Dental Insurance

As an insurance broker, we’re often asked if dental insurance is worth the expense.  A typical dental plan premium (the fixed amount you pay monthly) will cost between $20-50 per month; and whether or not it makes sense will likely depend on the following factors:

Do you regularly go for preventive care?  Most dental plans will cover 100% of your preventive care if you visit an in-network dental provider. Preventive benefits will typically cover exams, cleanings, x-rays and fluoride treatments for minors. If you regularly go for your preventive care, the cost of dental insurance can pay for itself.

Is your dentist in-network? If your dentist is in-network with your dental plan, you will generally have lower out of pocket costs for your dental care. For example, your preventive care is usually covered 100% if your dentist is in-network, but you may be responsible for excess charges if they are out-of-network.  

Over the years we have seen a trend with more dentists choosing to no longer accept dental plans as an in-network provider, and instead accept PPO dental plans only as out-of-network providers.  This can be confusing for consumers because they’re often under the impression that they’ll receive the same coverage - but they can be subject to higher out of pocket costs when receiving care.

If your dentist is in-network with your dental plan, or if you’re willing to switch to an in-network dentist, dental insurance can make more sense and offer more value.  

Dental Preferred Provider Organization (PPO)

With a dental PPO plan, the insurance company has negotiated contracts with a network of dentists that have agreed to charge set fees for approved services.  Patients will typically receive lower out-of-pocket costs if their dentist is in-network, and will also have the flexibility to use out-of-network dentists (generally at a higher cost). Dental PPO plans are the most common type of dental policy

Dental Maintenance Organization (DMO) 

A DHMO typically offers a lower monthly premium with an emphasis on preventive care.  Patients are required to choose a primary dental facility or clinic to coordinate and manage their dental care. If there is a need for a specialist, the primary provider will be required to submit a referral. DHMOs do not offer coverage from out-of-network dental providers.