What’s Included in Dental Health Insurance?

Rohan Mathew

At the end of 2018, about 80% of the population in the United States had dental health insurance.

If you had dental benefits or were thinking about signing up for them, you might be wondering what’s included or not.

Thankfully, we have you covered. Keep reading to find out what’s covered by dental insurance or not!

What’s Covered

Dental plans can vary depending on the insurance company and the plan you choose, so it’s best to ask for that information before you sign up for one. They normally provide a document that will list the different types of plans and coverages so that you can choose the best one.

In general, though, dental insurance will cover things like cavity fillings, tooth extractions, X-rays, a root canal, dental appliances (like retainers), crowns, implants, bridges, cavity fillings, teeth cleanings, emergency procedures, and possibly even oral surgery. 

Even though all of these things might be covered by your plan, you should check to see how much the insurance will cover. For example, they will normally cover the cost of two tooth-cleanings a year. 

But they may only cover a small percentage of any oral surgery. 

If you need a bridge or a crown and are wondering if it’s covered, you can always click here to find out more!

What’s Not Covered

In general, most dental insurance plans don’t provide coverage for things like tooth-colored fillings or other cosmetic dentistry. This could also include teeth-whitening treatments or getting veneers.

You will also have to find another plan for things like braces or other orthodontic treatments. If you have a pre-existing condition, you’ll also have to find out if this is covered under your plan. 

Different Types of Plans

The coverage will also vary depending on the different types of plans you choose. There are normally two main types: preferred provider organization (PPO) and Dental Health Maintenance Organization (DHMO). 

A PPO plan comes with a list of dentists that have already told the insurance company that they will accept that plan. That doesn’t mean you have to go to the dentists on that list.

You can always go to one that is out of network, but you may have to pay higher out-of-pocket costs. 

On a DHMO plan, you’ll have a list of dentists who will take your plan, but you’ll have to pay a set copay. Sometimes there’s no fee at all. But you won’t be able to see any dentist that is out of network. 

You could also sign up for some discount or referral plans. These plans will give you certain discounts on some dentists, but you don’t have to pay anything monthly. Instead, when you go to that dentist, they agree to give you a discount. 

What to Consider When Choosing a Plan

If your employer is giving you dental coverage, they’ll likely only give you one option, which makes it easier. However, normally it’s cheaper to get a plan on your own. 

You should make sure that you find a plan as soon as possible. Most insurances have a waiting period from when you sign up to when you can start using their benefits, so the sooner you find one, the better. 

This means that you’ll have to shop around for the perfect plan. If you already have a dentist that you love going to, you can ask them what insurances they take or recommend and start from there. 

When you start looking at other plans, you should consider a few factors. First, is that dentist in that insurance network? Would any other specialists be in that network if you needed them?

You should also look at the costs. This means figuring out how much you’ll pay monthly each year, how much the deductible is, and what the co-pays are. 

Does that insurance plan put any limitations on any pre-existing conditions? If they do, you might not be able to get them covered, and you’ll have to pay for dental insurance and the cost of the treatment. 

When you do narrow it down to a few plans that would work, make sure you always read the fine print before you sign up. Sometimes there are details in there that are easy to miss and could mess you up when you try and use it to help cover the cost. 


There are a few things that can affect how much the cost of your policy will be as well. For example, dental premiums can be anywhere from $20 to $60 a month. This will depend on where you live and what kind of coverage you decided to get. 

Most dental plans also come with average coverage maximums though. This means that if you have a limit of $2,000, once you hit that, you’ll have to pay all of the remaining costs until it resets the next year. 

You may also have different coverage levels for different procedures. For example, routine cleanings can normally be covered without using any extra out-of-pocket costs. But if you need a filling, they may only cover 80% while you have to pay the other 20% of the procedure. 

Learn More About Your Dental Health Insurance

These are only a few things to know about what your dental health insurance covers, but there are many more things to be aware of!

We know that dealing with any type of health insurance can be stressful, but we’re here to help you out!

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