Do you want to maintain your dental health but can’t decide the best plan or best insurance provider? This article is the best guide for you then.
Dental insurance offers coverage that pays for routine checkups or accidental damages to your teeth. There are many plans that give comprehensive coverage, but the cost mainly depends on the plan type, number of people in the policy, provider, level of coverage, and state of residence.
The policyholders pay monthly or, in some cases, annual premiums for the range but that is not the only factor to consider when evaluating the cost of dental care. Individuals should also consider deductibles, copays, coinsurance, annual maximums to determine the average price of the policy you buy. This article is the best guide to get insight into the best dental insurance.
What is dental insurance?
The dental insurance pays your dentist for the dentist’s treatment. It covers the cost of routine checkups along with accidental damage to your teeth and covers preventive services like teeth cleanings, oral exams, and x-rays. Other insurance covers certain restorative or orthodontic services such as cavity fillings and braces.
The charges for the dental plan may include monthly or annual premiums or lifetime deductibles in addition to copayments and coinsurance. Generally, the cost for the dental services may be high, but with the dental insurance plan, you end up paying less with always having peace of mind for a preemptive backup plan. The dental insurance companies negotiate prices with the providers in the network, which helps keep the cost for your plans low.
Your health insurance program does not include the dental plan as it was separated a long ago. If you are receiving a health insurance plan through your employer, the dental insurance plan may be included as part of your employment package. Otherwise, you can also purchase it from a dental insurance company.
Some plans have a waiting period of some weeks before your coverage begins that may exclude the medical conditions before the plan. Some plans also offer a maximum allowance that insurers will contribute to the member’s dental expenses within a year.
What does dental insurance cover?
Generally, dental insurance policies cover some portion of the cost of preventive care that includes fillings, root canals, oral surgery such as tooth extraction, crowns, etc. They may also cover periodontics, orthodontics, the structures that support and surround the tooth, and prosthodontics, such as bridges and dentures.
As the converge depends on the insurance provider, procedures and care commonly covered by dental insurance include:
- 100% routine and preventive services: These services include dental x-rays, teeth cleaning, dental exams, dental sealants, and fluoride treatments.
- 80% of basic services: These services include tooth extractions, fillings, and root canals.
- 50% major services: Include dental crowns, dental bridges, dental implants, orthodontics, and some non-cosmetic veneers.
Teeth whitening and cosmetic procedures such as veneers that are not medically required are not covered in dental insurance plans. Some companies, however, may offer you to purchase add-on benefits that include teeth whitening too.
Dental insurance cost
The cost without the insurance may be high, but depending on your anticipated needs and the type of dental plan you choose, it is vital to select the best plan for you. The price of dental coverage consists of dental insurance costs, the factors that influence them, what you get in the plans.
While there is no way to estimate the exact dental insurance cost in the given year, there are some ways to determine the approximate amount you may spend on the plan. For instance, in 2019, the total dental expenditures in the United States were $143.2 billion. With a population of roughly 328 million, the average consumer would have spent $437.
Another helpful piece of data from the American Dental Association states that if you had dental insurance in 2015, you could expect to spend roughly $453 to $520, including premiums and out-of-pocket costs. Given the inflation in the calculation, which works out to around $529 to $606 in 2021. Ultimately, the actual annual costs depend on several factors, such as your policy type, your dental needs, and location.
Five sources determine the dental costs, including premiums, deductibles, copays, coinsurance, and annual maximums. Here is the description of each factor:
Premiums are the monthly or annual sum of money you pay to the insurance company to maintain your coverage. Here are some 2022 samples from different counties of the country that use the Affordable Care Act (ACA) marketplace:
- Travis County, Texas: $8.93 to $63.07/month
- Saint Johns County, Florida: $7.95 to $44.24/month
- Hawaii County, Hawaii: $18.06 to $52.06/month
Costs for the premiums vary within states because of the coverage variations and between the states because of differences in costs of living.
They are the costs you must contribute to the plan annually before your insurance helps with the rest. Here are 2022 dental deductibles from the same areas mentioned above:
- Traves county, Texas: $0 to $60
- Saint Johns County, Florida: $0 to $75
- Hawaii County, Hawaii: $0 to $150
Deductibles have inverse relations with premiums which means policies with higher premiums have lower deductibles and vice versa. Some policies don’t have deductibles, however.
