Dental insurance premiums can range between $15 and $85 per month, but most people pay between $20-$50. This cost changes based on the type of plan, deductible, annual maximum, and coverage options. You may pay more per month for a more extensive plan, but that could save you a significant amount of money, depending on the amount of work you need.
However, even purchasing an inexpensive dental insurance plan can lower your out-of-pocket costs significantly.
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The Real Price of Dental Care
It takes time and money to take care of your teeth. Insurance typically covers two routine cleanings per year, but you could pay $200-$400 for those services without coverage. However, overlooking your oral health costs much more in the long run. Root canals, for example, might run more than $1,000.
There are non-financial costs to neglecting preventative care, too. Americans who feel negatively about their teeth report more anxiety, less satisfaction, and less confidence to interview for jobs. Additionally, teeth and gum health may be connected to long-term conditions such as Alzheimer’s and diabetes. Still, the cost of dental insurance prohibits many people from seeking coverage.
Breaking Down the Fees of Dental Insurance
Your dental insurance cost goes beyond the monthly premium. After purchasing a plan, you may have to adhere to a waiting period before receiving care. Many plans cover 100% of preventative care, 80% of basic dental services, and 50% of major services, but they might categorize those services differently. Consider the following costs when comparing plans.
- Monthly premiums: Paying a premium each month ensures you stay enrolled in your dental insurance plan.
- Copays: You may pay a set dollar amount when you receive certain services, even after meeting your deductible.
- Deductibles: This is the amount you’ll pay out of pocket before your insurance starts to help. This resets every 12 months.
- Coinsurance: After you hit your deductible, you’ll pay a percentage of the cost for covered dental services.
- Annual maximums: Most dental plans employ a limit on how much they will assist each year. For example, your plan may only cover up to $1,000 every 12 months.
What Factors Determine Your Costs?
Insurance companies determine your monthly premium based on your deductible, annual maximum, and coinsurance amounts, in addition to the following factors. These also influence your total out-of-pocket payments.
- Age: Insurance companies tend to charge lower premiums to younger adults.
- Location: Dental services cost more in higher cost-of-living states.
- Waiting period: After first enrolling, you may have to wait 6-12 months before receiving coverage for non-preventative care.
- Out-of-network care: Your plan may not cover out-of-network services at the same rate, or at all.
- Coverage categories: Some plans consider a root canal a major procedure and offer minimal coverage, if any. Others might categorize it as a basic service and pay for half the cost.
Always research what services your insurance actually covers. You’ll usually pay out-of-pocket for cosmetic procedures, such as teeth whitening.
Types of Dental Insurance
You can choose between several options for health insurance, depending on your coverage needs and budget.
Dental Preferred Provider Organizations (DPPO)
Just like health insurance, PPO plans cover services by dental providers within their network. If you receive care from an out-of-network dentist, the plan pays for a lower portion of the cost. These plans often charge higher monthly premiums, but that tradeoff may be worth it if you want to keep your existing dentist or have more options for out-of-network care.
Dental Health Maintenance Organizations (DHMO)
On the other hand, HMO plans limit coverage to in-network dentists. However, this often translates to lower monthly premiums, no annual maximums, and a nonexistent deductible, meaning the plan helps pay immediately. HMO plans tend to focus on preventative care, and you may need a referral to see a specialist.
Fee-for-Service Plans
Fee-for-service dentists charge you the full price upfront. Then, you or the dental office can submit a claim to the insurance company for reimbursement. This allows you to receive any out-of-network services you need, not just ones covered by your insurer, but you will pay more at the time of service. Some dentists provide an estimated cost of service and charge a copayment.
Discount or Dental Savings Plans
Dental savings plans often serve as an affordable alternative to dental insurance. Rather than covering dental services, these plans allow you to receive discounted prices from participating dentists. They usually cost less than $150 per year and do not have a deductible, annual maximum, or waiting period. The flat discount may save you more money than insurance if you need extensive dental work.
