Securing the best dental insurance for the level of dental care you need can help cover some of the costs of preventive treatment and services, which is important as dental care in America can be expensive. Basic dental insurance plans cover hygiene sessions and routine dental check-ups, while premium dental plans cover a higher number of treatments such as bridges and crowns. Therefore, the right dental insurance for you depends on what state your teeth and gums are in, what treatment you may need going forward, and what you can afford each month.
"Dentists love to tell their patients they 'create smiles'. But people who pay out of pocket or out of network don't often leave a dentist's office smiling. By better understanding dental insurance policies, a dentist near you can see you for procedures from routine cleanings to root canals within the framework of your dental coverage. There are varying costs for procedures, but you can get an idea for how much a procedure will cost on FAIR Health Consumer's Dental Cost Estimator."
- National Association of Insurance Commissioners
Where you live also has an impact on which of the best dental insurance providers are available to you, same as with the best health insurance companies. So, as you can already see, there are a few moving parts involved when picking a dental insurance plan. By now you’re probably wondering, how much does dental care cost in America? Well, according to research gathered by the American Dental Association, dental care spending by those aged 35-49 with private dental care averages at $399 a year. That increases to $523 for those aged 50-64, which is natural as our teeth need more attention the older we get.
That’s also why securing one of the best dental insurance plans is worth considering if you’re aged 50+. Coverage varies between the dental insurance providers, so to ensure you’re getting the best deal, work out how much you normally spend on oral care per year, and the approximate cost of treatment you think you’ll need in the year ahead, to figure out which of the top dental plans are good value for your needs. This is the same advice we give when looking at the best vision insurance.
Securing the best dental insurance is a way to avoid paying high out of pocket costs, but it’s true that more extensive dental treatments hike the cost of a dental plan. Even the most generous dental insurance providers may introduce caps on the number of dental care procedures you can have during a specific period of time. Prevention is better than cure, which is why dentists recommend brushing twice a day, for two minutes at a time. Using one of the best electric toothbrushes makes this easy as they have two-minute timers built-in. If you’re dealing with staining, take a look at our guide to the best teeth whiteners.
Choosing the best dental insurance
How we chose the best dental insurance for this guide
For our guide to the best dental insurance, we looked at a long-list of various dental plan providers before whittling it down to the shortlist you see here. To help you find top rated dental insurance that you can comfortably afford, where possible we looked for plans with low premiums and reasonable annual benefit maximums.
Then, to ensure you are able to access treatment where you live, we whittled the list down further by only looking at dental insurance plans with a broad network of dentists available.
Waiting times and financial ratings
Another consideration was waiting time. After all, frustrating waiting periods make using dental coverage difficult, so we worked hard to select, where possible, providers without lengthy waiting lists (ie, lists exceeding six months for basic care).
Financial rating and assurance is important too, so we only considered dental insurance companies with a strong financial score. To aid us with this specific aspect of research, we turned to Standard & Poor’s. For existing customer reviews and insight, we used the likes of Better Business Bureau, Consumer Affairs, Consumer Advocate and BestCompany to get an informed look at how these dental insurance providers treat their customers.
Getting clear on dental insurance costs
Since many dental offices require you to pay the estimated uncovered balance upfront, get that figure in advance so that you can plan your budget. If you can't cover the remaining balance, you may want to ask if your dentist provides financing. That means you can pay monthly for dental care and spread the cost.
Finally, if you're changing dental insurance providers yet want to continue using your current dentist, visit the website of the dental insurer you’re thinking about signing up with and search to see if your dentist accepts the new type of insurance. Sometimes these search results aren't updated regularly, or only show offices seeking new patients. In that instance, ask your dentist for clarification.
What does dental insurance cover?
Most full coverage dental insurance plans cover two preventive maintenance visits a year without requiring a deductible payment. However, most require a deductible per person per year to cover dental care costs beyond preventive check-ups. If you need work done, most plans will cover a part of the costs.
