How Much Does Dental Insurance Cost?
Learn dental insurance prices and methods you may save
Dental insurance is meant to cover the expense of dental treatment. Most insurance include preventative care, such an oral checkup, tooth cleanings, and x-rays. More comprehensive dental insurance policies also cover some restorative or orthodontic treatments, such as cavity fillings and braces.
The expense of dental treatments without insurance might be high. But, based on your projected requirements and the sort of dental plan you pick, it’s crucial to assess which form of coverage is ideal for you.
Here’s everything you need to know about the price of dental coverage, including different dental insurance prices, the variables that determine them, and what paying them normally gets you.
- The cost of dental procedures might be costly, but an insurance coverage won’t necessarily save you money. You must examine your dental requirements to decide if the expense of coverage is worth it.
- Dental insurance expenses occur in five types: premiums, deductibles, copays, coinsurance, and yearly maximums. Incorporate all of them in your thoughts.
- Overall dental insurance prices vary across plans and states, but you should expect to spend roughly $529 to $606 per year on average.
Dental Insurance Expenses
Although there’s no way to tell precisely much you’ll pay on dental insurance in a given year, there are methods to approximate it. For example, in 2020 overall dental expenditures in the United States were $142.4 billion.1 The U.S. has a population of around 332 million according to the latest estimates, so it works out to an average of nearly $428 per consumer.
Another helpful data point is the latest study released by the American Dental Association, which found that if you had dental insurance in 2015, you could expect to spend roughly $453 to $520 including premiums and out-of-pocket costs. Adjusting for inflation, that works out to around $529 to $606 in 2021 dollars.4 Ultimately, your actual annual costs depend on several factors, such as your dental service needs, location, and policy type.
Dental insurance expenses originate from five sources: premiums, deductibles, copays, coinsurance, and yearly maximums. Here’s how each one works, as well as what you can expect to spend for them.
Premiums are the monthly or yearly payments you make to an insurance provider to keep your coverage. Here are some 2022 examples from zip codes from the following counties that utilize the Affordable Care Act (ACA) marketplace:
- Travis County, Texas: $8.93 to $63.07/month
- Hawaii County, Hawaii: $18.06 to $52.06/month
- Saint Johns County, Florida: $7.95 to $44.24/month
Costs range within states owing to coverage changes and across states because of variances in expenses of living.
Deductibles are the amount you must put toward your services yearly before your insurance assists with the remainder. These are the 2022 dental deductible ranges for the same locations indicated above:5
Travis County, Texas: $0 to $60
Hawaii County, Hawaii: $0 to $75
Saint Johns County, Florida: $0 to $150
Deductibles normally have an inverse connection with premiums, meaning insurance with larger deductibles have lower rates and vice versa. Certain dental plans have no deductible.
Copays are costs that you may have to pay out of pocket when you see your dentist that connect with the price of the treatment. For example, many insurance give preventative care with no premium, but a 20% to 50% payment for a root canal operation. It implies for root canals costing $1,500, you may be liable for a copay of $300 to $750.
Coinsurance is the proportion of treatment that you must pay for after reaching your deductible. For example, the ACA dental insurance with the lowest rates in Texas, Texas Essential Health Benefit plans, offer 100% of preventative treatment after your deductible. Unfortunately, they only pay for 50% of restorative treatment for adults and 50% of orthodontic care for children.
Yearly maximums are the highest that dental insurance coverage will pay in benefits. After your coverage covers its yearly limit, you’re liable for any dental bills for the remainder of the year.
For example, the Texas Essential Health Coverage plan has an annual limit of $1,000.
NoteYearly maximums only apply to adults and are the reverse of out-of-pocket maximums. After you reach an out-of-pocket limit, the insurer covers the balance of your spending for the year. Out-of-pocket maximums only apply to dental coverage for children. They must be $350 for ACA coverage covering one kid and $700 for policies that cover two or more.
How Dental Plan Type Affects Cost
There are five major kinds of dental insurance coverage. Whatever one you pick also influences the cost of your dental insurance. Here’s what they are and how they effect expenses.
- Dental Preferred Provider Organization (DPPO): DPPOs provide you a network of providers to pick from; going to a dentist out of the network will raise your rates. DPPOs often include deductibles, and copays and coinsurance are common for anything beyond preventative care.
- Dental Health Maintenance Organization (DHMO): DHMOs provide you a network and no coverage beyond it. They generally have no deductible or yearly cap and charge costs for non-preventive procedures.
- Dental Indemnity: They tend to cost more since plans don’t confine you to a network or a primary care dentist. You’ll normally pay coinsurance for treatments after you satisfy your deductible.
- Dental Exclusive Provider Organization (DEPO): These plans also frequently feature deductibles and coinsurance. You don’t need a main dentist, but you must utilize a dentist within the plan’s network in order to be covered.
- Dental Point of Service (DPOS): These plans frequently feature higher deductibles, premiums, and copays. You are allowed to visit an out-of-network dentist, but prices may increase.9
Out-of-Pocket Dental Expenses
Dental insurance coverage have limits, and you may have to pay out of cash for certain services. The lowest insurance only cover preventative care, and even those are subject to limits. For example, you may only obtain two complimentary tooth cleanings every year.
The next level up in plans also includes restorative treatment, such as fillings for cavities, teeth extractions, or root canals. They cost more but are still typically cheap compared to having to pay for these procedures without any insurance coverage.
The most costly and comprehensive plans also include orthodontic treatments. They fix your teeth and bite alignment.
Some services are often not covered by any dental insurance policy. Such examples include cosmetic operations, like as teeth whitening, and ailments that existed before you enrolled in the coverage.
Lowering Dental Care Expenses
Dental insurance may save you money, but only if you buy the correct coverage. Correctly forecasting your dental care requirements is the key to keeping expenses low.
For example, assume you have healthy teeth, and your only requested dental procedures in the following year are two teeth cleanings. Your study shows you each one would cost you $100 with no insurance.
To evaluate whether you may save money with dental insurance, you check for packages that give two free tooth cleanings. You locate one that just costs $8 in monthly premiums. It would make sense to purchase because you’d pay $96 per year with the coverage and $200 without it.
Nevertheless, if the lowest insurance offered cost a $20 premium, coverage wouldn’t be worthwhile. You’d spend $240 per year with insurance vs only $200 without it.
Another approach to keep your expenditures down is to remain on top of your oral health. Preventative treatment and basic cleanliness might lessen the possibility that you’ll require more costly restoration procedures in the future.
Commonly Asked Questions
Is dental insurance worth it?
Dental insurance is worth it if you find a policy that covers the dental treatments you need for less than you would spend for them without coverage. Compare a plan’s cost in premiums, copays, deductibles, coinsurance, and yearly maximums to the amount you’d pay for your preferred services without it.
What does dental insurance normally cover?
Standard dental insurance coverage include preventative procedures that keep your teeth healthy, such as semi-annual cleanings. More costly and comprehensive dental insurance packages also cover restorative and orthodontic procedures, such as root canals and braces.