What Does Dental Insurance Cover?
Most dental insurance plans cover the costs of preventive care, including routine exams, cleanings, and x-rays. Some may also offer coverage for certain basic restorative services like fillings, but you may pay more. It is important to understand what dental insurance covers to help you select the right plan.
There are stand-alone, comprehensive dental plans that offer broader coverage. While they may not cover 100% of the costs – they do include preventive care and most basic and major dental procedures.
Coverage may include:
- Crowns, root canals, and surgical extractions
- Dentures, dental implants, and veneers
- Braces, clear aligners like Invisalign, and other orthodontic treatments
Know that with some plans, dental procedures beyond preventive care may require a waiting period.
What Does Dental Insurance Cost?
Depending on your state and how much coverage you want included in your plan, rates will vary. The many options available for dental coverage make balancing budget with coverage more flexible. For more benefits and available services, along with lower copays and deductibles, you may pay a higher premium. While for lower premiums you may have higher out-of-pocket costs at time of service.
Premium – what you pay monthly for your plan
Deductible – what you may need to pay before the plan pays
Copay – what you pay with every visit to a dentist
Coinsurance – the percentage of costs you pay after you meet your deductible
Annual maximum – the most your plan will pay for coverage in a plan year
What Are The Types Of Dental Plans?
While every dental plan is different, there are two main types:
1. A medical plan that includes dental benefits, which is convenient, but may have coverage limitations.
2. A stand-alone dental insurance plan, which offers more flexibility and more coverage options.
Some of the benefits of a stand-alone dental plan may include no dental insurance waiting periods so you can receive preventive care right away. Many stand-alone dental plans may also include low deductibles, no copays or no additional costs for preventive care.
Consider Networks When Selecting A Dental Plan
Dental insurance plan networks vary by the availability of dental providers. Some plans offer broad networks, others are more restricted, but may cost less. Consider what type of dental insurance plan network meets your coverage needs while also fitting your budget.
Preferred Provider Organization (PPO)
- PPO dental insurance provides a list of preferred dentists within the plan network.
- You can go out of network if you do not mind paying extra for a favorite dentist. However, you will pay a deductible, and a higher coinsurance.
Dental Health Maintenance Organization (DHMO)
- DHMOs provide a network of dentists that have agreed to set dental insurance rates, including copays, but you are limited to in-network dentists.
- DHMOs have no annual benefit maximum or a deductible. Some procedures have zero out-of-pocket costs.
Indemnity or Fee-for-Service Dental Plans
- Fee-for-service dental plans make all dental providers available.
- You pay a percentage for a specified dental service — the plan pays the rest. The percentage you pay depends on the procedure.
Why Dental Insurance Matters For The Whole Family
Family dental insurance provides more than just bi-annual exams. It includes comprehensive dental health benefits for family members of all ages.
Dental insurance for kids covers the potential need for braces, coverage for dental injuries due to sports activities, and enhanced preventive care with fluoride treatments, sealants, and space maintainers. With so many options, you may want to ask your dental plan insurer what coverage options are available to help protect your children.
Older adults in the family may be prone to dental health issues that come with aging. Having a plan covering some of the costs for gum disease treatment, dentures, crowns, and implants can help to take care of older family members.
Depending on the plan, you may also receive popular dental services that will brighten the smiles of the whole family, including cosmetic teeth whitening and composite white fillings. With all of its wellness advantages, a dental plan is worth it for you and your family.
Anthem offers a variety of affordable dental insurance plans that fit you, your family, and your budget. Let us help you compare plans today.