Dental insurance is insurance designed to pay a portion of the costs associated with dental care. There are several different types of individual, family, or group dental insurance plans.
In general, a dental insurance plan covers a percentage of the dental charges incurred at a dental office, and may include free preventative services such as cleanings. There is no industry standard annual maximum limitation, deductible, or co-pay. Such coverages and benefit limitations are determined by each insurance company.
In the past 30 years, dental insurance has grown from a rare fringe benefit to standard fare in many employee health-care packages.
About 156 million Americans have dental coverage, estimates Evelyn Ireland, executive director of the National Association of Dental Plans, a Dallas-based trade organization whose members include providers of managed-care and other dental plans.
Of that total, roughly 90 million have traditional indemnity plans; 60 million have managed-care plans; and 6 million operate on a referral system, going to dentists who have agreed to offer special rates, Ireland says. Referral systems, however, are not insurance plans.
People who work for large companies are most likely to have dental coverage. About 90 percent of employers with 500 or more employees offer dental benefits. Across the board, about 50 percent of companies offer dental coverage, Ireland says. The self-employed are the least likely to be covered.
While nearly everyone in a dental plan is covered for preventive and restorative work such as fillings, only about 70 percent of those with dental plans have orthodontia covered, according to EBRI.
How do you decide which plan is for you? "Look at the percent covered, (along with) what's covered and what's not," suggests Werntz. Determine if the plan provides for early intervention to ward off more extensive problems later, he adds.
If you have young children or teenagers, preventive care is especially important and an orthodontia benefit is ideal. If you're middle-aged, check whether the plan lets you see a periodontist (gum specialist), since gum disease becomes more common with age.
