Your Guide to Dental Insurance
Frequently Asked Questions
What insurance covers dental implants?
According to our research, Delta Dental offers one of the best dental plans for implants. Coverage for implants, also called prosthodontics, varies between insurers and dental plans—you’ll need a plan that covers “major procedures” and you’ll need to check coverage specifics and limits. Insurance will usually cover a portion of the expenses related to getting implants but not the entire cost.
What does dental insurance cover?
Dental insurance is broken down into three coverage areas: preventive care, basic procedures, and major procedures. Preventive care is often fully covered with no deductible, while other plan tiers may have both a deductible and coinsurance portion that you’re responsible for. Basic procedures include fillings, tooth extractions, and root canals. Major procedures include crowns, dentures, implants, and surgery.
Is a dental discount card or dental insurance better?
Both dental discount cards and insurance are ways to save on dental services. If you’re comparing plans, which is better largely depends on how good of a dental insurance plan you have access to. You also need to consider how well each addresses your specific needs. For example, if you need major procedures and the dental insurance you can buy provides limited coverage, a discount card could be the better choice.
How do dental savings plans work?
A dental savings plan, also called a dental discount plan, can help you save money on dental care, but it’s not actually insurance. Instead of an insurance premium, you pay a membership fee and show your card when you go to the dentist to receive discounted rates. You receive the discount at the time of service and there’s no waiting period.
How do dental credit cards work?
A dental credit card is a line of credit you use specifically for dental services. You have to apply and be approved for a card based on your credit history, and your payments (or lack thereof) will be reported to the credit bureaus. Be aware that if you don’t pay off your balance during a deferred interest promotion, the entire amount of interest (calculated on your initial balance) could be added to your current balance.
A dental insurance waiting period is the length of time after purchasing your dental benefits plan during which it won’t pay for certain procedures. A dental benefits waiting period may last anywhere from a few months to a full year, depending on the type of plan you have purchased and the insurance benefits wording.
An insurance deductible is the amount you pay for covered services before coverage kicks in.
Coinsurance is the percentage of the cost of a procedure you’re expected to pay. Your plan might pay 80% for a specified service, meaning you’ll need to cover the remaining 20%.
A copay, or copayment, is the fixed dollar amount you’ll pay for a specified service after you pay your deductible. For example, your plan might require a $20 copay for a dental office visit.
This is the maximum amount you could spend on covered services with your plan. If you spend up to the out-of-pocket maximum, your plan will cover 100% of the cost of covered services for the rest of the year.
An insurance claim is a formal request for payment made by an insured individual to their policy provider. An insurance claim is made after an incident occurs that's covered by the insurance policy. Payment from a claim is usually used to replace or repair property or pay for health care costs related to an injury.
The maximum amount the insurance company will pay each year. After the company has paid out this amount in benefits, you are responsible for any further expenses for the remainder of the year.
Preventive care is any medical service that protects against or reduces the likelihood of health emergencies. It is covered under the Affordable Care Act and helps keeps health care costs low.
Basic coverage helps pay for the cost of routine, non-preventive dental care, such as fillings, tooth extractions, and root canals. Many dental insurers structure plans to cover 80% of basic dental care. You’ll also need to cover your deductible and any amount over your annual maximum when getting basic care.
Major dental procedures may include crowns, dentures, implants, and oral surgery. Many plans cover 50% of the cost of major procedures. However, you often have to go through a waiting period before you can get a major procedure covered.