How to Buy Dental Insurance

Choosing a dental insurance plan should be much easier than getting a root canal. But finding affordable dental insurance that meets your needs, now and into the future, isn’t always a painless process. This guide to dental insurance will help you to avoid unpleasant surprises by giving you the information you need to choose the best dental insurance.

How to get dental insurance

What is the best dental insurance?

There is no single “best” dental insurance. The best insurance is a plan that will save you money on the dental care that you (and your spouse/family) needs. For some people, the best dental insurance needs to cover braces, others may want a plan that helps reduce the cost of restorative dental care.

If you have a dentist, ask them to recommend an insurance plan based on your dental health needs. Dental insurance is a great way to maintain your good oral health. Consider insurance alternatives – such as a dental savings plan if you need to get your smile back in shape. Dental savings plan members report saving an average of 50%* on their dental care. Find out more about the differences between dental savings plans and dental insurance.

How do I buy dental insurance?

Best case scenario is that your employer offers dental insurance as part of your benefits package, or as a voluntary benefit (“voluntary” means you pay for it, but you get a lower rate since it’s group coverage). If you are self-employed and belong to any trade organizations or other associations, you may wish to see if they offer group rate dental insurance to members.

Otherwise, there are limited options available (mostly for children’s dental insurance) on healthcare.gov, or your state’s own ACA marketplace. You can only purchase dental insurance on the ACA marketplaces if you also have an ACA healthcare plan.

If you’re a Medicare recipient, you are not covered for regular dental work. You can often get dental insurance through a Medicare Advantage plan, but make sure Medicare Advantage is the best healthcare option for you before you sign up or switch from traditional Medicare just to get dental insurance.

You can also purchase private dental insurance from a broker, or online.

Is there an open enrollment period for dental insurance?

You can purchase private market dental insurance online or via a broker whenever you wish.

If you are buying dental insurance as part of a Medicare Advantage plan you need to do so during the Medicare open enrollment (October 15 to December 7 of every year) or during the extended special open enrollment when you are first eligible to sign up for Medicare (which starts three months before the month you turn 65 and ends three months after your birthday month.) There are some exceptions that enable you to sign up outside of the open enrollment period.

If purchasing an ACA plan, you’ll have to do so during open enrollment (dates vary, check Healthcare.gov for the latest info) or demonstrate that you are eligible for a Special Enrollment Period due to a “qualifying life event” such as having a baby, getting married, or losing your health care coverage.

Anyone can join a dental savings plan at any time of the year.

How do I find a dentist?

You can use a dentist search tool. You can also look at reviews online, and ask your family, friends and coworkers for recommendations. If you are looking for a dentist that accepts your dental insurance, check with your insurance provider or look on their web site.

Understanding dental insurance

What is the difference between a DPPO plan and an DHMO plan?

DPPO stands for Dental Participating Provider Network. A DHMO is a Dental Health Maintenance Organization. Get the details on the difference on these types of dental insurance, the information below is an overview.

DHMO plans tend to be less expensive – and less flexible – than DPPOs. With a DPPO, you don’t have an annual maximum spending limit, and you’re covered for dental care right away. You must see an in-network dentist who will be your primary provider, you’ll need a referral to see a specialist, and there may be limits on how often you can get specific treatments.

DPPO plans are widely accepted at dental practices nationwide, and although you’ll save more with in-network dentists, you can go out-of-network if you choose. Most DPPO plans don’t require referrals before you can see a specialist. There is an annual deductible of $50-$100, and the typical annual maximum coverage limit is $1000- $1500. If you reach your spending limit, you’ll need to pay for your care out of pocket for the rest of the year. DPPO plans have waiting periods before new members are covered for major dental procedures like crowns, root canals, bridges and dentures. Typically waiting periods can be 6-12 months.

What is fee-for-service insurance?

Also known as indemnity insurance, this is the most expensive type of dental insurance. You can see any dentist you choose, and you pay the dentist in full at the time of treatment and are later reimbursed a set amount by your insurance company. These plans often have a higher annual maximum spending limit – $2,500- $3,500+, and may have a shorter than usual waiting period than DPPO plans (check plan details, as this can vary). Indemnity insurance plans were once the only option for dental insurance, but these plans are now increasingly harder to find.

What kind of dental insurance covers everything?

Dental insurance can definitely help you save money but it typically doesn’t cover everything. Most will not cover treatments for dental problems that you have prior to joining the plan or treatments that were already in progress, and some do not cover dental implants or cosmetic treatments. Dental savings plans, an alternative to traditional dental insurance, typically do cover care for existing dental issues (but not treatments already in progress) as well as dental implants and cosmetic procedures.

Can I be turned down for dental insurance?

It is unlikely that you will be turned down for dental insurance. Your claims may be denied, though.

Claims can be denied for many reasons, including preexisting conditions, non-coverage of specific services, waiting period limitations, patient age or treatment frequency limitations, or mistakes that your dentist/dentist’s staff made when processing the claim. If your insurance company refuses the claim, you must pay the total cost of care out of pocket. Dental savings plans eliminate reimbursement aggravations since you pay the discounted fee directly to the dentist.

Dental Emergencies and Dental Insurance

Can I buy dental insurance today and use it tomorrow?

DMHO plans don’t have waiting periods. With a new-to-you DPPO plan, for anything outside of preventive care, you’ll typically need to wait for 6-12 months before you qualify for restorative care. If you were previously covered by dental insurance for a solid year just prior to purchasing a new plan, you may be able to get the waiting period waived – ask before you purchase a new plan. Find out more about how to work around waiting periods.

Have no insurance, and need to see a dentist right now?

Consider joining a dental savings plan. Most dental savings plans activate within 72 hours of purchase, and you can use the plan to save on virtually all dental treatments right away. Plan members report saving an average of 50%* on their dental care.

Of course, you don’t need to wait for an emergency to join a dental savings plan. And, unlike dental insurance, with a dental savings plan you don’t have to worry about deductibles, annual spending limits or waiting before you qualify for reduced rates.

Want help choosing a dental savings plan or dental insurance that’s right for you? Give us a call at 1-833-735-0399 for personalized help or answer a few quick questions here to see your options.

*Discount Health Program consumer and provider surveys indicate average savings of 50%. Savings may vary by provider, location, and plan.