A new dental plan won’t cover an emergency you’re experiencing now either, as most have a waiting period of six to 12 months for major work. However, some insurers will waive that if you recently had dental insurance.
|UnitedHealthcare||Physicians Mutual||Humana Dental||MetLife Dental||Guardian Direct||Delta Dental|
|Exams, x-rays and cleanings?||✓||✓||✓||✓||✓||✓|
|Basic care (fillings, etc)?||✓||✓||✓||✓||✓||✓|
|Major care (root canals, etc)?||Varies||✓||✓||Varies||✓||✓|
|Large network of dentists?||✓||✓||✓||✓||✓||✓|
|Short wait for basic care?||✓||✓||x||x||✓||Varies|
The best dental insurance to consider now
To generate our list below, we reviewed the top dental insurance providers in America. In our opinion, these are the best dental insurance options available today. That said, each provider and plan has its own pros and cons, so it's a question of weighing up what is most important to you. This list isn't ranked in order, so instead we have highlighted who or what each dental insurance option is best for.
UnitedHealthcare Dental: Best dental insurance for preventive cover
What we like
- Wide network of dentists
- Many plans include 100% preventive care
What we don't like
- Annual max benefit as low as $1,000
- Waiting periods vary for major care
UnitedHealthcare Dental, underwritten by Golden Rule Insurance Company, is part of America's largest network of dental providers. It also has a solid A+ financial rating from Standard & Poor. That's because it's part of the UnitedHealth Group, a Fortune 500 company.
There are no age limits on the various UnitedHealthcare Dental insurance plans, and preventive care is covered without any deductibles or frustrating waiting periods for basic through to common dental procedures. Coverage amounts and maximum benefits vary between plans and are also dependent on where you live.
Online browsing of plans is simple, and you can quickly get a hassle-free quote. As mentioned above, preventative care is covered, meaning exams, x-rays and cleaning won't be a worry for the foreseeable.
There are four PPO plans available with pricing starting at around the $20 mark. That should get you up to around 85% savings at in-network dentists. Some plans have a waiting period of up to four months, so check before you sign up if you need faster access to treatment.
UnitedHealthcare Dental user reviews and ratings
Compare UnitedHealthcare Dental against other providers using HealthInsurance.net. You'll get multiple quotes to compare dental plans that better suit your needs and budget.VIEW DEAL ON HealthInsurance.net
- Scores 7.2 at BetterCompany
- Scores 4.9 at Consumer Advocate
UnitedHealthcare Dental has mostly positive customer reviews across a variety of consumer review websites. The customer service and clear pricing are frequently held up as positive factors, as is the large network of dentists spread across America.
One BestCompany review stated that, 'co pays are reasonable and affordable', while another had 'nice coverage for dental needed emergency dental work and had it done at a nice price.'
Less favorable reviews concerned waiting times, especially when it came to bill settlement and being able to access bigger treatments such as dental implants. One review on Consumer Advocate complained that the company was taking too long to respond to a claim.
- Read our full United Healthcare Dental review for in-depth analysis
Physicians Mutual Dental: Best dental insurance for seniors
What we like
- No deductibles
- No waiting period for preventive care
What we don't like
- Three-month wait for basic procedures
- 12-month wait for major care
Physicians Mutual Dental Insurance spans a whopping 470,000 locations across America and will cover you for over 350 procedures. This insurer also offers good rates on its PPO plans, starting from as low as $24 per month.
Physicians Mutual Dental Insurance doesn't have any deductibles, and preventive care coverage kicks in immediately. If you need a filling, extraction or other preventive care treatment, expect a waiting period of up to three months. That extends to up to 12 months for services such as root canals and crowns.
There are no annual or lifetime benefits maximums on your coverage, and there are three dental insurance plans to choose from. With savings ranging from 33-50%, this is a great way to get a broad range of coverage at a low price.
The plans include Economy Plus, Standard Plus and Preferred Plus. The level of reimbursements for basic and preventive care varies according to the dental plan you pick.
Best of all, Physicians Mutual Dental Insurance includes benefits to help you pay for dentures, plus senior-specific pricing on certain treatments.
