Dental Insurance: Coverage, Costs, and More [Up to date] – Dentaly.org

Delta Dental is the largest dental insurance provider in the US, offering some of the best dental plans — with affordable and comprehensive care. With a range of options tailored to meet the needs of both children and adults, Delta has a plan for everyone, from children to seniors.

We’ve chosen it as the top plan for orthodontics for Delta Dental’s braces coverage options for adults and children. Find out more in our full review of Delta Dental insurance.

Overview

Delta Dental offers 3 primary plans:

  • Gold PPO: Largest network of dentists with a maximum of $1,000
  • Diamond: Benefits increase after first and second year, plan maximum of $2,000
  • Immediate: Plan maximum of $3,000, no waiting periods
  • Enjoy peace of mind with Delta Dental, a leading dental insurance provider network with over 128,000 dentists nationwide. With such a vast network, choosing the perfect dentist for your needs has never been easier.

    Rest assured in the financial strength of Delta Dental, as evidenced by its impressive A+ (Excellent) rating from AM Best.

    Delta Dental offers a range of insurance options, including plans that cover essential orthodontic care. Their individual PPO plans, for instance, cover orthodontia at 50% for both children and adults, with a $50 deductible and a $2,000 annual maximum for care.

    Rest easy with comprehensive coverage. Delta Dental covers preventive care like cleanings and X-rays at 100%, while basic and major services, including root canals, implants, and crowns, are covered at 50%.

    Remember that pricing and plan options can vary by state. Visit Delta Dental’s website to explore the offerings available in your area and make an informed decision about your dental insurance needs.

    Key features of Starter plan
  • Annual maximum: $1,000-$3,000
  • Deductible: $50 per person
  • Waiting period: Varies by plan
  • Why we like it

    Unlike most other providers, Delta Dental sets itself apart by offering multiple affordable choices for orthodontic treatments, catering to both children and adults.

    Pros & Cons

    Pros

  • Large nationwide network
  • Some plans include orthodontic coverage
  • Most plans have 100% coverage for preventive care
  • Cons

  • Annual maximums are low
  • Ortho only covered by 50%

  • Types of dental insurance plans

    Dental insurance plans can be divided into three main types, which we’ll talk more about now:

    Dental indemnity insurance plans

    Indemnity dental insurance lets you see whatever dentists you want, as there is no network. That means you don’t need to choose your primary care dentist, and you might not need referrals to see specialists.

    When you compare dental insurance plans, you’ll notice that indemnity plans normally have an annual deductible and coinsurance. The deductible means that you will pay out of pocket for services until you reach the deductible. Once you meet the deductible, your dental insurance plan will share the costs with you for covered services—that’s the coinsurance.

    This type of plan typically costs more than the other types of dental insurance, but it may be the best dental insurance plan for you if you want more freedom and fewer restrictions and requirements.

    dental checkup
    Checkups are often included

    DHMO (Dental Health Maintenance Organization)

    Also known as a Dental HMO, this type of plan offers coverage through a particular network of dentists. Members benefit from discounted rates for their treatment, and some services, like cleanings, exams and x-rays are usually covered 100%. DHMO networks are typically quite small and there is no cover if you are treated by a dentist from outside the network.

    As you compare dental insurance plans, you’ll find the lowest premiums with this type of plan, often with the added benefit of no annual limits or deductibles. Some plans come with little or no waiting period, even for major dental work, so they can be a popular last-minute purchase for people facing otherwise unaffordable treatment.

    PPO (Preferred Provider Organization)

    PPO dental insurance plans are similar to DHMO, but usually with a wider network of approved dentists.

    These plans may provide some level of coverage for treatment with dentists outside the network, too. However, you can expect to receive a smaller discount if you use a non-approved dentist. These plans also typically cover 100% of in-network preventive care like cleanings, exams, and x-rays.

    With a PPO, you do have to pay higher premiums, and you’ll have higher deductibles and coinsurance than with a DHMO plan.

    Best for…

    Indemnity insurance

    High annual caps for a broad range of treatments; see any dentist

    High premiums and annual deductibles; usually only for groups

    People who want high limits and less restrictive coverage

    Offer a % discount without deductibles or paperwork; low cost premium; some preventive care may be included

    Restricted network of providers

    People who need affordable dental insurance and are happy to stick to an approved provider network

    Offer a % discount without deductibles or paperwork; more flexible and broader benefits than DHMO; can see any dentist

    Higher premiums than DHMO; lower discounts for out-of-network dentists

    People who need the flexibility to see any dentist for a range of treatments

    What is the best dental insurance for cosmetic treatment?

