Q&A Dental
What Is Dental Insurance?
Dental Insurance provides coverage to help protect you financially from the high costs of dental care. Policies are separate from your primary health insurance, though some health insurers provide dental insurance plans.
Dental insurance may be offered to you as an employment benefit, or you can buy a plan from a dental insurance company.
How Does Dental Insurance Work?
Most dental insurance plans work like this:
- You pay a monthly premium.
- You may face waiting periods for some types of care, but preventive care (such as cleanings) often doesn’t have a waiting period.
- You may need a primary dentist in the insurance provider’s network.
- There may be an out-of-pocket deductible to meet before your plan covers a percentage of the out-of-pocket costs for care.
- Most plans have an annual maximum allowance.
- Your plan may require a copay for dentist visits.
- Most preventive care is covered 100% by the dental plan—this includes an annual exam, cleaning and X-rays.
What Does Dental Insurance Cover?
Dental insurance policies typically cover preventive services at 100%, but what they cover varies by plan. Some policies cover a percentage of the cost of basic services, while others cover some of the cost of both basic and major services.
Routine and preventive services
- Generally covered at 100% of the costs
- Cleanings and check-ups every six months
- Annual X-rays
Basic services
- Coverage percentage varies, but often 80% of the costs
- Fillings
- Simple extractions
Major services
- Coverage percentage varies, but often 50% of the costs
- Root canals
- Bridges
- Crowns
- Dentures
- Implants
What Dental Insurance Does NOT Cover?
Dental insurance generally doesn’t cover services like:
- Cosmetic dentistry that’s not medically necessary
- Bonding
- Non-essential veneer placement
- Missing teeth prior to insurance
Dental insurance may not cover the services below. Make sure to read the fine print if you’re interested in this dental work because there might be lifetime maximum benefits or waiting periods to get the services even if they’re covered:
- Teeth whitening
- Orthodontics or Braces – mostly for adults
- Fluoride Treatment for Adults
If your policy provides coverage for one or more of these services, it may be at a smaller percentage.