Physicians Mutual Dental user reviews and ratings
Compare Physicians Mutual against other providers using HealthInsurance.net. You'll get multiple quotes to compare dental plans that better suit your needs and budget.VIEW DEAL ON HealthInsurance.net
- Rated A+ at Better Business Bureau
- Scores 4.0 at BestCompany
Physicians Mutual has mostly positive reviews online across several websites, though it's worth noting that these reviews are mostly for the parent company and don't focus solely on the dental insurance service.
The Better Business Bureau has accredited Physicians Mutual with an A+ rating. The large majority of complaints logged via the BBB website have been in relation to billing issues. There were 65 complaints in the last three years, and 25 were resolved in the last year.
A recent customer review on BestCompany stated that Physicians Mutual, "Offers reasonable rates, and always there to answer questions. Cannot find anything bad to say about this company."
- Read our full Physicians Mutual Dental Insurance review for in-depth analysis
Humana Dental: Best dental insurance for value
What we like
- Works with over 270,000 dentists
- Good country-wide coverage
What we don't like
- Waiting periods up to 12 months
- Annual max benefits as low as $1,000
Humana Dental Insurance has a lot going for it as one of the larger US providers, covering all 50 states and offering PPO, DHMO and voucher plans. These represent savings of up to 45% when using in-network dentists, of which there are 270,000 available to choose from.
As with the other top dental health insurance providers, plans and coverage amounts vary widely depending on where you live. There are specialist plans for veterans too, giving you access to deeper savings.
What we like about Humana is its clear pricing and sheer value for money, as well as 100% coverage for preventive care such as exams and cleanings. This also will make a big difference to your oral health.
The maximum benefits amount also ranges from a low $1,000 a year up to unlimited, depending on the policy you pick. Waiting times currently range from six months for basic dental care, to over a year for bigger dental procedures.
Humana Dental Insurance user reviews and ratings
Compare Humana Dental against other providers using HealthInsurance.net. You'll get multiple quotes to compare dental plans that better suit your needs and budget.VIEW DEAL ON HealthInsurance.net
- Rated A+ at Better Business Bureau
- Scores 4.7 at Consumers Advocate
Humana Dental Insurance reviews are mostly favorable, with customers praising the PPO plan's low deductibles, no copayments, and 100% coverage for preventive procedures.
Positive reviews center around regular cleanings and dental exams, with one customer review on Consumer Advocate stating how, 'This plan has a monthly premium of only $12.99/mo and I go twice a year for cleanings and exams. I pay a $15 Co-Pay each time. All of my x-rays are: No Charge! I selected an In-Network Humana Dental Provider close to my home. I receive a 25% discount if I go to a specialist.'
The biggest complaints are to do with poor customer service via telephone, and call center staff not adequately understanding the different dental plans on offer. Other criticisms are around Humana not keeping its list of in-network dentists up to date, which has led to some customers being caught out.
- Read our full Humana Dental Insurance review for in-depth analysis
MetLife Dental Insurance: Best dental insurance for families
What we like
- Over 400 procedures covered
- Orthodontics included
What we don't like
- Only two employer-provided plans
- Often lengthy waiting periods
MetLife is the best dental insurance provider for those seeking cover for their entire family. The PPO and DHMO options are limited to just two plans, but preventative care is covered.
MetLife Dental Insurance offers two kinds of plans: a Dental PPO Plan and a Dental HMO/Managed Care Plan. The latter is available in California, Florida, New Jersey, New York and Texas. With these plans, you don't have deductibles or claims forms to deal with, but you must pick an in-network dentist when enrolling.
The PPO plans give you more freedom when choosing a dentist, and while you can see both in- and out of network dentists, better discounts are available when you have treatment with in-network dental care providers.
Included orthodontics make it ideal for families who have children in need of braces, while low copays help it appeal to anyone hoping to make a decent saving on dental care. With up to 45% to be saved, this is one of the better options out there, spanning over 400 procedures and a network of 90,000 dentists.
MetLife Dental Insurance user reviews and ratings
Compare MetLife Dental Insurance against other providers using HealthInsurance.net. You'll get multiple quotes to compare dental plans that better suit your needs and budget.VIEW DEAL ON HealthInsurance.net
- Rated A+ at Better Business Bureau
- Scores 4.4 via Consumers Advocate
Like a lot of the big dental health insurance companies, MetLife has is rated A+ at the Better Business Bureau, and has a 4.4 star rating at Consumers Advocate. That said, reviews are a mixed bag across different websites, and it seems as though customer service is at the heart of both the positive and negative reviews.
