocket first.

Dental Insurance Cons
  • Waiting periods – You may have to put off dental services until you’ve had your plan for 6-12 months to take advantage of your benefits for certain services like fillings and root canals.

  • Calendar-year maximums – Unlike ACA plans that don’t have annual maximums for essential health benefits, dental plans have annual caps on how much the plan will pay per year (e.g., $1,000). Even with dental insurance, you will be responsible for the costs of services that exceed the annual limit.

  • Not ACA-qualifying major medical coverage – Dental insurance is a form of supplemental health insurance, not ACA-qualifying major medical coverage.

Legal Disclaimer: The above list is not a complete list of pros and cons.

Think dental insurance may be right for you?

Get an instant quote and select a plan that meets your needs.

Who Should Get a Dental Insurance Plan?

A dental insurance plan may be a good option if you:

  • Don’t have dental benefits through your employer

  • Have purchased an ACA major medical plan in the private market or from HealthCare.gov (these plans don’t include dental coverage for people over 18 years of age)

  • Are enrolled in a non-ACA alternative health insurance policy and want additional supplemental private dental insurance to round out your coverage

How Dental Insurance Works

1

You pay a monthly premium to maintain your dental plan.

2

When you obtain services from a provider, present your dental insurance card and pay your office copay (if that’s part of your plan).

3

Your dentist bills your insurance company and the company pays their percentage, then bills you for the remaining balance that you owe (including your deductible if applicable). 

Ready for help with your dental bills?

How Much Does Dental Insurance Cost?

Dental insurance is affordable. For example, a 41-year-old woman in Phoenix, Arizona, can get a dental insurance plan for:

  • $28.13 - $43.11 monthly premium
  • $50 deductible
  • $0 - $20 copay
  • $1,000 - $1,500 annual limit[3]

Find out how much it will cost you each month to cover your mouth.

3 Ways to Get Started with a Dental Insurance Plan

Get an Instant Dental Insurance Quote

Speak to an Agent

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Save on Healthcare Costs – Learn More at Our Blog

by Jenifer Dorsey September 7th, 2018
by Jenifer Dorsey September 6th, 2018

[1] Glover, L. (2016). How Much Does a Root Canal Cost? - NerdWallet. NerdWallet. Retrieved 15 August 2018, from https://www.nerdwallet.com/blog/health/how-much-does-a-root-canal-cost/

[2] Ibid

[3] Health eDeals Marketplace Quote, 8/15/2018. Plan options and premium vary by state.