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How does dental insurance work?

Dental insurance can help you budget for the cost of maintaining your oral health. Dental insurance generally covers a portion of the cost of a range of dental services from routine preventive care to dental surgery.

If you have individual dental insurance, you may select a plan based on your budget and the services you need. Monthly premiums will depend on the insurance company, your location, and the plan you choose.

If you already have a dentist who is in the insurance company’s network, you can take advantage of negotiated discounted prices charged by the dentist and you may not have to submit claim forms. If your dentist is not in the network, you can use them if you have a PPO plan, but you may have to pay higher prices for going out of network. If you have a DHMO plan, you must use an in-network DHMO dentist.

Dental procedures are generally grouped into three main categories: preventive, basic and major. Many dental insurance plans cover preventive care at 100%, basic procedures at 50-70%, and major services, such as surgery at 50%. However, coverage and costs can vary depending upon the plan level you select.

Do You Pay Up Front with Dental Insurance?

Payment may vary based on the insurer. Signing up directly through an insurance company’s website may be one of the fastest and most secure ways. There, you can usually select a payment method and the payment frequency.

How Long Does Dental Insurance Take to Kick In?

There are no waiting periods for preventive care, such as cleanings, exams, and x-rays. Basic services such as fillings and simple extractions may have a waiting period of six months or less, depending on your state. Major dental work, such as root canals, crowns, implants, and kids’ braces may have a waiting period of 12 to 18 months, depending on your state.

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Brought to you by The Guardian Life Insurance Company of America (Guardian), New York, NY. Material discussed is meant for general illustration and/or informational purposes only and it is not to be construed as tax, legal, investment or medical advice.
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