Some praised the service received, while others were frustrated with long wait times on phones, and lack of payments where cover was allegedly not fairly dealt out.
Positive reviews on ConsumerAffairs stated that, 'There was never an issue with claims processing,' and that the policy was, 'an add on to my existing health insurance through my employer. The value was great.'
- Read our full MetLife Dental Insurance reviewfor in-depth analysis
Guardian Direct Dental: Best dental insurance for plan choice
What we like
- Over 336,000 dentists in-network
- Affordable pricing
What we don't like
- Customer service issues for some
- Some report delays to bill payments
Guardian Direct Dental Insurance is a division of Guardian Life Insurance Company of America, which is one of the biggest mutual insurance companies in America. The provider holds an A+ rating with the Better Business Bureau, plus premium ratings for financial strength and stability.
There are a wide range of dental plans on offer here, with an easy search function accessible via the website so that you can find a dentist within the 100,000+ professionals listed as in-network. This is for both PPO and DHMO plans.
Guardian Direct Dental Insurance plan costs are reasonable, with plans starting for as little as $16 per month. You can access up to 35% discounts on some treatments, with reasonable copay options for larger dental treatments.
The Guardian Dental website offers three step-by-step mini Q&As to help you find the right dental coverage. Just answer the questions to get a hassle-free quote.
Guardian Direct Dental user reviews and ratings
Compare Guardian Direct Dental against other providers using HealthInsurance.net. You'll get multiple quotes to compare dental plans that better suit your needs and budget.VIEW DEAL ON HealthInsurance.net
- Rated A+ at Better Business Bureau
- Scores 4.8 at Consumer Advocate
Depending on which site you search, Guardian Direct Dental Insurance reviews are also wildly mixed, which is interesting. According to Consumer Advocate, Guardian Direct Dental has a 4.8 rating out of 5.
One recent review stated that, 'I'm so thankful that my employer chose Guardian Dental as our provider - they have covered so much and even have a rollover plan that has come very handy when I maxed out my yearly benefit.'
Other customers were unhappy with the customer service, complaining that staff need to be more clear when explaining benefits, caps and reimbursements.
- Read our full Guardian Direct review for in-depth analysis
Delta Dental: Best dental insurance for orthodontics
What we like
- Wide plan variety
- Free x-rays
What we don't like
- Not all procedures are approved
- Availability varies by state
Delta Dental is one of the largest dental insurers in America, covering all 50 states, and has six different plan options. These span PPO and DHMO, and include full mouth x-rays every two years.
There are over 340,000 dentists in the Delta Dental PPO and Dental Dental Premier Plans, so you'll hardly be stuck for choice. As with all of the best dental insurance providers, plans and the exact levels of coverage varies by state. Pricing varies on where you live too.
Preventive care such as cleanings and X-rays are covered at 100%, and all basic and more in-depth dental treatments and services such as crowns, root canals and dental implants are covered at roughly 50%. Some plans also include orthodontics care, which isn't commonly available with other dental insurance providers.
There is a state by state variation on availability, but with over 78 million people using Delta Dental Insurance, it's clearly doing something right. Cover not only works for individuals but also extends to families and can be accessed via your employer too.
Delta Dental Insurance user reviews and ratings
Compare Delta Dental against other providers using HealthInsurance.net. You'll get multiple quotes to compare dental plans that better suit your needs and budget.VIEW DEAL ON HealthInsurance.net
- Rated A+ at Better Business Bureau
- Scores 5.7 at BestCompany
According to Best Company, Delta Dental customers are ‘Typically satisfied with the coverage and service they receive from Delta Dental. Reviewers are also happy with its large network of dental providers.’
That said, some reviewers experienced difficulties when getting dental procedures approved, leading to frustrating delays. Others encountered issues when moving states and trying to transfer policies.
Delta Dental offers a range of plans, and the level of customer experience varies across them.
