Is Dental Insurance Worth It?

Is Dental Insurance Worth It?

It’s no secret that dental care can be expensive, particularly if you’ve neglected your oral health for a long period of time. Many major dental treatments can cost thousands of dollars. Even routine preventive cleanings can rack up a pretty penny, now adding in the cost of potential extensive restorative dental treatments can easily make you squirm.

This is where dental insurance comes in. Dental insurance offers benefits that help to cover the costs of dental work. There are a variety of options to choose from, and this blog will give you the context you need if it’s dental insurance you’re after.

How Dental Insurance Really Works

How dental plans work and what they cover vary from place to place. However, the basic premise of how dental insurance works can be broken down as follows.

Premium payment

This is the amount you pay monthly to have dental insurance. 

Waiting periods 

With any type of health insurance, there is often a waiting period. This means you must wait a maximum of 6 months before you are covered for dental care that goes beyond preventive exams.

In-network or out-of-network 

Another insurance clause is the network. Depending on your insurance plan, you may or may not be required to see dentists who are part of the specific insurance dental provider network.

Frequency and limitations 

This states which dental services are covered with dental insurance and which are not. So you might be eligible for a free dental exam and cleaning once every 6 months, but, you may only be covered for a limited amount of dental care and treatment.


A deductible is an amount you must pay out-of-pocket for dental treatments before your insurance company will share in those costs.

Basic Dental Care Covered By Dental Insurance

Most dental plans provide 80% coverage for basic dental services, which include the following: 

  • Fillings
  • Non-routine x-rays
  • Extractions
  • Sealants 
  • Certain periodontal treatments

It also typically covers the entire cost of preventive procedures such as: 

  • Dental exams
  • Routine cleanings
  • Routine x-rays 

Some dental treatments, however, such as crowns, dentures, and bridges, are not included in basic dental care. The typical dental plan covers only 50% or less of these procedures. When it comes to specialist dental care, these are likely not covered in full by dental insurance, However, other options, such as dental payment plans and dental savings plans, are available.  

Types of Dental Insurance Plans 

When deciding to get dental insurance coverage, we understand it can be overwhelming. Let’s go through the 3 most common types of dental insurance plans available today and what they mean.

Preferred Provider Organization 

This is a dental insurance plan that uses a specific network of dentists to set fees under that particular insurance. If you have a dentist you’d prefer to see and they are not within this network of dental providers, you’re likely going to have to pay for that service yourself. 

Dental Health Maintenance 

Think of this as a prepaid dental insurance plan that exists to assist you in paying less for out-of-pocket payments. This type of dental insurance focuses purely on dental health, rather than aesthetic treatments. 

Discount Dental Plans    

This type of dental insurance is similar to that of a referral plan. So, instead of the plan paying for you to have dental care, you join this referral program and use the dentists within that network and pay the rate determined by your plan.

Difference Between Dental Insurance And Dental Benefits Plan

On the other hand, only certain costs are covered with dental insurance, whereas, your dental benefits plan will only cover some procedures in full, while it covers a certain percentage for other procedures. Some procedures your dentist prescribes may not be covered at all. Therefore, it’s important to check with your plan administrator to see if a procedure is covered, and if it is not, pursue other options to complete your prescribed treatment at an affordable price.

Questions To Ask When Choosing a Dental Insurance Plan 

Choosing the right dental plan can help reduce expensive healthcare costs. But before you store around for the best dental insurance plan for your teeth, make sure you get the answers to these commonly-asked questions.

  1. Do you have a network of dental providers I need to choose from?
  2. What are the total monthly costs associated with your dental insurance premiums?
  3. Are there annual payments?
  4. Does the plan cover orthodontic treatment?
  5. What are the out-of-pocket limitations?
  6. Does the plan cover emergency dental procedures?
  7. Am I covered for restorative dental treatment?

Jefferson Dental and Orthodontics Accepts Most Dental Insurance

Not only do we accept most private dental insurance plans, we even file the claims for you. We also offer a Dental Savings Plan if you don’t have or choose not to get dental insurance. Finally, we are committed to making your care affordable, so we offer payment plans for all credit levels, even those with no credit. Give us a call or book your appointment today!

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