How Does Dental Insurance work?
Dental insurance plans can be purchased individually, or they may be bundled with other insurance such as health and vision.
Like most types of insurance, dental insurance usually includes deductibles, copays, and maximums:
- A deductible is the amount you will need to pay out-of-pocket before insurance starts to pay for dental costs. Once the deductible is exceeded, you will have to pay coinsurance or a percentage of the service or procedure cost.
- A copay is the set amount of each treatment or visits you need to cover.
- Maximums are the most insurance will pay for dental costs in a given period. Once this amount is met, the individual is responsible for paying any remaining costs.
FYI: Dental insurance plans vary as to how deductibles, coinsurance, copays, and maximums work and what the amounts are, so double check before purchasing a plan.
Some insurers will also cover you if you use a dentist they are not directly contracted with (typically called an out-of-network provider). However, the amount you can claim is likely to be much lower than if you use an in-network dentist, and not every insurer covers out-of-network treatments.
If you already have a dentist you prefer, you can ask them if they take any of the dental insurance plans you are considering. If they do, research those insurers first to see if any of them suit you – if they do, you can sign up for a plan with them and stick with your preferred dentist. If not, you may need to find another primary care provider.
Tip: In-network dental care has less expensive co-pays and handles the paperwork, so you do not have to submit claims yourself.
Once you find a dentist, you are responsible for paying a copay or reduced fee when attending the treatment office. In some cases, you may need to file an insurance claim with your provider to recoup the cost after the fact though sometimes the office will handle that.