- Read our full Delta Dental review for in-depth analysis
Compare dental insurance quotes
Dental insurance can be expensive, depending on where you live and the plan you choose, so start your search today at HealthInsurance.net and get multiple quotes to compare dental insurance that fits your needs.VIEW DEAL ON HealthInsurance.net
Within each dental insurance review you’ll learn more about the specific dental plan costs, what is and isn't covered, any annual treatments caps, and more.
Choosing the best dental insurance for you
When it comes to picking a dental plan, make a list of your main oral care needs and balance those against a list of ‘nice to have’ benefits. Think about whether superb customer service and a large network of dentists are most important to you, or whether you just need routine preventive care and low monthly costs.
When you have settled upon a dental plan, check the fine print to ensure there are no hidden surprises, and to get familiar with what your coverage includes. In our experience, we've found that the majority of dentists are familiar with what standard and full coverage dental insurance extends to and can therefore talk you through this before any treatment is offered.
Flexible plan options
Does the dental insurance provider you’re considering offer a good selection of plans in your state? What are the out-of-pocket costs? Are they affordable? These can quickly add up, so make sure you can get the care you need without having to pay through the nose once you exceed any annual maximum limits.
Large provider network
It’s important to choose a dental insurance company with a large network of dentists and oral care providers, otherwise you may end up having to travel further than you’d like just to get treatment. You’re paying for this, so only go with a dental insurance provider that has a good number of dentists near to where you live.
Small number of exclusions
The truth is, the cheaper dental insurance plans often have more exclusions (ie, what they don’t cover), but is this cost-effective for you in the long run? Well, if your teeth and gums are in good health, and so you only need basic check-ups and cleanings, you could be fine with one a cheaper plan. If you need more ongoing care, the best dental insurance plan for you is one with fewer restrictions.
Minimal or zero waiting periods
If you have a pressing need for dental care, we’d recommend avoiding dental insurance plans with waiting periods, or else you may be facing a waiting period of up to one year before coverage begins - and you can get the treatment you need.
Everything you need to know about dental insurance
How does dental insurance work?
Dental insurance is different to dental discount plans, as the latter only offers reduced pricing on services for dentists in a specific network.
Dental insurance provides various tiers of coverage for a range of dental procedures. These include basic, preventive care, through crows and root canals. You pay a monthly insurance premium, and you may even have to pay an annual or lifetime deductible, plus any copayments, when you visit a dentist for treatment.
While the Affordable Care Act prevented any limits on health care coverage from being applied in a given year, even the best dental insurance often comes with annual limits as low as $750 per person. This is known as an annual maximum limit.
What happens once your maximum limit has been reached? You’ll need to cover the cost of any further dental care, also known as out of pocket costs. In addition to annual maximum limits, dental insurance often comes with waiting periods, depending on the dental care you need access to.
What is the cost of dental insurance?
The cost of dental insurance varies depending on the state you live in, how old you are, and the specific dental plan you’re thinking of selecting. The less expensive dental insurance plans, so those with low annual benefit limits, usually start at less than $20 a month per person. Again, this is largely dependent on where you live.
More premium plans can reach up to $60 plus a month per person (depending on where you live). If you have one of those, you will enjoy a higher annual maximum benefit limit (enabling you to get more treatment), plus extra coverage and dental services.
Is dental insurance worth it?
You are the only one who can answer this question from your perspective. To help you answer this, we would recommend looking at how much you have spent on dental care over the past three to five years, and whether you have seen an increase in the amount of dental care you are needing.
Take the cost of what you have paid for dental care in recent years and compare it against how much you would pay for dental insurance premiums, copayments, and deductibles each year with the dental insurance plan you’re considering.
You may discover that, if your oral care needs are low, you’re financially better off paying out of pocket. If you do take out a dental insurance plan, make sure you use it to ensure you’re getting the best value for money each month. That means attending all of your allowable preventive exams and cleanings.
What are the different types of dental plans?
Most dental insurance companies offer a variety of plans across many states. That means you should be able to find plans ranging from affordable to 'gold level', premium coverage. Here are the most common dental insurance plans available now:
Dental discount plans
These are not full-coverage plans and should not be considered dental insurance, but they do provide discounts for common procedures. Discount plans usually only cost around $10 per month per person and the benefits can be used immediately, without a waiting list.
