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Nov 16, 2023
The 411 on dental insurance: Choosing a plan that fits your needs

Good dental health is key to maintaining overall health and well-being. But choosing the dental plan that is right for you may feel daunting.

We sat down with Dr. Cary Sun, chief dental officer at Cigna Healthcare, to discuss how to pick the dental plan that best suits your needs.

What is the best insurance to have for dental coverage?

The first thing to consider is what’s best for your overall health and financial picture. Someone who is between jobs may have different needs than someone who is retiring. Likewise, a person with serious oral health issues may have different needs than a person with excellent oral health.

Ask questions like: Can I find a dentist I like who is in-network? Does the plan I’m considering cover all the services I need? Can I afford the monthly premium?

If you have a short-term need for a dental plan, consider whether a plan that covers preventive services only – things like exams, dental cleanings, and X-rays – is right for you. You might also look into dental discount plans that provide discounts on dental services. These plans are usually less expensive and typically don’t have waiting periods.

If you want longer-term dental insurance or more robust coverage – such as fillings, extractions, root canals, crowns, and dentures – many comprehensive dental plans are available. It really depends on what you are willing to spend, as services could be subject to monthly fees, deductibles, and waiting periods.

People who previously had dental insurance through an employer may be eligible to have certain waiting periods waived, so they should check if they qualify for any waivers.

Most dental plans require that patients see a dentist in the carrier’s network.  If seeing a preferred dentist is important, check if that dentist is in the network for the plan you select.

What is the most common type of dental insurance?

Networks and costs can differ widely between the three main types of dental insurance: Dental preferred provider organizations (PPOs), dental health maintenance organization (DHMO) plans, and indemnity plans (or fee-for-service).

More than 80 percent of dental plans in the U.S. are PPOs, which offer affordability and flexibility. Dentists who are part of a PPO network negotiate their fee structure with insurers and can provide a discounted rate to their customers. If a consumer opts to go out of network, they must pay more out of pocket. Additionally, PPOs generally offer more flexibility because they have a broader network of dentists available. Some comprehensive plans are bundled with vision and hearing benefits. Premiums may be higher due to the additional benefits.

DHMO plans require consumers to see an in-network dentist. Indemnity plans, which don’t have networks, allow consumers to see the dentists of their choice but typically require consumers to pay the cost upfront, file a claim, and await reimbursement.

What doesn’t dental insurance cover?

In most cases, dental plans do not cover services that are specifically completed for cosmetic reasons, such as teeth whitening and veneers.

On the other hand, orthodontic treatment – which helps the alignment of your teeth and improves appearance – is often considered clinically necessary because it contributes to your ability to function and helps the general health of your teeth. Many comprehensive plans cover orthodontics at certain benefit levels.

What should consumers look for in a dental plan?

Having the right dental plan can provide peace of mind when it comes to improving your oral health and ensuring you can afford the care you need. Getting regular checkups also helps catch little problems before they become big ones. Below are two key considerations when looking for a dental plan.

Consider what you get for the cost: People will obviously need to weigh monthly fees and deductibles, but they will also want to consider what they’re getting for the money. For example a lower-cost plan may be cheaper upfront, but it could end up costing more in the long run if extensive dental work is not covered. Much like health insurance, consumers should consider their unique dental care needs before choosing a plan.

Look at the network: The bigger the network, the more choices people will have in terms of dentists. And as mentioned above, PPO dentists are often able to offer consumers better savings due to the terms they negotiate with insurers. So, in addition to asking about the size of the network, people should also ask about the savings they’re getting by choosing a particular dental plan.

What steps should consumers take to buy dental insurance?

Step 1: Do your research. Consumers should have a basic understanding of how dental insurance works, the types of dental plans that are available, and the costs of those plans.

Step 2: Know your needs. People should assess their dental needs. Are they temporary or long term? Do they have good oral health or have had challenges that require a more comprehensive plan?

Step 3: Shop around. There are many online tools that can help consumers comparison shop for a plan, as well as brokers who can help them purchase an individual dental plan. Dental plans can be purchased year-round. People can also contact insurers directly to learn more about their dental options for individuals.

woman at the dentist

A healthy mouth is as important as a healthy body

When you care for your teeth, your whole body benefits. Learn more about dental care and other oral health topics.

Learn more