    Cosmetic dental treatment like teeth whitening, braces, veneers, and cosmetic contouring is rarely included in cheap dental insurance plans. (Find out more about dental insurance for veneers). However, more premium plans may offer some level of cover.

    Orthodontic treatment for children is more likely to be included than for adults. Read more about dental insurance for braces and Invisalign insurance. You can read more about this topic in our full guide to cosmetic dental insurance.

    Explanation of terms

    It’s easy to get lost when talking about insurance if you don’t understand some of the basic terminology, so let’s go over that now:

    • Annual maximum benefit limit: An annual maximum is the total amount your dental insurance provider will pay for dental care within a 12-month period. Under your dental plan, you will be responsible for covering costs that exceed the limit. The most affordable dental insurance plans will have a lower annual maximum.
    • Annual deductible: Dental insurance policies with an annual deductible require you to pay a fixed amount before any reimbursement is given. Some insurers waive the deductible for routine diagnostic and preventive treatment.
    • Copay: This is a set rate that you will pay for dentist visits, prescriptions and other services under your family or individual dental insurance plan.
    • Waiting periods: This is the period of time you must wait after you purchase your insurance, before your coverage kicks in.
    • Coinsurance: This is the percentage of your care cost that you are responsible for paying, after you’ve met your deductible and paid your copay.

    Is dental insurance worth it?

    Yes, dental insurance is worth it, especially preventive care plans, or if you have constant dental treatment needs. And if you can’t afford one, you should try to find a discount plan.

    The long answer is: The cost of dental care has increased by 20% over the past decade, and almost a third of uninsured Americans say they have avoided getting the treatment they needed for financial reasons.

    Despite the high cost of dental care, around 74 million Americans don’t have dental insurance through an employer, group program, or public program. Are you one of them? If so, it’s understandable.

    What is the best dental insurance?
    Find the best dental insurance plans for you

    But a consequence of not having insurance on a national level is that 41% of adults have medical and dental debt — as was found in a recent survey by the Kaiser Family Foundation. What’s more, three out of four dentists plan to increase the costs of care this year.

    Even though an insurance plan can help spread the cost and protect against any unexpected bills, plans can cost a lot and provide little coverage for the most expensive procedures.

    That being said, it’s worth the effort to compare dental insurance plans and at least sign up for a low-cost dental plan that covers preventive care, if nothing else, so you don’t have to pay for more expensive restorative procedures down the road.

    All in all, the best dental insurance plans for you will be the plan that you can afford, and that provides at least basic coverage, and coverage for some of the procedures you may need in the future.

    Choosing a dental insurance company

    The best dental insurance plan for you will depend a lot on the products available in your state and the work you need to have done. If you already know what treatment you need, it can be well worth taking the time to work out exactly how much you’ll have to pay with different insurance plans.

    Some things to keep in mind include:

    • Insurance coverage is usually priced out for either individual or family coverage
    • Age can impact pricing
    • The top dental insurance companies should offer plans that follow a cost model similar to: 100% coverage for preventative, 80% of basic services, and 50% major procedures
    • Your insurance provider may send the check for dental payments directly to you instead of the dental office, in which case it is your responsibillity to ensure your provider receives these payments

    In this detailed case study from Policygenius, a patient needing basic preventive care, a filling, and an extraction could get their annual expenses down from $1,488 to $420 with one particular insurer. A patient requiring a root canal and porcelain crown saved almost nothing with that same insurer, but could more than halve their expenses with a discount plan.

    To find out more about dental discount plans, read our article here.

    Dental insurance plan alternatives

    Often lumped in with insurance plans are payment plans and discount plans (also called savings plans). While these are not dental insurance plans, you may find that either a savings plans or a payment plan works better for you.

    • Discount/Savings plans: Discounts for dental savings plans are from around 10-50% depending on the type of treatment. The annual fee often includes free dental checkups and cleanings. This preventive care is a good way to protect against and identify any potential problems before they become more costly.
    • Payment plans: A dental payment plan is simply a way to pay for an expensive dental procedure in stages, or installments.

    How to get dental insurance

    There are two routes you can go to sign up for dental insurance:

    • Choose a health and dental insurance plan: You can search for these plans through the Affordable Care Act on the online insurance Marketplace, but you can only do so during the enrollment period, unless you have a major life event that could affect your insurance eligibility like losing a job, changing income, or moving.
    • Purchase a stand-alone dental plan: If you already have health insurance and you’re looking for a separate dental insurance plan, or a supplemental dental insurance plan, you can search for these through the government’s online marketplace, or you can go directly to an online marketplace like dentalinsurance.com, or the insurance companies’ websites and enroll there.

