The best dental insurance is coverage that fits your individual budget and needs. As such, you need to consider a few questions:
- Do you have some funds in savings to cover out-of-pocket costs as well as the costs of services beyond a policy’s annual maximum benefit limit?
- Who needs coverage – just you or your entire family?
- Why are you seeking coverage – for an existing issue or to prepare for future oral healthcare needs?
We’ll review these questions and some other considerations you may want to be aware of when looking for the best dental insurance.
What is the best dental insurance for you?
The best dental insurance helps you get access to the care that you need to help maintain your tooth and gum health, as well as your overall health.
That may mean cost, convenience and value need to be weighed. Let’s take a look at some of the considerations when shopping for and comparing dental insurance plans.
Who are you shopping for?
Are you looking for dental for yourself or for your whole family? It could affect your choice of plans, cost and amount of benefits. Some questions to consider if you’re shopping for a household:
- Is anyone in the family likely to need a major procedure in the near future?
- Is it likely your kids will need braces?
- Does your plan’s provider network include pediatric dentists that are taking new patients?
- Are there providers convenient to your kid’s school or yours, or your spouse’s office?
Why do you need dental coverage?
Are you looking for preventive care? If you generally have good dental habits and get regular cleanings, preventive care will be important. The good news is that most dental plans cover preventive care (checkups and cleanings) at 100%.
Are you experiencing tooth pain now? Even with the best oral hygiene habits, chances are you’ll need basic dental care at some point. While not as expensive as major procedures, the cost of basic services can add up without insurance. Some average costs for basic dental procedures, without coverage, include:
These procedures – and others that fall under the category of “basic” care – are usually covered by dental policies at 80%.
Is it likely that you will need major services like root canals, crowns, braces or dentures in the near future? If you’ve had dental issues in the past, chances may be good that they’ll continue as you age. Major procedures are commonly covered by dental policies at 50%, though some policies may include pre-existing conditions or missing tooth exclusions.
If you’re looking for coverage for a specific issue that may result in basic or major services keep in mind that dental policies typically have waiting periods for such services. Many policies also have annual maximum benefits limits, meaning they won’t continue to pay for covered services once you’ve reached the benefit limit on your policy.
Learn more about how dental insurance works – including levels of coverage.
- When visiting a dental insurer’s website or speaking with customer service, are you satisfied with your experience?
- Do your friends, family or coworkers have a dental insurer they recommend?
- What is the company’s reputation? Check reviews and ratings such as A.M. Best and the Better Business Bureau.
Do you currently have a dentist? If so, double-check plan networks
A familiar face may make a trip to the dentist’s office less stressful, and if you’re already established with a provider it may be more convenient to stick with them.
If you have a dentist you’re comfortable with, make sure they are “in-network” if you choose an HMO or PPO plan. Provider directories can usually be found on a dental insurer’s website, or you can call the company’s member services number for assistance and the most up-to-date information.
Alternatively, an indemnity plan may have more provider options but these plans may come with higher premiums.
Is an individual dental plan the best option for you?
When shopping for dental insurance, you may also want to consider if options other than individual coverage could be available and fit your needs. Consider the following:
Do you have access to an employer or other group dental plan? Employer-sponsored plans and other group plans, such as those offered by AARP, often have lower premiums than individual plans. But even so, it’s important to make sure the coverage is worth the money based on your needs.
If you are enrolled in an employer-sponsored plan, does it offer enough coverage? A supplemental dental plan, that is, one that supplements your existing group or individual benefits, can help reduce your out-of-pocket costs.
Do you already have a health savings account (HSA) or flexible spending account (FSA)? You can use HSA or FSA dollars to pay for most medically-necessary dental care as long as you’re not also being reimbursed by a health or dental policy. Qualifying expenses are generally the same as those that qualify for tax deductions, however, you’ll want to check with your HSA or FSA in regards to specific procedures you’re considering.
Could a dental discount plan be a good fit? While not insurance, a discount plan provides access to a group of dentists who offer services at a discount. With this type of product, your dentist charges you a discounted rate, you pay them directly and that’s it – there is no claim to process or waiting period before you can obtain services.
Ready to get dental coverage?
Here are a few things to keep in mind as you review individual dental insurance plans:
- Dental plans typically cover services like cleanings and exams, extractions, x-rays, fillings, crowns, bridges, and root canals but exclude elective or cosmetic procedures.
- The costs of preventive care like cleanings, x-rays, sealants, and oral exams are often 100% covered other than an office visit copay.
- Policies are usually guaranteed-issue, however, there are waiting periods for certain dental services.
- Premium amounts and out-of-pocket costs tend to be relatively affordable, however, there are annual out-of-pocket benefit limits.
- Dental coverage is available year-round and is not limited to an open enrollment period, unless you want to purchase your dental plan from the ACA Exchange.
Compare policy costs and coverage by requesting a quote, it just takes a minute to see multiple plan options.
Summary + Next Steps
When looking for the best dental plan for yourself or your family:
- Go beyond comparing just the monthly premiums and out-of-pocket costs – make sure you understand the annual benefit limit on policies you’re considering.
- If you’re seeking coverage for an oral health care concern, make sure you understand how different services are covered at different coverage levels and what waiting periods may apply.
- Consider if another form of coverage, or if a non-insurance product, would meet your needs, such as a dental discount plan, supplemental dental policy, or using existing HSA or FSA dollars.