While most people want healthy teeth and gums, the cost of dental care can often feel prohibitive. Nearly one-third of young adults haven’t seen a dentist in the past 12 months, and many cite lack of insurance coverage as a contributing factor.1
Without insurance, even routine dental services can be expensive. Fortunately, affordable dental insurance can help bring this essential care within reach. Read on to learn what dental insurance covers so you can choose the right plan and understand your out-of-pocket costs.
What does dental insurance typically cover?
Most dental insurance plans group coverage into the following categories: preventive care, basic services and major procedures. A treatment’s category often determines what percentage the insurer will cover.
In many cases, preventive care is covered at the highest level, followed by basic services and then major procedures. Let’s take a closer look at each of these categories.
Preventive care
Preventive services help you maintain your oral health and give your dentist the chance to identify potential issues early on. They include:
Dental insurance may cover these services up to 100%. Insurers offer this high level of coverage because preventive services may reduce the risk that you’ll need more complex treatments later on.
Basic procedures
Basic services focus on treating common dental issues before they become more serious. Some examples include:2
These treatments may be necessary to restore your oral health and prevent further damage. As a result, dental insurance plans often provide significant benefits for them, sometimes covering up to 80% of the procedure cost.
Major procedures
Major procedures include more advanced or restorative dental work, such as:2
Since these treatments are more complex and often more expensive, dental insurance plans usually cover them at a lower rate. Even so, having coverage can still significantly reduce your overall costs.
For example, if you need a dental crown to repair a damaged tooth, the cost can average around $1,300 without insurance.3 If you have a dental insurance plan that covers 50% of major procedures, your out-of-pocket cost could drop to about $650.
What dental insurance may not cover
While dental insurance covers many essential services, it doesn’t cover everything. Most notably, cosmetic procedures like teeth whitening, veneers or cosmetic bonding are less likely to be covered.
Coverage for orthodontic care, such as braces or aligners, is less common, especially for adult patients. These benefits are often limited to patients under 18 or are only available under certain plans.
Many plans also impose waiting periods for some basic and major treatments, which means you won’t receive coverage for them right away. Insurance companies do this to discourage people from signing up to get high-cost procedures and canceling shortly after, which helps keep premiums more stable for policyholders.
How much does dental insurance cost?
Now that you know what dental insurance can help pay for, you may be wondering what it costs. To obtain coverage and keep your plan active, you’ll typically need to pay a monthly premium. When you receive treatment, you may also need to pay:
Finally, some plans have annual maximums, which cap the amount of coverage you can receive in a calendar year. Once you reach that amount, you’ll have to pay for the rest of your dental care on your own.
The good news? You can choose from a wide variety of dental plans. Based on your expected dental treatments and monthly budget, some plans may be more cost-effective than others. Choosing the right plan can help you maintain a healthier smile while keeping costs manageable.