Dental Insurance

As an insurance broker, we frequently encounter the question of whether dental insurance is worth the cost. A typical dental insurance premium, which is the fixed amount you pay monthly, generally ranges between $20 to $50. The value of this investment often hinges on several factors:

Do you regularly seek preventive dental care? Most dental plans cover 100% of your preventive care when you choose an in-network dental provider. Preventive benefits usually include exams, cleanings, x-rays, and fluoride treatments for children. If you consistently utilize these preventive services, the expense of dental insurance can effectively pay for itself.

Is your dentist considered in-network? If your dentist is part of your dental plan's network, you will generally incur lower out-of-pocket costs for your dental care. For instance, preventive dental care is typically fully covered when visiting an in-network provider; however, you might face additional charges if your dentist is out-of-network.  

We've observed a growing trend where more dentists opt not to accept certain dental plans as in-network providers, instead agreeing to work with PPO dental insurance only as out-of-network providers. This situation can create confusion among consumers who might believe they will receive the same coverage, yet they could end up with higher out-of-pocket costs when seeking care.

If your dentist is in-network with your dental plan, or if you are open to switching to an in-network dentist, having dental insurance can be more beneficial and provide greater value.

Dental Preferred Provider Organization (PPO) dental insurance

With a PPO dental insurance plan, the insurance company has negotiated contracts with a network of dentists who have agreed to charge set fees for approved services. Patients will typically enjoy 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. PPO dental insurance plans are the most common type of dental plans available.

Dental Maintenance Organization (DMO) dental insurance

A DMO dental insurance plan typically offers a lower monthly premium with a strong emphasis on preventive dental care. Patients are required to choose a primary dental facility or clinic to coordinate and manage their dental care. If a specialist is needed, the primary provider must submit a referral. It's important to note that DHMOs do not offer coverage for out-of-network dental providers.