Dental Insurance
Finding the Plan that Fits
Dental insurance covers issues related to the teeth, gums and preventative care such as annual cleanings. Not all procedures are covered such as cosmetic procedures like crowns or whitening. There are deductibles, co-pays, and co-insurance that applies with most dental plans. And many policies have annual coverage maximums that are relatively low.
What is the cost of a dental plan?
Although the monthly premiums will depend on the insurance company, your zip-code and the plan you choose, for many, the monthly premium will be around $50. Similar to other insurance, premiums are paid even if you don't get any work done.
Waiting period for dental insurance
Most dental insurance policies have waiting periods ranging from six to 12 months before any standard work can be done. Waiting periods for major work are typically longer and can be up to two years. These periods are set in place by insurance companies to guarantee they profit off a new account and to discourage people from applying for a new policy to cover impending procedures.
How dental insurance categorizes and pays for procedures
Dental procedures covered by insurance policies are typically grouped into three categories of coverage:
Preventive
​Most dental plans cover 100% of preventive care such as annual or semi-annual office visits for cleaning, X-rays and sealants.
Basic
​Basic procedures are treatment for gum disease, extractions, fillings, and root canals, with deductibles, co-pays and co-insurance determining the patient’s out-of-pocket expenses. Most policies cover 70% to 80% of these procedures, with patients paying the remainder.
Major
Major procedures such as crowns, bridges, inlays and dentures are typically only covered at a high co-payment, with the patient paying more out-of-pocket expenses than other procedures.
Every policy differs in how procedures are categorized as preventive, basic and major, so it is important to understand what is covered when comparing policies. Some policies group root canals as major procedures, while others treat them as basic procedures and cover much more of the cost.
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It's also important to note that most dental insurance policies do not cover any costs for cosmetic procedures such as teeth whitening, tooth shaping, veneers and gum contouring since these procedures are not considered medically necessary.
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Yearly maximums
Coverage maximums typically range from $750 to $2,000 per year and generally speaking, the higher the monthly premium, the higher the yearly maximum. Once the yearly maximum is reached, patients must pay for 100% of any remaining dental procedures. Many insurance companies offer policies that roll over a portion of the unused annual maximum to the next year.