Different dental plans from different insurance companies offer various combinations of benefits, features, and options, so it can pay to shop around. But generally speaking, the best dental insurance for individual and family needs is a plan that meets their needs and supports dental health by letting them see a dentist they like, with coverage for the treatments they're likely to need, at a price that fits their budget.
Most dental policies are dental PPOs.⁵ These plans have a network of dentists who agree to provide care at a discounted rate. When you go to an in-network dentist, your out-of-pocket cost for dental treatment will likely be less. With a dental PPO plan, you may also see a dentist who isn't in the network; however, your out-of-pocket costs may likely be higher. Dental PPO plans generally let you see a wider range of providers than a dental HMO, but dental HMOs typically have lower premiums and fewer out-of-pocket costs. With DHMO you must obtain services from a designated Primary Care Provider (who is in network) in order to be eligible for benefits.
There is no set standard for what constitutes “basic” dental coverage, and different dental insurance plans cover different procedures. But generally speaking, a basic plan will cover standard preventive dental care — checkups, cleanings, routine x-rays, and sometimes, fluoride treatments. Insurance companies such as Guardian also provide more comprehensive plans that can cover other things that contribute to oral health:
Basic care: Fillings, extractions, and other minor services
Major care: Root canals, crowns, bridges, and dentures
Orthodontic treatment: Braces and other types of teeth aligners
Each dental insurance plan will have its own list of covered and non-covered procedures. Generally speaking, the most inexpensive basic plans will have a shorter list of covered procedures (typically for preventive care) with more exclusions, and the more expensive comprehensive plans will cover more procedures with fewer exclusions.
Yes, as with health insurance, you can buy dental insurance as an individual or family if benefits aren't available through your employer. Dental insurance cost doesn't have to be a barrier: a variety of affordable dental plans are readily available, and you don't need to go through an insurance agent. Major insurance companies like Guardian make it easy for individuals and families to shop dental plans, get a free quote, and buy directly online. Or you can shop for a Guardian dental plan on the Federal Exchange Marketplace.
According to HHS.gov, states are required to cover dental services for people with Medicaid under the age of 21, as part of the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit. However, states may or may not elect to provide dental benefits to their adult Medicaid-eligible population, and fewer than half of states provide comprehensive dental care.
Different dental plans from different insurance companies offer various combinations of benefits, features, and options, so it can pay to shop around. But generally speaking, the best dental insurance for individual and family needs is a plan that meets their needs and supports dental health by letting them see a dentist they like, with coverage for the treatments they're likely to need, at a price that fits their budget.
Most dental policies are dental PPOs.⁵ These plans have a network of dentists who agree to provide care at a discounted rate. When you go to an in-network dentist, your out-of-pocket cost for dental treatment will likely be less. With a dental PPO plan, you may also see a dentist who isn't in the network; however, your out-of-pocket costs may likely be higher. Dental PPO plans generally let you see a wider range of providers than a dental HMO, but dental HMOs typically have lower premiums and fewer out-of-pocket costs. With DHMO you must obtain services from a designated Primary Care Provider (who is in network) in order to be eligible for benefits.
There is no set standard for what constitutes “basic” dental coverage, and different dental insurance plans cover different procedures. But generally speaking, a basic plan will cover standard preventive dental care — checkups, cleanings, routine x-rays, and sometimes, fluoride treatments. Insurance companies such as Guardian also provide more comprehensive plans that can cover other things that contribute to oral health:
Basic care: Fillings, extractions, and other minor services
Major care: Root canals, crowns, bridges, and dentures
Orthodontic treatment: Braces and other types of teeth aligners
Each dental insurance plan will have its own list of covered and non-covered procedures. Generally speaking, the most inexpensive basic plans will have a shorter list of covered procedures (typically for preventive care) with more exclusions, and the more expensive comprehensive plans will cover more procedures with fewer exclusions.
Yes, as with health insurance, you can buy dental insurance as an individual or family if benefits aren't available through your employer. Dental insurance cost doesn't have to be a barrier: a variety of affordable dental plans are readily available, and you don't need to go through an insurance agent. Major insurance companies like Guardian make it easy for individuals and families to shop dental plans, get a free quote, and buy directly online. Or you can shop for a Guardian dental plan on the Federal Exchange Marketplace.
