Dental Insurance

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How Dental Insurance Works

Sometimes you are reimbursed after you submit a claim with the dental insurance company and other dental insurance policies pay the provider directly. There is often a maximum benefit amount per year.

Many orthodontic and other special needs trigger a coinsurance requirement in dental insurance plans. Many routine appointments, cleanings, and x-rays do not require coinsurance contributions.

Where to Get Dental Insurance

Employers support many different types of dental insurance plans. Individual dental plans are hard to find, so many individuals will purchase a dental discount plan in lieu of dental insurance.

Dental coverage for children may be included in the Childrens' Health Insurance Program (CHIP), so check with your nearest CHIP office.

Differences Between Dental Insurance and Dental Discount Plans

Dental Discount Plans

• Dental discount plans are membership based programs with enrollment fees and monthly charges.
• Dental discount plans are unregulated.
• Dental discount plans can charge any amount to provide any services and switch them at any time.
• Salespeople do not need to obtain a license or have any experience in the dental care or dental insurance fields to offer dental discount plans.
• With a dental discount plan, you still pay the bills. You just get a lower price where the discount card is accepted.
• Network size for dental discount plans can be extremely limited. Be certain that there are providers in your area and be aware that the providers may revoke their membership in the dental discount plan at any time.
• Some dental discount plans offer discounts on cosmetic procedures not covered by dental insurance.

Dental Insurance

• Dental insurance has premiums, co-payments, and deductibles.
• After the deductible is met, all costs are covered, up to the annual maximum benefit.
• Dental insurance policies are only sold by licensed agents.
• Dental insurance is regulated by state governments.
• Typical services covered by dental insurance:
  • Dental checkups and cleanings every 6 months
  • X-rays (as needed)
  • Oral surgery, tooth extraction, and root canals
  • Fillings, dentures, crowns, bridges, dentures (prosthodontics)
  • Treatment of gum diseases and other periodontal tissues
  • Orthodontics (braces, retainers, etc.)

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