A routine dental visit can cost over $100. If they find a cavity, expect the cost to triple — at least.
You might expect dental insurance to be included in your health insurance package, but dental insurance is a separate product. It can sometimes be purchased along with your health insurance. If your health insurance program through your employer doesn’t offer dental coverage, or only offers it as an add-on paid out-of-pocket, you’ll need an affordable solution.
Quick Look: The Best Affordable Dental Insurance Providers
- Delta Dental
What is Dental Insurance?
Similar to health insurance, dental insurance can reduce your cost for dental care. In exchange for a monthly premium, your dental insurance can cover many dental-related expenses or often provides dental services for a fixed fee or fixed percentage of the cost.
One notable difference between health insurance and dental insurance is that health insurance typically utilizes a maximum out-of-pocket cost for the coverage period. The coverage period usually lasts a year and your health insurance will pick up the tab for approved healthcare claims after that.
Dental insurance often works in the opposite way. Most plans provide maximum coverage for the coverage period (usually a year), after which the consumer picks up the remaining cost.
With dental insurance, there is no limit to your potential out-of-pocket costs, which makes choosing the right plan essential. Some insurers offer plans with no maximum benefit limit. However, many of these plans are discount plans or fixed-rate plans that use a pricing schedule for routine checkups and dental procedures. Some may also be HMOs, which can limit your choices.
Without insurance, the cost of a routine cleaning averages $125 and filling a cavity can cost $200. A crown can set you back over $1,000 and braces cost an average of nearly $5,000. The right dental insurance plan can help make these expenses more affordable.
Can I Buy Dental Insurance Through the Marketplace?
Some insurers offer dental insurance plans through the Marketplace at healthcare.gov. However, not all insurers participate in the Marketplace. Also, you’ll only be able to purchase dental insurance if you’re also buying health insurance through the Marketplace simultaneously.
If you need both health insurance and dental insurance, the Marketplace can be a good option. You’ll need to be within the open enrollment period, however. There are many comparable plans that you can purchase outside the Marketplace with no buying restrictions.
Dental Insurance Terms
When buying dental insurance, you’ll encounter many important terms.
A premium for dental insurance is the amount you’ll pay for your policy for coverage for a set period. Typically, premiums are divided into monthly amounts for easier payments. In the insurance world, a premium payment is necessary to bind coverage. If premiums aren’t paid, the policy is subject to cancellation.
- Deductible: The deductible is the part of the insurance claim that you pay, although there may be other expenses as well. For both health insurance and dental insurance, the deductible is a cumulative amount.
- Dual coverage: You might be covered by 2 dental plans, or you might have purchased an indemnity plan to complement your existing dental insurance. These plans can work together to reduce your costs but your coverage can’t exceed 100% of your expenses. In some cases, the dual coverage may be further limited.
- Maximums: Maximums refer to the most an insurer will pay during a coverage period. Once you reach your maximum benefit, the insurer won’t pay any additional costs during the benefit period.
- Coinsurance: If your plan uses coinsurance, this means you’ll pay part of the costs on a percentage basis. The insurer pays a percentage and you pay the remainder.
- Copayment: While similar to coinsurance, a copayment is usually a fixed dollar amount for a specific dental service, as opposed to a percentage of the cost. In this case, you pay the copayment and the insurer pays the balance.
- Exclusions: Every insurance policy has exclusions. For dental insurance, exclusions refer to types of dental services that won’t be covered. As with all types of insurance, check the exclusions on your dental insurance policy carefully before buying a policy.
Using an HSA with Dental Insurance
If you have a qualifying High Deductible Health Plan (HDHP), you may qualify for a Health Savings Account (HSA).
The money you contribute to your HSA is tax-free (within IRS limits) and can be used to pay health expenses not covered by health insurance. This includes dental expenses, like deductibles, or even vision expenses. Your HSA funds can’t be used to pay insurance premiums, however, except in special situations defined by the IRS.
Funds within your Health Savings Account that you don’t use within a given year can be rolled over to the next year, providing a tax-free way to save for future health expenses.
DHMO vs DPPO vs Dental Discount Plans
Dental insurance comes in many types, some of which aren’t insurance at all, like discount dental plans. Some of the primary types you’ll see include:
A DHMO is a Health Management Organization designed specifically for dental health needs. DHMOs are often more affordable than DPPOs, which we’ll discuss next. Your coverage is limited to in-network providers. Often, there’s no deductible for DHMO plans. However, expect to pay a copayment for most services.
A Dental Preferred Provider Organization (DPPO) provides greater choice, meaning you can choose your own provider, but premiums are usually higher than with DHMOs. If you use an out-of-network provider, you may have to handle the claim paperwork yourself.
Coinsurance costs, where you pay a percentage of the bill, are often higher for out-of-network services as well.
Dental Discount Plans
As an option that’s growing in popularity are dental discount plans. They offer a schedule of discounts for dental services, including cosmetic dentistry which often isn’t covered by traditional dental insurance.
Dental discount plans don’t have premiums. Instead, expect to pay an annual membership fee. Participating dentists honor the discounted rates negotiated for the plan and you pay the dentist directly.
If your dental health is in good shape, a dental discount plan may be a way to avoid paying pricey monthly premiums. A dental discount plan can also help you sidestep lengthy waiting times common to traditional dental insurance plans.
Dental Indemnity Plans
Another option available to consumers is a dental indemnity plan. These plans work by reimbursing you for a fixed amount of dental expenses depending on the type of dental services you had performed.
