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Dental Insurance - Understanding Coverage, Costs, and Options for Dental Care

What You Need To Know Before Purchasing Dental Coverage.

Premiums, deductibles, annual caps, waiting periods, PPOs and HMOs, co-pays – yes, choosing dental insurance can be complicated. You want coverage that doesn’t take a huge chunk out of your monthly budget and provides affordable preventive and restorative dental coverage when you need it. Here’s how to find your plan.
Affordable Dental Insurance

How Does Dental Insurance Work?

Dental insurance plans are intended to reduce the cost of dental care. Providers typically negotiate lower fees with in-network dentists, and also pay ("cover") a percentage of the reduced fee. You pay the rest out of pocket. Here’s how the savings break down:

  • Preventive: Dental insurance plans typically cover 100% of the cost of preventive care, which includes annual checkups, bitewing x-rays, and routine cleanings.
  • Basic: Most insurance plans cover 80% of the cost of "basic," uncomplicated services, such as fillings, simple extractions and some types of deep cleanings.
  • Major: Dental insurance typically covers 50% of treatments such as root canals, crowns, bridges and dentures.

Simple, right? Yes, but you also have to factor in waiting periods, copays, annual maximums, and your oral health needs.

Understanding Dental Insurance Terminology

Annual Maximums & Coinsurance
  • Annual maximum: The amount your dental insurance plan will pay annually toward your cost of care
  • Coinsurance: A percentage of the cost of a dental service that you pay out-of-pocket
Copays & Deductibles
  • Copay: A flat fee you pay for a dental service covered by insurance
  • Deductible: The amount you pay out-of-pocket before your coverage begins
In-Network & Premiums
  • In-network: Dentists who have a contract with your dental insurance company
  • Premium: The amount you pay each month for dental insurance
Pre-existing conditions & Waiting periods
  • Pre-existing conditions: Any dental problems that you had before getting insurance
  • Waiting period: The length of time – six months to a year – that must pass before basic and major dental procedures are covered by your dental plan

How Much Does Dental Insurance Cost

Costs vary according to the type of dental insurance you choose and the coverage it offers. Here are some examples:
Aetna Dental Direct Preferred PPO Aetna Dental Direct Preferred PPO
Plan covers preventive
and restorative care

Cost starts at $24.27 a month

View Plan

Delta Dental PPO Individual Premium Plan Delta Dental PPO Premium
Plan covers preventive care and restorative care, including braces and dental implants

Cost starts at $25.15 a month

View Plan

Humana Complete Dental Insurance Humana Complete
Plan covers preventive
and restorative care.

Cost starts at $37.99 a month

View Plan

Renaissance Dental Insurance Plan III Renaissance Dental Insurance
Plan covers preventive
and restorative care.

Cost starts at $35.60 a month

View Plan

Other things to consider when searching for dental insurance.

Look at a plan’s annual spending maximum, the type of insurance plan, waiting period,
and what procedures the plan covers as well as how that coverage aligns with your dental care needs.

Does Dental Insurance Cover?

Missing Tooth Replacement?

Dental insurance plans may not cover the costs for some treatments, no matter how long you wait – such as replacing a tooth that you lost prior to purchasing the policy or dental work that is already in progress. Look for the “missing tooth” clause (yes, that’s what its typically called) when you are reviewing plan details.

Cosmetic Treatments?

Most dental insurance plans do not cover elective procedures such as teeth whitening or porcelain overlays.

Dental Implants?

Typically, no, since there are less-expensive ways of restoring missing teeth. But some plans, like Cigna Premium, do cover dental implants.


Some dental insurance plans do. But check the annual lifetime coverage limit for orthodontics and ask your dentist/orthodontist for a cost estimate. You may be able to save more money on braces with a dental savings plan.

Dental Insurance Coverage
Dental Insurance Worth

Is Dental Insurance Worth It?

It depends on your dental care needs, and how you pay for dental insurance.

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