Some dental care will still be an out-of-the-blue emergency, such as breaking a tooth.
But less obvious dental needs often can be predicted (or avoided!)
What’s Included in a Dental Plan?
RBFried / Getty Images
The member is free to use any dentist, and the plan will reimburse based on its fee schedule.
In other words, a more robust plan will tend to be more expensive than a less robust plan.
Discount Plans
There are also dental discount plans, which are not actually insurance.
You pay for your own treatment, albeit at the discounted rate.
You may be able to pay an annual fee to your dentist, in trade for various benefits.
One of those benefits is pediatric dental care.
But the rules for pediatric dental coverage aren’t the same as the rules for other essential health benefits.
If you purchase health insurance in theMarketplace/exchangein your state, it might or might not include pediatric dental coverage.
Dental coverage for adults was not addressed in the Affordable Care Act.
This is generally more than enough to pay for the routine dental care that most people need.
It’s also important to note that many dental insurance plans consider implants to be “cosmetic.”
And it’s also common to have waiting periods before these services are covered.
Most dental plans have annual benefit caps of $1,000 to $2,000.
Colgate.Is indemnity dental insurance right for you?
Kaiser Family Foundation.Employer Health Benefits, Summary of Findings.
American Student Dental Association.Understanding dental insurance.
Bankrate.Dental loans: How to finance dental costs.
Humana.The scoop on dental discount plans.
Healthinsurance.org.Is pediatric dental coverage included in exchange plans?
National Association of Dental Plans.Regulatory treatment of pediatric dental insurance outside exchanges.
April 10, 2024.
Healthinsurance.org.If I buy a dental insurance plan, what sort of out-of-pocket costs should I expect?
HealthCare.gov.Dental coverage in the Marketplace.
April 2, 2024.