    In the video below, you can watch a summary of some things you should consider before choosing a plan and a carrier. The video is provided by Delta Dental, but the considerations can be applied to every company.

    When it comes to dental insurance, there are many carriers out there. Learn how to find the best one using by looking at these four important factors.

    What’s the best dental insurance in my state?

    Insurance options vary based on where you live. We have individual articles about dental plans available in each state. Choose your state from the dropdown list to find out more.

    Conclusion

    Dental insurance as it is today isn’t the perfect solution for most American households, but one thing is for sure: it’s way better than nothing. We encourage you to enroll in a plan now so that you aren’t bombarded with unexpected fees in the future.

    Remember, if you can’t find an insurance plan that works for you, you can also consider dental discount plans, which are typically more affordable and still provide great discounts, especially for preventive care. 

    Read more about other options for paying for a cheap dentist without insurance. If you’re looking specifically for a family plan, check out our full article about family dental insurance as well. Seniors may find that they want Medicare supplemental dental insurance, to help cover the costs of their Medicare plan.

    FAQs

    Can you get supplemental dental insurance?

    Most insurance companies allow you to sign on to one of their plans as a supplement to insurance that you already have that may not cover the procedures you need.

    In some cases, you may be able to get a discount plan to supplement your insurance plan, but you’ll need to discuss this with your insurance provider.

    Additionally, HSA and FSA accounts allow you to put tax-free dollars from your paycheck aside to be used for dental procedures.

    Is there Medicare dental insurance?

    Normal Medicare doesn’t cover dental, but you may have the option to enroll in a sort of Medicare supplemental dental insurance, in the form of a Medicare Advantage Plan (Medicare Part C). These plans are offered through private dental insurance companies that are approved by Medicare. Not all Medicare Advantage Plans cover dental.

    If you are enrolled in Medicare and don’t have dental coverage, you should also enroll in a dental insurance plan, or consider enrolling in a dental discount plan. The best dental insurance for seniors on Medicare may be offered by any of the insurance companies we go over in this article. One of those is Delta Dental through which AARP offers dental insurance plans for seniors.

    How much does dental insurance cost?

    The average dental insurance cost is between $200 and $400 per year per individual, with an annual deductible between $50 and $200, and the annual maximum benefit between $500 to $2,000.

    Some plans also offer discounts to customers who participate in annual preventative screenings.

    What is the cost of dental insurance?

    Affordable dental plans are easy to find — dental insurance costs anywhere from $300 to $700 per year for the average plan. This is much less than standard health insurance. Standard insurance can have monthly premiums of $200 for basic coverage. But keep in mind that many plans have yearly maximums of around $1,000 and deductibles of $1,000 as well.

    What is the best dental insurance?

    The best dental insurance is a plan that covers your specific needs. It doesn’t really matter which company you choose, you need to consider what dental expenses you may have in the future.

    Do you just want routine preventive care? Then the best plan for you might be one will a low annual fee, and no deductible. However, if you think you might need major restorative services, your plan may be one that costs more, but has a higher annual maximum to cover more expensive treatments.

    Does health insurance cover dental?

    Health insurance plans don’t automatically cover dental. However, if you’re looking for health plans on the ACA marketplace, you can find some plans that offer dental as well. Another option is to buy a stand-alone dental insurance plan.

    Is there dental insurance for college students?

    Your school may offer a limited insurance plan, but some providers have plans for low-income individuals. You may also want to consider dental discount plans.

    Keep in mind that under the Affordable Care Act, adult children can stay on their parent’s insurance plan up to 26 years of age. Read our full article on dental insurance for college students.

    What is the Best Dental Insurance? Compare and Find Your Plan

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    Contributors:

    Natalie used to work as a Community Health Worker and Health Insurance Navigator. She continues to follow her passion for connecting people with the healthcare they need by writing informative content about dentistry and medicine.

    Amanda Napitu

    Amanda specialises in writing informative content about dentistry. She has been a regular contributor to Dentaly.org since 2017, and collaborates with dozens of dentists to keep this content accurate and up-to-date.

    Medically reviewed by:

    Dr. Karen Kemp-Prosterman is a practicing pedodontist with over 17 years of experience. She completed her dental education at Meharry Medical College in Nashville, TN in 2002. She is a Diplomate of the American Board of Pediatric Dentistry, and among other achievements is currently the Founder and CEO of PGP Dental Consultancy in Stamford, Connecticut.

    Author: Health Watch Minute

    Health Watch Minute Provides the latest health information, from around the globe.