The initial transaction is between you and your dentist. After you’ve made a payment, submit a claim and the indemnity insurance provider reimburses you, in part, according to the terms of your coverage. In many cases, dental indemnity coverage is purchased to supplement existing coverage because the reimbursement amount is often a small percentage of the total cost.
What to Look for When Buying Dental Insurance
Like many things in life, price isn’t everything. A plan with a low price may leave you on the hook for many routine expenses or may require that you cover some larger expenses out-of-pocket. Many plans will provide coverage for bi-annual exams — which are key to catching problems early. However, many plans also don’t provide 100% coverage for additional dental work, like fillings or crowns.
If you don’t have much in savings, opting for a plan that pays a higher percentage for common services may be the best choice to avoid taking on debt for dental expenses. If you’re willing to take on some financial risk yourself, a plan with lower premiums may be a fit.
Be aware that you’ll often have to pay a larger share and some services covered elsewhere may not be covered at all. The good news is that dental care isn’t likely to run up a 5 or 6-figure bill as can happen with other healthcare needs.
Coverage exclusions matter. Some dental insurance plans don’t cover services you might expect to be covered, like certain expensive root canals or cosmetic options. You may not care if you get a stainless steel cap instead of porcelain, but a surprise bill for a $1,600 root canal might break the budget. Read the exclusions carefully before signing up for a dental insurance plan.
Coverage limits matter. Some dental insurance plans provide an unexpectedly low maximum coverage limit, sometimes well under $2,000 for the year. If you’re not in a strong savings position, a plan with a higher maximum benefit provides a bigger safety net.
In general, less expensive plans are less expensive because they provide less coverage or require you to pay more for many dental services. When choosing a dental insurance plan or a dental insurance plan, investigate the coverage of services you expect you’ll need.
A less expensive plan can become a more expensive plan if you have to pay for costly services yourself. The same is often true for discount dental plans, with plans that charge a larger membership fee often offering more aggressive discounts for dental services.
Best Dental Insurance Companies
As with health insurance, many dental insurance providers or discount dental plans aren’t available in all states. Below are some standouts in a crowded field, each with a unique value proposition that benefits consumers.
It’s rare to find a provider that offers coverage in all 50 states. Delta Dental is nearly everywhere in the US, including Puerto Rico and other US territories through its network of affiliate companies. Delta is also the nation’s leading dental insurance provider.
With several customizable dental plans, Delta has a coverage solution for most households. Among its offerings, Delta provides many of the plan types discussed earlier, including DHMO, DPPO, and discount plans. This makes one-stop shopping possible if you’re not sure what type of plan you want to buy.
Delta provides a set out-of-pocket expense for many common procedures, creating more transparency, which can make budgeting for dental expenses easier.
As the largest health insurance provider network, it’s no surprise that UnitedHealth is also a leading provider of dental insurance plans. While among the more affordable options for dental insurance, UnitedHealth does come with some potential drawbacks.
Some services have long waiting periods for coverage eligibility — sometimes up to 6 months. Some pre-existing conditions may not be covered.
A range of plans available through UnitedHealth include lower cost plans with copays for routine visits to more comprehensive plans that cover 100% of preventative care dental visits. Expect a $50 per person deductible, which caps at $150 per family, making UnitedHealth worth a closer look if you have a large family that needs coverage.
Humana is among the better values when shopping for affordable dental insurance coverage.
One standout feature is that Humana offers coverage that increases over time.
This annual increase applies to both maximum coverage limits as well as the percentage paid for certain dental procedures.
As with all insurers, be sure to read the fine print before purchasing coverage.
Some of Humana’s plans don’t cover orthodontics, for example, which can be a big consideration for a growing family. Check out Benzinga’s guide to orthodontic insurance for more information.
If you need coverage for braces — and you don’t live in New York or Washington — Cigna may be a good choice for you. This insurer provides partial coverage for orthodontics as well as 100% of preventative care.
Coverage for fillings may not be as generous as with other providers but big expenses, like root canals, are often covered with a larger percentage than many competitors.
Cigna’s website is easy to use and clearly explains the benefits of the company’s plans. Expect a smaller provider network than you’ll find with some competitors but with over 85,000 participating dentists, it’s likely that you’ll find a Cigna dentist near your home.
If you have healthy teeth and you’re looking for a way to take the sting out of occasional dental needs, Aflac is worth considering. Aflac dental insurance plans are indemnity plans, meaning the insurer will reimburse you for a fixed amount. This depends on the dental services you have performed.
Aflac might be the best fit for single individuals or those who are self-employed and don’t have frequent dental needs. Expect a waiting period for coverage for some procedures, a drawback common to other insurers as well.
Coverage is limited to reimbursements and nothing is covered 100%. Aflac can be among the more affordable options for dental insurance. Choose from three plans: Basic, Standard, or Premier, with the top plan offering the highest percentage reimbursement.
Choosing the best affordable dental insurance can seem like a contradiction in terms, but it really isn’t. Affordable coverage is available but you’ll have to read the fine print to be sure the plan you’re considering matches up well with your family’s needs.
If the kids will need braces, or you suspect you might need a root canal, look at companies that provide better coverage for these expensive services — but expect a waiting period before you’re eligible. If your dental needs are less extensive, a dental discount plan, possibly combined with an HSA, can be a more affordable option overall.