These low-premium plans may be suitable for those who don’t usually need dental work, and will help you cover the cost of preventive exams and cleanings.
Standard individual plans
The most popular dental plan for individuals since it covers most costs associated with preventive exams. Most cover two exams, cleanings and x-rays per year, and will partially cover additional work. There may or may not be a small exam copay.
Family dental plans
These dental plans are similar to standard individual plans. However, many insurance companies will offer the benefit of a family deductible. While most dental plans require a $50 deductible per person, the majority have a maximum family deductible of $150, which could be beneficial to those who need to insure more than three people.
Premium dental plans
The premiums for these plans cost more but often may include a higher yearly payout rate. The plans may also enable more cleanings per year, such as one every four months rather than every six months. Other options to ask about include add-on plans for things such as assisting with adult implants.
What is the best dental insurance for individuals?
Most dental insurance companies offer plans for individuals, but obviously some are better than others. Based on our research the best dental insurance for individuals is offered by Delta Dental. It offers affordable dental plans for single people, and has an extensive network of dentists to pick from in over 330,000 locations nationwide.
You can choose from an HMO plan, with affordable copays on preventive, basic and major dental services, and best of all there are no waiting periods for many services. There’s a PPO plan on offer too, for all three tiers of care. It includes a deductible and there is an annual maximum on treatment, so you’ll have to cover any additional fees after you have reached that maximum within a year.
Does expensive dental insurance mean it’s the best?
For this guide to the best dental insurance, we consulted with three dentists to get their perspective on dental insurance providers. However, since they often have to negotiate prices with insurance providers, we’ve kept them anonymous to protect those interactions.
Each dentist said the same thing: be wary of choosing the cheapest provider in your area because they are typically the worst when it comes to approving procedures or reimbursements. And while it didn’t affect our evaluations, each dentist named Delta Dental and MetLife as the most reliable and easiest to work with.
The dentists recommended that you start by assessing your current dental health. What work do you expect you’ll need in the next two to three years? For example, if you haven’t been to a dentist in a long time, you should consider a comprehensive coverage plan.
Do you have children who may need braces? Do you need implants? Most insurance plans don’t cover these procedures until you’ve been on the plan for at least 12 months, so it’s worth taking the time to evaluate your oral health, even if it means getting a checkup with a dentist prior to deciding on a plan. Your dentist can help you project what kind of work you may need.
Will dental insurance cover implants?
According to the American Academy of Implant Dentistry, ‘Think of dental implants as artificial tooth roots, similar in shape to screws. When dental implants are placed in your jawbone, they bond with your natural bone. They become a sturdy base for supporting one or more artificial teeth, called crowns.’
Dental implants are far more preferable compared to dentures, but the cost of implants can be prohibitive for some. The cost of the implant and the procedure itself can often range from $1,500 to $6,000, and the large majority of basic dental plans simply won’t cover this. In that instance, you may be better off choosing a dental savings plan to access discounts on dental implants.
There are dental insurance plans that cover implants, including the likes of Delta Dental and Cigna, but check the particulars of the plan to see if there are any caveats. For example, you don’t currently have any missing teeth.
Does dental insurance cover whitening?
Teeth whitening is classed as a cosmetic procedure because it is primarily used to reduce staining and improve the look of your teeth. As such, you’ll have to cover the cost entirely of any teeth whitening procedures you opt for with your dentist.
In-dentist whitening treatments can cost up to $600 per session, depending on where you live. That’s why many people explore teeth whitener kits and strips to brighten their smile at home instead. To learn more, read our guide to how teeth whitening works.
Does dental insurance cover dentures?
The majority of full coverage dental insurance policies include some form of restorative coverage, and usually around half the cost of dentures is covered. Deductibles and copays still apply though, so you’ll find that the final cost to you can still be high.
The waiting period for new dental insurance patients applies to dentures too, as these are considered a non-emergency procedure. So you could be waiting anywhere between six months to a year or longer. And obviously dental plans have an annual maximum limit, so any previous dental work that year will chip into your dentures allowance.
Which dental insurance covers braces?
