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What You Need to Know about Dental Insurance

Tuesday - July 2nd, 2019
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If you’re like many adults, you may sometimes take your dental health for granted. Foregoing regular dental care can not only have serious health consequences, it can also be a bad financial decision. According to a 2019 survey by the National Association of Dental Plans, approximately 47% of adults participate in employer-sponsored dental insurance plans but many, in turn, don’t make use of this benefit. Less than half of insured adults actually use their dental insurance and a mere 4.2% reach their annual maximum. With the average annual cost of dental insurance for an individual at about $360 a year, it just makes sense to get the most out of that investment. To help you better understand dental insurance and dental benefits plans, we’ve pulled together some essential information you should know.

Don’t let your dental insurance go to waste.

Health insurance is both expensive and confusing which causes many of us to simply adopt an avoidance strategy when it comes to understanding the details. Dental insurance is a different animal altogether, so it pays to understand the differences.

Dental benefits versus insurance.

Dental insurance doesn’t work like other insurance types. An insurance plan is set up to cover a loss and the insurer carries the risk. So, your homeowner’s insurance will reimburse you if you lose your home to a fire or natural disaster and if you total your vehicle, your car insurance pays you the value of your car. Dental coverage is set up as a benefit plan-it will cover certain costs up to a maximum amount. For example, free preventative care (exams, cleanings, and X-rays), $1,500 to $2,000 annually for restorative procedures (fillings, crowns, etc.) and a $1,500 to $ 2,000-lifetime benefit for orthodontics are typical max thresholds. It’s even possible that some procedures recommended by your dentist won’t be covered at all by your dental benefits plan. The vast majority of dental plans are based on care delivered within a calendar year. What you don’t use in that year, you lose. Also, dental insurance deductibles tend to be quite low, often under $100, which makes this less of a deterrent than comparable health insurance plans.

What does dental insurance cover?

In the majority of cases, while many dental benefits cover preventative care (two cleanings and two dental exams per year), most won’t cover other services at 100% because they are designed around annual maximum benefits vs. a cost-of-care model. When you sign up for dental insurance, be sure to understand what is covered by your benefits and what you will be responsible for. Here are some of the terms you might see:

In most cases, dental benefits plans will require you or your provider to submit a treatment plan for prior authorization before any services are completed. If you have any concern that a procedure might not be covered, it’s always a good idea to run it by your plan’s administrator who will review the treatment proposal, determine the patient’s eligibility for the procedure, the co-payment that will be required, and the max amount to be covered.

Types of dental plans.

When shopping for a dental plan it’s easy to get discouraged by all the acronyms that fly around. PPO to DHMO can leave you with FOMO (fear of missing out) on what might be a better plan and exclaiming OMG! Never fear, here are the most common types of plans:

What you should know to get the most from your plan.

Whether you already have dental insurance or are trying to assess the best dental coverage for you and your family, you will want to get the most for the benefits you purchase. Keep in mind, you can only benefit from dental insurance if you actually take the time to visit the dentist. Here are some important tips for getting the most out of your plan:


At Bright Now! Dental, we know that rising healthcare costs are no small matter. That’s why we want to help all our patients get the most out of their benefits and why we continually stress the importance of preventative dental care to help avoid oral health conditions that can be both painful and costly. That’s also why we accept most dental plans, accept credit cards for payment, and offer flexible financing terms and our OneSmile Dental Plan for patients without insurance. Our Smile Now, Pay Later program gives our patients flexible payment plans with low interest and extended terms.

There’s a lot to think about when it comes to understanding dental insurance. You can count on us to advise you regarding what we know about your plan or what you should consider when shopping for a dental plan. If you’d like support, please give us a call at 1-888-BRIGHT-NOW (1-888-274-4486) or contact us online to talk to our staff about our flexible payment plans.