According to HHS.gov, states are required to cover dental services for people with Medicaid under the age of 21, as part of the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit. However, states may or may not elect to provide dental benefits to their adult Medicaid-eligible population, and fewer than half of states provide comprehensive dental care.
Are you a dental professional?
Find out how to join Guardian’s growing network of dental benefit providers.
1 Mayo Clinic, Oral health: A window to your overall health, 2021
2 Costs vary by state and available plan type selected.
3 Mayo Clinic, Oral health: A window to your overall health,
4 2021, https://www.guardianlife.com/dental-insurance/individuals
5 Colgate, Types Of Dental Coverage: Which Is Right For You?, 2023
* Actual costs vary, but dental crown can cost $2,000 or more. A good comprehensive plan can lower that to under $700. Here's how: We'll assume you have a PPO dental plan that covers major procedures at 50%, you're past the waiting period, and your dentist's customary fee for the treatment is $2,000. With a 35% in-network discount, the fee goes down to $1,300. After paying your $50 deductible, the insurance company pays half of the remaining $1,250 charge, and you owe the other half ($625). You save $1,325, and your total out-of-pocket expense is $675.
** Mobile app currently only supports Group planholders.
Links to external sites are provided for your convenience in locating related information and services. Guardian, its subsidiaries, agents and employees expressly disclaim any responsibility for and do not maintain, control, recommend, or endorse third-party sites, organizations, products, or services and make no representation as to the completeness, suitability, or quality thereof.
DentalGuard Insurance is underwritten and issued by The Guardian Life Insurance Company of America, New York, NY. Products are not available in all states. Policy limitations and exclusions apply. Optional riders and/or features may incur additional costs. Generic Policy Form # GP-1-DG2000, et al; GP-1-DEN-16; DG7-P. The state approved form is the governing document.
Individual dental insurance products are underwritten by The Guardian Life Insurance Company of America, New York, New York or by one of its wholly owned subsidiaries. Dental provider networks vary by state, by market and by plan type. Plans availability, benefits and deductibles vary by state. Rates are guaranteed for one year for the plan benefits initially selected. Policies renew annually. Please refer to your plan documents for a complete list of limitations and exclusions. Policy Form IP-DEN-16; IP-DEN-20; et. al. Plan documents are the final arbiter of coverage. This policy provides DENTAL insurance only.
[This information is not intended for residents of New Mexico.]
1 Mayo Clinic, Oral health: A window to your overall health, 2021
2 Costs vary by state and available plan type selected.
3 Mayo Clinic, Oral health: A window to your overall health,
4 2021, https://www.guardianlife.com/dental-insurance/individuals
5 Colgate, Types Of Dental Coverage: Which Is Right For You?, 2023
* Actual costs vary, but dental crown can cost $2,000 or more. A good comprehensive plan can lower that to under $700. Here's how: We'll assume you have a PPO dental plan that covers major procedures at 50%, you're past the waiting period, and your dentist's customary fee for the treatment is $2,000. With a 35% in-network discount, the fee goes down to $1,300. After paying your $50 deductible, the insurance company pays half of the remaining $1,250 charge, and you owe the other half ($625). You save $1,325, and your total out-of-pocket expense is $675.
** Mobile app currently only supports Group planholders.
Links to external sites are provided for your convenience in locating related information and services. Guardian, its subsidiaries, agents and employees expressly disclaim any responsibility for and do not maintain, control, recommend, or endorse third-party sites, organizations, products, or services and make no representation as to the completeness, suitability, or quality thereof.
DentalGuard Insurance is underwritten and issued by The Guardian Life Insurance Company of America, New York, NY. Products are not available in all states. Policy limitations and exclusions apply. Optional riders and/or features may incur additional costs. Generic Policy Form # GP-1-DG2000, et al; GP-1-DEN-16; DG7-P. The state approved form is the governing document.
Individual dental insurance products are underwritten by The Guardian Life Insurance Company of America, New York, New York or by one of its wholly owned subsidiaries. Dental provider networks vary by state, by market and by plan type. Plans availability, benefits and deductibles vary by state. Rates are guaranteed for one year for the plan benefits initially selected. Policies renew annually. Please refer to your plan documents for a complete list of limitations and exclusions. Policy Form IP-DEN-16; IP-DEN-20; et. al. Plan documents are the final arbiter of coverage. This policy provides DENTAL insurance only.
[This information is not intended for residents of New Mexico.]