What is dental insurance?

Dental insurance helps you manage the cost of dental care so you can maintain your overall good health. Most dental insurance covers preventive care, which includes regular checkups by your dentist, and may also cover care for cavities, implants or getting a tooth knocked out.

How does dental insurance work?

Dental insurance works a lot like health insurance. Each month you pay a premium (a set dollar amount) and when you visit the dentist, you may be responsible to pay a copay, if your plan includes copays. The dentist’s office will bill the insurance company directly for your care. Most preventive dental care visits, which often cover checkups and cleanings, are covered under your dental insurance plan. Your insurance company will pay the dentist directly for your preventive care visits while you are only responsible for your copay, if your plan includes copays.

If you have a dental procedure that is not considered preventive care, the dentist’s office will send your insurance company a bill and, depending on your plan, your dental provider will bill you for the portion of the procedure your insurance company did not cover. You can find which procedures are covered by reviewing your plan details.

How much does dental insurance cost?

Like health insurance, there are a variety of dental insurance plans that offer a range of coverage options. Depending on your family’s needs and your budget, there are several affordable dental options available for you to choose from Humana. To calculate the cost of dental insurance for you and your family, first identify your specific needs and then choose a plan that meets those needs.

  • Do you have children that need regular, preventive care?
  • Will you or your children need orthodontic care?
  • Does anyone in your family require care for dental issues?
  • Are you or your family members in need of crowns or similar procedures?
  • Have you been to the dentist in the last year?
  • Do you visit your dentist on a regular basis?
  • Do you have any medical conditions such as diabetes or hypertension?

Be sure to do the math. Often your annual premium is less than the cost of 2 visits to your dentist per year for regular checkups. You can call your dentist and ask for the price of a visit if you pay yourself, without insurance. It’s likely that dental insurance is cheaper than paying for 2 visits out of your pocket. Plus, you get the added benefits of having dental coverage that will save you money in case unexpected dental issues come up.

Can I buy dental insurance without health insurance?

Yes, you can buy dental insurance without health insurance. When you purchase a health insurance plan, it doesn’t automatically include dental coverage. Dental insurance is separate from health insurance.

Unlike health insurance, you can buy dental insurance anytime of the year and from any insurance provider. You do not have to buy health insurance and dental insurance from the same insurance company. Make sure that the dental insurance plan you choose has the coverage and benefits that you and your family need.

What does full coverage dental insurance mean?

The term “full coverage” can mean different things to different people. For some, “full coverage” means a dental plan that covers basic preventive services, such as routine checkups, cleanings and X-rays. Others expect a full-coverage dental plan to reduce the cost of any dental service they may need, such as crowns and root canals. The good news is that Humana has a range of dental plans, so you can find the coverage that best fits your needs.

What is PPO dental insurance?

Like health insurance, there are different kinds of dental insurance plans. 2 types are health maintenance organization (HMO) plans and preferred provider organization (PPO) plans. Take a look at our helpful table that explains the difference between HMO and PPO plans.

PPO dental insurance means that you can choose any dentist, in or out of network, and you don’t need a referral. You also have the flexibility to visit dentists and specialists outside of your network, but at a higher cost.

Dental insurance from an HMO comes at a lower cost, but requires that you only visit dentists and specialists that are in network (part of Humana’s set of participating providers). Dental HMO plans also commonly include copays.

What does dental deductible mean?

Every dental insurance plan is different. Much like in health insurance, a deductible is the amount you pay before your insurance company begins paying. A dental deductible is the amount you will have to pay towards your dental bill before your dental plan will contribute to the cost of your dental treatment. Typically, there is a basic level of preventive services like checkups that are covered whether you have paid your deductible or not.1

Does dental insurance cover braces?

Today, kids and adults both need braces. If you or a family member needs orthodontic care, or will need it in the future, it’s smart to look for a dental insurance plan with orthodontic benefits in order to manage those costs. Different dental insurance plans offer different discounts on the cost of braces and other devices, so be sure to read carefully through the benefits offered in each plan.

Orthodontic care may not be covered if you begin treatment before you start a dental insurance plan. Be sure to get dental coverage before you start working with an orthodontist.

Does the Affordable Care Act cover dental?

No. The Affordable Care Act (ACA) doesn’t cover dental insurance. However, under certain conditions you can purchase dental insurance from the Marketplace.2

Am I required by law to have dental coverage?

No. The ACA doesn’t require adults to have dental insurance. Having dental coverage is an important part of being fit and staying healthy.3

Is dental insurance worth the cost?

Yes, dental insurance is worth it! In many cases, your annual premium is less than the cost of 2 visits to your dentist per year for regular checkups.

Maintaining good oral health is a key part of staying healthy. It’s important that your kids have regular dental care as they grow. Dental insurance helps manage the costs of preventive care and also helps lower costs in the case of unexpected events, like a broken tooth or a cavity.

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Sources

  1. “Choosing the right dental plan for you,” American Dental Association, last accessed April 14, 2023, https://www.mouthhealthy.org/dental-care-concerns/choosing-the-right-dental-plan-for-you.
  2. “Dental plans offered through the Affordable Care Act (ACA),” American Dental Association, last accessed April 14, 2023, https://www.mouthhealthy.org/dental-care-concerns/aca-dental-plans.
  3. “Dental plans offered through the Affordable Care Act (ACA).”