Health insurance doesn't cover dental procedures but a dental insurance plan can offer coverage for a wide range of preventative and restorative services. Dental plans can cover basic services like routine exams, fillings, and tooth extractions, and even crowns and root canals at a fairly low monthly cost as low as $15 per month. Dental insurance can be a great deal considering the high cost of dental care. For example, a typical check-up exam can cost up to $250, a filling may cost $100 to $250, and a crown can cost $850 or more.
Do you have questions about how dental insurance works to decide if it's a good investment? Here are some questions you may have about dental coverage and how it works.
Common Questions About Dental Insurance
1. What does the typical dental plan cover?
A: Most plans offer 100/80/50 coverage. Preventative care is usually covered 100%. This includes cleanings, exams, and x-rays. Basic dental procedures like tooth extractions, fillings may be covered 70-80% which leaves an out-of-pocket cost of 20-30%. Major procedures like crowns, dentures, bridges, dental implants, and root canals are usually covered at 50% or less. Plans vary in what is considered major and basic care, however, and some plans exclude orthodontic work like dentures and braces
2. Is there a limit to dental benefits?
A: Yes, most dental plans have a maximum annual benefit per person. This may be as low as $500 per year or it can be as high as $2,000 or more. While medical insurance covers medical expenses after the policyholder reaches the annual deductible, dental insurance is the opposite: coverage cuts off after reaching the limit per year. Any additional dental costs must be paid out of pocket. While a limit of $2,000 in coverage per year may seem low, it's estimated that just 4% of people exhaust their annual benefit. Still, this limit can be exceeded very quickly if you need a dental crown, bridge, or root canal.
3. Is there a waiting period before coverage starts?
A: It's common for dental insurance plans to have a waiting period, which is a period of time you must have coverage before you can have any benefits paid. This waiting period typically only applies to major work, not routine care or preventative care. For example, a waiting period may apply to a root canal or crown but not a filling. The waiting period may range from 6 to 12 months or even up to 2 years.
4. How much does dental insurance cost?
A: The cost for dental coverage can range a great deal. Some employers provide basic dental insurance for free with a low annual maximum benefit. Dental coverage can also be purchased through group benefits with an employer. On average, basic dental insurance costs $20 per month per person. For a family of four, the cost may be $400 a year for coverage of $500 to $1,500 per person with a total maximum benefit of $2,000 to $6,000 per year. The higher the annual maximum benefit per person, the higher the monthly premium for insurance.
5. Does dental coverage have a copay or deductible?
A: Dental insurance may come with a copay, or a fixed dollar amount you need to pay for treatment. Preventative care usually has no copay with 100% coverage and no out-of-pocket costs. With a typical dental plan, there may be a $50 copay for major restorative and basic services. A deductible may be involved instead of a copay. A deductible is a fixed amount you must pay within a year before your health insurance benefits kick in. Deductibles for dental coverage are usually low, between $25 and $75.
6. Does dental insurance cover cosmetic work?
A: It's very uncommon for a dental plan to cover cosmetic or elective procedures like tooth whitening, veneers, or crowns unless the primary reason for the procedure is restorative. Tooth whitening is always considered cosmetic. Crowns are considered cosmetic if the only purpose of the crown is correcting cosmetic defects like a poorly shaped tooth but they are covered if they are used to restore a severely damaged tooth. Many procedures can be covered if they are used for both cosmetic and restorative purposes such as veneers, implants, crowns, bridges, and bonding.
The articles on this website should not be used to start the use of dietary supplements or vitamins, natural or herbal products, homeopathic medicine or other mentioned products prior to a proper consultation with a doctor or certified health provider.