Coinsurance is the percentage of care you have to pay after paying your deductibles. For example, Texas Essential Health Benefit plans which provide the ACA dental policies with the lowest premiums in Texas, cover 100% of preventive care after you are done paying your deductibles. However, they only cover 50% orthodontic care for children and 50% restorative care for adults.
This out-of-pocket money you pay to your dentist for the services that correlate to the price. For instance, some policies don’t offer copays for the preventive services but 20% to 50% copay on root canal procedure, which means if a root canal is costing you $1,500, you will pay $300 to $750 copay cost.
Annual maximums are the most that the insurer will pay in benefits. You are responsible for the dental costs for the rest of the year once your policy pays its annual maximum. For instance, the Texas Essential Health Benefits offer yearly pay of $1,000.
The annual maximums are only paid for the adults. This amount is opposite to your out-of-pocket maximums, which suggests that once you reach the out-of-pocket maximum, the insurance plan pays the rest of the costs for your dental treatment for the year.
Types of dental plans
There are several types of dental plans depending on out-of-pocket costs, benefits, deductibles, and so on. Which one you choose affects the price of your dental insurance. Following is the list of the type and their costs:
- Dental Preferred Provider Organization (DPPO): With DPPOs, you get a network of providers from which you can choose, as going out of the network will cost you more. DPPOs typically have deductibles, coinsurance and copays are typical for everything beyond preventive care. The members are subject to pay the lowest out-of-pocket costs while receiving the treatment from an in-network dentist. This out0of-pocket cost is the designated percentage of the reduced fee called coinsurance; the rest of the price is covered by the plan.
- Dental identity: As they don’t provide a network of providers or primary care dentists, they can cost you relatively costly. You are supposed to pay coinsurance for services once you pay your deductibles.
- Dental Health Maintenance Organization (DHMO): You are provided a network and no coverage outside of it. They usually have no deductibles or annual maximum and charge fees for non-preventive services. The dentist network size is relatively smaller than the DPPO, but the premiums are much lower with higher potential for savings.
- Dental Exclusive Provider Organization (DEPO): These dental plans also have concurrence and deductibles. You are not required to have a primary dentist, but to be covered, you must consult the dentists from within the provided network of providers.
- Dental point of Service (DPOS): These plans often have higher deductibles, premiums, and copays. You may see an out-of-network dentist, but you will pay increased costs.
- Discount plan: The discount plan includes a panel of participating dentists who charge discounted services; members are allowed to choose from the board, which gives them a wide variety of options where they pay directly to the dentists at the time of treatment; no paperwork is necessary. Discount plans typically have lower premiums than DPPO and Managed Fee for Service Plan.
Best dental insurance plan
If you have health insurance but are looking for dental coverage, you need to check for various options that will best suit your needs and budget. The best dental insurance plans are the ones that provide you access to a broad network of dentists, the potential for low premiums, and reasonable annual benefit maximums. When you search for the best dental insurance plan, make sure that you compare the plans, read the reviews from the customers, and know the details of each policy so that you make a well-informed decision.
Here is the list of the eleven best dental insurance plans from the best-known providers in the country with their specific services:
Delta Dental: Best for braces
Delta Dental offers comprehensive coverage options to its customers within one of the largest provider networks in the country. It is considered the best for braces because they provide different prices for orthodontic coverage for both children and adults.
If you consider getting your braces from Delta Dental, you can input your zip code to see which plans, rates, and benefits are available in your state. Currently, the company offers four plans:
- Delta Dental PPO
- Delta Dental PPO Plus Premium
- Delta Dental Premier
- DeltaCare USA (HMO)
A sample code provided for New York includes two plans with orthodontic coverage. Delta DeltaCare (DHMO) sets a fixed copayment fee while Dental covers 50% of the orthodontic care. With copayments, the out-of-pocket costs will vary from state to state.
They have extensive coverage to all 50 states of the country, Puerto Rico, and other US territories, which give access to every citizen in the country to reach Delta Dental. Their plans also qualify for the marketplace healthcare.org, where qualifying plans must offer pediatric benefits.
|Low NAIC complaint index||Available plans vary significantly from state to state|
|Available on federal and state exchange (marketplaces)|
|No waiting period on preventive services|
|Some plans include teeth whitening.|
Guardian Direct: Best for major work
Guardian work presents its plans in tiers; golden, silver and bronze. The premiums of the Bronze plan start from $22.26 a month that offer 100% preventive care coverage with no waiting period and 50% basic care coverage with a 6-months waiting period. The Silver and Gold plan, however, offers complete major dental care that includes crowns, oral surgery, complex extractions, partial dentures, and implants.