How Much Does Preventative Dental Care Cost?
Traditional dental insurance plans typically cover 100% of preventative care, or regular services that help keep your teeth and gums healthy. These routine visits enable dentists to monitor your oral health and detect potential issues early. Preventative services include:
- Dental cleaning: Most plans cover twice-a-year cleaning and polishing. Without insurance, each visit could cost $75-$200.
- X-rays: Routine X-rays monitor your teeth roots, jawbone, and nerve health. You may pay $100-$200 without insurance.
- Sealants: Insurance may cover this preventative procedure for children, which costs $30-$40 per tooth otherwise.
- Fluoride: Insurers often cover fluoride treatment up to age 18. It can cost $20-$50 without coverage.
How Much Does Orthodontics Cost?
Orthodontic treatment costs thousands of dollars, but the amount varies significantly based on what kind of braces you choose and how long you need them. The procedure may total $2,000-$10,000, and most insurers do not cover this service for adults. In many cases, this fee is all-inclusive and includes:
- Consultation
- Cleanings
- Check-ups
- X-rays
- Dental appliances
- Retainer
If your insurance company does not consider braces a medical necessity, you may be able to find an orthodontist that offers a dental discount plan. You can also purchase supplemental orthodontic insurance.
How to Make Dental Care More Affordable
If you cannot afford dental insurance, you’re not alone. In 2023, an estimated 68.5 million U.S. adults did not have dental insurance. But delaying oral healthcare can lead to a host of more severe problems, so if possible, consider the following ways to receive care at a lower cost:
- Maintain a preventative care routine. This is the most important step you can take to prevent more expensive procedures later on.
- Shop around for affordable care. Weigh your options for dental insurance, dental savings plans, and providers’ costs.
- Visit a dental school. Supervised student clinics provide reduced-cost general services to eligible individuals.
- Find low- or no-cost community health clinics. Research government-sponsored or nonprofit services in your area.
- Ask about a payment plan. Some dentists offer discounts, payment plans, or memberships to reduce your immediate out-of-pocket expenses.
- Use an FSA or HSA. You can use these tax-advantaged savings accounts to pay for dental care.
Should You Get Dental Insurance?
Only you can decide whether enrolling in dental insurance fits your budget and needs. Examine the pros and cons before committing.
Advantages
While dental insurance requires an upfront cost, it often pays off in the long run. Consider a few benefits listed below.
- Encourages you to maintain your oral health. If you already pay for insurance, it helps remind you to schedule regular cleanings and invest in your health.
- Saves money in the long run. Insurance helps pay for preventative care that decreases your chances of developing tooth decay, gum disease, or other serious health conditions.
- Increases access to dental care. Paying a small monthly premium makes routine maintenance more affordable.
- Offers budget-friendly options. While the average dental insurance cost is under $50, you can enroll in even cheaper plans that provide some coverage without burdening your monthly expenses.
Drawbacks
For some, however, dental insurance is not worth the monthly premium. Take the following scenarios as examples.
- Not all plans cover all procedures. More expensive services may not receive any coverage, even if they’re necessary.
- Annual maximums limit your savings. If you need extensive work, you may hit the maximum quickly.
- Premiums add up. If you pay $40 per month but only need two cleanings, for example, your total premiums may cost more than paying for those cleanings out-of-pocket.
- Network-based plans can limit your options. HMO plans will not cover out-of-network care, while PPO plans offer limited coverage.
All in All
Dental insurance lowers the immediate and future costs of taking care of your teeth. You’ll pay less for preventative care, while receiving some financial assistance for more expensive services. Maintaining routine cleanings is crucial to preventing serious health issues.
If you cannot afford dental insurance, research Medicaid eligibility in your state. In some states, Medicaid covers adult dental services, often in emergencies. If you are not eligible for Medicaid, look for low-cost health clinics or dental schools, or shop around for a dental insurance plan that fits your budget.