Dental insurance, sometimes called dental benefit plans, can differ quite a bit based on who you choose (or who your employer chooses) as a provider. Despite their differences in coverage, however, most dental insurance plans are structured similarly. Because we’re now in a new year, we thought it might help a few people if we covered some of the basic things you should know about your dental insurance in 2023.
The Main Purpose of Dental Insurance Is to Keep You Healthy
One of the best ways to lower healthcare costs is to practice good preventive medicine. To put it simply, preventive care helps keep people in a healthcare system healthier. This is true for both your primary care physician and your dentist. Dental insurance covers the cost of many preventive and routine care appointments to catch decay, symptoms, and diseases early. This keeps oral health issues from becoming more expensive, invasive surgeries.
What’s Typically Covered Under Most Dental Plans
The focus of most dental insurance plans is to provide low-cost, preventive coverage. According to Delta Dental, one of the largest dental insurers, most dental insurance covers a portion or all of these costs:
- 100% - cleanings and regular exams
- 80% - basic procedures such as dental fillings and tooth extractions
- 50% - major procedures such as crowns and bridges
Cosmetic Procedures are Not Covered
Much work is being done to increase dental insurance coverage of some dental procedures, such as dental implants, that may contribute to significantly better oral health. However, if your dental insurance company deems a procedure purely cosmetic in nature, it likely will not be covered. In some cases, pre-existing conditions, such as a missing tooth, may not be covered either.
There Are Two Basic Types of Dental Plans
The majority of dental insurance plans fall under two main categories:
- Preferred Provider Organization – A preferred provider organization, or PPO, is a network of dentists who provide services for pre-determined fees outlined in a contract. If you have PPO insurance, going outside your network of dentists results in higher costs for care.
- Dental Health Maintenance Organizations – In this type of dental insurance plan, dentists receive a fixed amount from the insurer for each patient assigned to them. Costs for services are usually very low or free, but patients typically have fewer dentists to choose from.
How Much Does Dental Insurance Cost?
Forbes did a survey of dental insurance plans and found the average cost for an individual dental insurance policy with comprehensive coverage was about $47 a month. The average cost for a preventive care plan only was about $26 per month. When you consider that the average out-of-pocket cost for a crown without insurance is about $1500, you can see why dental insurance can be worth the cost.
Thanks for Reading!
If you have questions about your dental insurance benefits, your dentist’s front office staff can be a great resource. Most dental practices are quite good at sorting through the red tape to tell you what your benefits cover and what to expect in terms of costs.
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