Orthodontics is the area covering braces and any treatments around bite alignment, and while orthodontics patients are mainly children, adults receive this type of dental treatment too.
As stated in an FAQ written by the American Association of Orthodontists, ‘According to the American Dental Association Survey of Dental Fees for 2016, the fee for comprehensive treatment of adolescents ranged from $4,978 to $6,900, and the fee for comprehensive treatment of adults ranged from $5,100 to $7,045.
‘Most orthodontists offer a variety of payment plans to make orthodontic care affordable. The plans offered likely vary from doctor to doctor. Each doctor sets his/her own policies on payment plans.’
If you or a family member needs braces, or will do in the future, when choosing among the best dental insurance plans, look for those with orthodontic benefits. Coverage could be for a percentage of the fee, or it might be capped at a specific amount.
Why do smokers pay more for dental insurance?
Most dental insurance companies charge smokers higher premiums than they do those who don’t use tobacco. This is because insurance companies assume more financial risk when they cover a smoker.
In general, someone is considered a smoker if he or she has smoked in the past year. Some insurance companies extend that criterion back as far as five years, according to InsuranceQnA.com.
“The reason why smokers are charged higher dental insurance premiums is that those who smoke are more prone to diseases of the gums and teeth,” the article says. “In fact, smoking is considered one of the main reasons for tooth loss.”
The Oral Health Foundation argues that individuals who smoke tend to produce more bacterial plaque in their mouths than normal, which can ultimately cause gum disease.
“The gums are affected because smoking causes a lack of oxygen in the bloodstream, so the infected gums don't heal. Smoking causes people to have more dental plaque and causes gum disease to get worse more quickly than in non-smokers.”
What if my favorite dentist is out of network?
Dentists can choose to join insurance providers’ preferred networks so that patients get the most out of their insurance benefits. If your dentist isn’t part of your new dental insurance provider’s network, you'll end up paying more for dental care.
As with other types of insurance, dental insurance companies prefer you use an in-network dentist and will cover a larger share of the cost than if you visit an out-of-network dentist. As part of their agreement with the insurance company, in-network dentists don’t charge patients more than the costs covered by the insurance plan.
Dental insurance glossary
- Accepted Fee: The amount the contracting dentist has agreed to accept as payment in full from you and your dental insurance provider.
- Annual maximum: The total amount that a dental plan will pay for any dental care costs incurred by you during a calendar year.
- Allowable amount: Also known as the maximum allowable amount. The highest amount a dental plan will pay toward the cost of your dental services in a calendar year.
- Closed network plan: A dental plan that requires you to use an in-network dentist in order to access benefits.
- Co-pay: A form of dental cost sharing. These are pre-set fees that you will have to pay each time you visit your dentist or need a specific service.
- Deductible: The amount you will pay for certain allowed (covered) dental services before your dental insurance provider starts paying benefits.
- DEPO: This is a type of dental plan called a Dental Exclusive Provider Organization. Care from out of network dentists is not covered except for emergencies.
- DHMO: Dental Health Maintenance Organization. These provide benefits at fixed copays, and require you to go to dentists in the DHMO network.
- Dental insurance policy: Your dental insurance contract wherein you or your employer pay premiums for the policy, and a dental insurer pays for some of all of your allowed dental care costs.
- DPPO: Dental Preferred Provider Organization (DPPO), another type of dental insurance plan. If you use an in-network dentist, treatment costs are usually less.
- Dental discount plan: A dental treatment savings plan, not insurance.
- In-network: Dentists and other dental care providers that contract to provide dental services on the dental policy or plan you have chosen.
- Lifetime maximum: The cumulative amount that a plan will pay for dental care incurred by you, either for your lifespan or the plan’s.
- Out of network: Dental care from dentists and providers who are not on your plan.
- Out of pocket maximum: The most a dental plan will require you to pay in a calendar year.
Related health guides
Electric toothbrushes for all
To keep your teeth and gums as healthy as possible between dentist check-ups, brush regularly with an electric toothbrush.
At-home teeth whitening
After brushing your teeth, consider using an at-home teeth whitening kit or simple whitening strips to remove stains and brighten your smile.