There is a requirement for paying deductibles for major dental coverage in-network. Unfortunately, the waiting period is 12-months, but the plan covers 50% of the coverage once the program begins. The limit is up to $1,250.
The limit keeps increasing once a year, and by the third year, it reaches $1,500.
|Has a network of 100,000 dentists||12-month waiting period for major work|
|PPO and DHMO plans are available||Well below average in J.D Power’s 2022 Dental Plan Satisfaction Study|
|Low NAIC complaint index|
|Premiums start at $20 per month in most states.|
Humana: Best value
The company is ranked the best value for its Loyalty Plus Plan. The Loyalty Plus Plans are expensive for different companies. Humana plans provide no waiting period and one-time deductibles under $30 per month in some states. There is no waiting period required for any services, including significant work, and the customer has only had to pay $150 deductibles once over the life of the plan.
Loyalty Plus Plan coverage increases with the time till you are a member of the plan, and preventive care is fully covered from the start. During the first year, the company covers 40% of the routine care and 20% for the major work up to $1,000 annual maximum.
By the third year of the membership, your coverage looks like this:
- 100% for preventive care
- 70% for essential dental services
- 50% for significant services with a $1,500 annual maximum.
In addition to the Loyalty Plus Plan, the company offers six different plans with varying prices and coverages, including a dental savings plan and preventive care plans.
|100% coverage for preventive services||High deductibles on some plans|
|Affordable, preventive care and dental savings plans||No coverage for implants|
|A broad network of participating providers||High NAIC complaints index in a lot of its state subsidiaries|
|Plan options with no waiting period on any services||No coverage for orthodontic care|
|Some plans include annual allowance for in-office teeth whitening|
Spirit Dental: Best for no waiting periods
Generally, dental insurance companies apply to wait periods on most of their services except preventive care. Spirit Dental, being one of the few providers in the market, enforces no waiting period for dental care, including treatment options like implants and dentures.
Unlike other insurance companies in the market, Spirit offers an annual maximum of up to $5,000, which is more than the average of $1,000. This is particularly beneficial for the people who may have to finance several significant services within a year, such as dentures, implants, and periodontal disease treatment. Other coverage highlights include two to three cleanings per year, out-of-network coverage, and a one-time $100 deductible.
|No upper age limit||Expensive premium rates|
|Coverage for implants and major services||$5,000 annual maximum is not available in all 50 states|
|Available in 50 states||Limited data on customer satisfaction|
|In-network and out-network coverage|
1Dental plan provides a dental discount plan that guarantees 15% to 60% at participating oral care specialists and dentists. Their network consists of 131,000 dental care providers through the Aetna Dental Access Network. Their three dental savings plans work as follows:
- Careington Care 500: It offers savings of up to 60%. The highest discounts are for preventive and basic care, which means you will save the most with general dentists.
- Dental Access: It offers a 15% to 50% discount on all procedures, offering the best savings with the best dental specialists
- Preferred plan: it combines the Dental Access and 500 Series Careignton at a discount. Customers get the highest savings at dentists and specialists and access to the broader provider network.
The charges to both Dental Access and Careington 500 costs members $99 an annual membership fee while the preferred plan prices $129 per year. If you want to pay every month, it will be expensive in the long run. Also, 1Dental charges a one-time $20 non-refundable setup fee on top of the membership fee.
All eligible dental services qualify for the flat-rate discount for whatever plan you choose, while the actual fee depends on how much the dentist charges.
|30 days money-back guarantee||$100 yearly membership fee|
|No deductibles, waiting periods, annual limits||Not dental care insurance, and all payments are out-of-pocket|
|Orthodontic discounts are available for both children and adults||Unavailable in Vermont and Washington|
Cigna: Best for seniors
Seniors looking to supplement their insurance can benefit from Cigna’s affordable Dental Preventive Plan. It has a vast network of 297,000 dental locations in the country that allow the members to access them from their nearby areas. The monthly premium starts from $19. Their plan includes two dental exams and cleanings a year, along with routine x-rays without deductibles and copays.
Cigna provides two comprehensive coverage options for preventive, basic, and restorative work:
- Cigna Dental 1000: The premiums in this plan start from $30 and provide annual maximums of $1,000 per person.
- Cigna Dental 1500: Premiums in this plan start from $35 and provide annual maximums till $1500. This plan includes orthodontic coverage
They provide immediate dental care to retirees and seniors who have lost employer-provided coverage, given that you had dental insurance in the past 12 months. Cigna relinquishes all waiting periods on restorative care, including cavity fillings and root canal.
|No waiting period for preventive care||12-month waiting period for major work|
|$1,500 annual limit on primary, major, and restorative services||6-month waiting period for primary care|
|Affordable, preventive plan||Extremely high NAIC complaint index in some of its subsidiaries|
|In-network and out-network coverage|
|Available in all 50 states|
DentaQuest: Best for routine care
DentaQuest is considered to be the best dental insurance service because of its prevention-focused oral health and plans that include complete coverage for routine care and no waiting period are there for preventive services. Personal Dental Plan covers 100% of the diagnostic and preventive services such as x-rays, checkups, and cleanings with starting premiums as low as $8 in some states.
The tiers such as Personal Dental Plan Basic and Personal Dental Plus add more coverage for restorative services, including fillings, extractors, oral surgery, and dental repairs. Personal Dental Plus offers the most comprehensive range with maximum benefit and coverage for complex dental work.,
DentalQuest also offers vision and dental benefits through personal insurance plans and federal and state marketplace. Access to out-of-network coverages depends entirely on the state of residence of the member.
|Affordable options for preventive and diagnostic coverage||Restorative work subject to a 6-month waiting period|
|Top position in J.D power’s 2022 Dental Plan Satisfaction Study||18-month waiting period on major work|
|Personal and state/federal marketplace plan available|
United Healthcare dental: Best for short waiting periods
The insurance companies which offer the plans with no waiting periods are relatively expensive, so UnitedCare’s Essential plan meets the needs of their customers by offering them preventive and basic care services with shorter waiting times while the plans are not that much expensive. With preventive care, there is no waiting period required while basic care has only a four-month waiting period. Some providers, however, make you wait for six months.
The premiums start from $24.56, and the plans include:
- Basic coverage: Include fillings and extractions while the policy covers 50% after four months. The plan coverage will increase by 80% by year two.
- Preventive coverage: offers 80% coverage from day one and the coverage reaches 100% by year two.
- No major work coverage
Although their Essential plan provides good coverage for the customers, besides that, they have added nine dental insurance plans. Most of these offered plans include preventive care with no waiting period. They also have plans with no waiting period having higher premium fees for preventive and basic services, coverage for implants, and orthodontic care for children and adults.
|Comprehensive coverage||Ranks below industry average in J.D’s power’s Dental Plan Satisfaction Study|
|Options at multiple price points||Above-average NAIC complaint index|
|Multiple PPO plan options||Not available in LC, CA, Washington, DE, DC, HI, MA, ME, ID, NH, MO, MN, NY, NM, NJ, ND, SD, RI, VT, VA, WA|
|4-month waiting period on basic services|
Denali Dental offers two dental insurance plans: the Denali Ridge plan and the Denali Summit plan. Denali Summit’s plan is beneficial for those customers who need complex care like implants, braces, bridges, and dentures. Coverage includes 100% for preventive care at the onset and 90% diagnostics, 60% major work, and providing $6,000 annual maximum by the fourth year of the plan.
Denali the Ridge plan includes slightly lower premium rates. The coverage includes 100% preventive care at the onset, 80% diagnostics, 50% major work, and a $2,500 annual maximum by year four. They don’t provide coverage for orthodontic treatments, however.
Both plans go off the track from the industry general standards in terms of preventive care benefits, covering two exams and up to four cleanings in a year. There are no waiting periods for any services, once the plan is approved, it gets into effect on the 1st or the 15th of the month.
|High benefit maximum||Limited data on customer satisfaction|
|One time $100 deductible||Very high premium rates|
|Comprehensive coverage||Not available in AK, MO, ME, KS, NH, NC, MT, SD, PA, UT, and WA|
Aflac: Best supplemental dental insurance
Aflac offers a variety of supplemental insurance products that are more comprehensive than the average plans offered in the market. These plans are for groups and individuals including accidents, cancer, short-term disability, critical illness, and vision insurance. The company divides its supplemental insurance plans into three tiers:
- Basic: $285 benefits payable
- Standard: $400 benefits payable
- Premier: $450 benefits payable
The policies of Aflac are designed to supplement your primary dental insurance and help you increase your savings when you consult your dentist. There is no network restriction but Aflac pays for your treatment of the covered services regardless of the provider you consult to.
As the policyholders pay to their health care provider, they can file an online claim to their insurers to receive a fixed reimbursement for the eligible services.
|Three plan tiers to choose from||You must file claims for reimbursement|
|No restriction of in-network providers, you go to the dentist of your choice||Dental insurance quotes are not available online|
|Direct deposit of reimbursed funds||It does not replace primary dental insurance|
|No 100% preventive care coverage|
DentalPlans.com: Best savings plans marketplace
DentalPlans.com presents a marketplace for dental discount plans and a smaller sum of dental insurance policies. They provide a network of 140,000 dentists and the discount ranges from 10-60% on most of the dental policies.
If you plan to buy a plan, you can search by dentists, procedures, and savings in order to compare the discounts you can get on each plan. For additional savings on some specific procedures not fully covered by the insurance plan such as orthodontia or implants, selecting the type of dental procedures will help you narrow down your choice.
Also, members have the option to purchase multiple discounts to use for separate providers. This helps you when your general dentists accept one plan while you need to see the specialists who work with a different discount plan.
|Price match guarantee||Sign-up is only available by phone|
|Plans activate within three days||Limited participating pharmacies for prescription card|
|Wide selection of dental discount plans||Not an insurance provider|
|Includes prescription discount card||A limited selection of dental insurance plans|
Other dental insurance plans to consider
Although the following list of insurers does not meet the criteria for the “best ones” their comprehensive plans are worth considering. Here are the pros and cons of each company that can be kept in mind when you plan to buy any of their plans:
|Low or no deductible options||DHMO plans are only limited to California, New York, Florida, Texas|
|PPO programs are active nationwide||Ranks well below the average industry average on J.D’s 2022 Dental Plan Satisfaction Report|
|DHMO and PPO plans available||The most affordable policy has a low annual maximum benefit of $750|
|DHMO plans cover 70% of orthodontic care for children and adults|
|No waiting period on preventive services||No orthodontic care coverage|
|Affordable preventive care plan||Limited coverage for basic and major services|
|3 PPO Plans|
|$1,000 annual maximum for all plan tiers|
|Premiums range from $25 to $57||50% orthodontic care is available for children only in their mid-tier plan|
|3 plan options are available||The preventive care plan has a very low annual maximum benefit of $750 with a $50 deductible|
|The maximum limit for the higher tier starters from $2,000 and increases to $2,500 the next year|
Smart health dental dental insurance
|Preventive PPO Plan without deductible||Preventive care plan a very low annual maximum limit of $750|
|Plans with no waiting period on major procedures||No quotes or premium estimates are available online|
|The national network of over 200,000 licensed dental providers|
|The underwriter has a low NAIC complaint index|
|No deductibles||No orthodontic coverage|
|Three plans to choose from: Preferred Plus, Standard Plus, and Economy Plus||No 100% coverage on preventive care|
|No waiting period on preventive care||A waiting period of 12 months for major work|
Cost of common dental procedures
The cost of dental procedures extensively depends on the location of the provider. Here are some statistics that can help you to have an idea of the most common procedures:
|Cost with dental insurance||Cost without dental insurance|
How to get dental insurance?
There are multiple ways to get dental insurance, most commonly from dental insurance companies and healthcare marketplaces. Most of the plans have easy and simple steps for online enrollment but some others may require you to speak with a representative to sign up.
The following steps can help you to get the right dental insurance policy:
- Assess your dental health requirements. Either you have healthy teeth that only need preventive care or do you anticipate restorative or major work?
- Determine your budget for your dental care plan
- Visit the comparison website to check the plans, prices, and discounts on healthcare.gov or other private marketplaces
- Look for 100-80-50 coverage that means the plan should cover: 100% coverage for preventive care, 80% coverage for basic care, and 50% coverage for major work
- Compare the cost vs. value of PPO, DHMO, direct reimbursement, and dental savings plans
- Evaluate premium rates, copays, deductibles, annual limits, and coinsurance
- Check the company of your choice from the websites such as state regulatory agencies, and the National Association of Insurance Commissions (NAIC) which registers and analyzes consumer complaint data from across the country.
If you are looking for some preventive care or major work for your dental health, dental health insurance policies can help you in a great manner. The providers take care of the needs of their customers and offer the policies that best suit their health requirements and budget. There are many types of plans available with different dental insurance providers that give you a list of plans to choose the best one for you.
The procedure to get the plan is simple and easy through online steps. You can compare the plans from different websites to check the prices, policy options, and discounts. The best policies to choose would be the one that offers 100% coverage for preventive care, 80% coverage for basic care, and 50% coverage for major work.