How Much Is Dental Insurance: 2023 Cost Guide

Proper dental hygiene is crucial to overall wellness. Dental problems can affect a person’s overall health, including their risk for cardiovascular disease, diabetes, and complications during pregnancy, if they aren’t addressed. However, typical health insurance typically does not cover dental and oral care. This is where having dental insurance really pays off. This kind of insurance can do far more than just aid in maintaining healthy teeth. In addition, dental insurance has certain distinct features despite sharing many similarities with standard health insurance. In this article, we will discuss how much dental insurance costs in a month, out of pocket, in Florida and Texas.

What is Dental Insurance?

Dental insurance is a type of health insurance designed to help cover the costs associated with dental care. It typically includes a variety of services such as preventive care (cleanings and check-ups), basic procedures (fillings and extractions), and major dental work (crowns, bridges, and root canals).

Also, dental insurance plans may have different coverage levels, deductibles, and premiums, and they often require you to choose dentists from a network to receive the maximum benefits. Having dental insurance can help reduce out-of-pocket expenses for dental treatments and encourage regular dental check-ups to maintain oral health.

How Does Dental Insurance Work?

Dental insurance policyholders must maintain continuous coverage by paying the required premiums. This can occur on a monthly, quarterly, semiannual, or annual schedule. Payments for company-sponsored plans may be deducted automatically from wages.

However, policyholders are also responsible for other out-of-pocket costs. In many cases, plan participants must pay the following out-of-pocket expenses before they can make use of their dental insurance:

#1. Deductible

The deductible is the portion of dental care costs that the policyholder is responsible for paying out of pocket before dental insurance kicks in. The amount of premiums a person pays is directly proportional to the amount of their deductible. Thus, the inverse relationship between the deductible and the premium is true; the bigger the deductible, the lower the premium.

It’s important to remember that most insurance plans waive the deductible for preventative care services like annual checkups and dental cleanings.

#2. Copayment

Copayments, or coinsurance, are the portion of dental care costs that patients are responsible for paying out of pocket, with insurance companies picking up the tab for the rest. This can be necessary during the surgical operation itself.

The policyholder’s total out-of-pocket expenses for dental care prior to insurance coverage being activated are summarized in the table below.

Cost	What it means
Deductible	The portion of coverage costs that the policyholder agrees to bear before the insurance company steps in to pay
Coinsurance	The cost of insurance beyond the deductible that is the policyholder’s responsibility.
Copayment	The policyholder pays a fixed amount for dental care, and the insurance company pays the remainder.
Annual coverage maximum	Annual maximum benefit; after that, the policyholder is responsible for 100% of dental care costs.

Dental Insurance Out-Of-Pocket Expenses

#3. Coinsurance

Coinsurance is a method by which the policyholder and insurer share the remaining costs after deductibles have been met. The typical breakdown of dental insurance payments is as follows:

100% coverage for preventative care
80% coverage for basic services
50% coverage for major restorative dental procedures

#4. Annual Maximum

What this means is how much of the cost of dental care your insurance will cover each year. Once this maximum is reached, the policyholder is liable for paying the full price of all dental care. There is often a $2,000 annual cap on coverage. Premiums will increase if participants choose to use plans with larger limitations.

What Are the Different Types of Dental Insurance Plans?

Like traditional health insurance plans, dental policies come in a variety of options to accommodate policyholders with various requirements for dental treatment. Some examples would be:

#1. Dental Preferred Provider Organization (DPPO)

You can save money on dental care with this plan by seeing a dentist who is part of the plan’s preferred provider organization (PPO). However, for an extra fee, customers are free to visit dentists, clinics, and dental service providers outside the network without a reference.

#2. Dental Health Maintenance Organization (DHMO)

In many cases, patients with a DHMO plan can only visit in-network dentists or those who have contracted with the DHMO. These experts offer protection for a flat copayment or no payment at all. However, specialists who are not part of the policy’s network are not covered. For some policies, having a place of residence or employment within the plan’s coverage area is a prerequisite for receiving benefits.

#3. Indemnity or Fee-For-Service Plans

Members of this coverage, which is not limited to a specific network of providers like DPPOs and DHMOs, have the freedom to visit any dentist they like. In most cases, the patient is responsible for paying the remaining cost after the plan has paid its share. It also doesn’t have any of the other plans’ lower prices.

#4. Discount or Referral Dental Plans

These plans provide savings on dental care from a network of dentists who choose to take part in the plan. All payments are made at the time of service directly to the providers.

What Does Dental Insurance Cover?

If you have dental insurance through your employer, the Health Insurance Marketplace, your state’s Medicaid program, Medicare Advantage, or a private insurance company, the benefits and premiums you pay will vary depending on which option you choose.

You may be able to get cleanings and checkups at little or no cost to you if your policy covers them. Even after you’ve paid your deductible, it might help pay for some of your dental work, such as fillings and extractions.

Some plans may partially cover more involved dental procedures like root canals, crowns, endodontics, and periodontics. However, there may be a waiting period before certain services are covered by your plan, or your plan may pay a greater percentage of their cost after you’ve had them for a while.

Also, cosmetic orthodontia services can be covered by some dental insurance plans. Generally speaking, orthodontia services are only covered under pediatric dental coverage obtained via a health insurance marketplace if they are deemed medically necessary. In addition, reviewing a dental insurance plan both before and after purchase is crucial.

What Is Not Covered by Dental Insurance?

Your dental insurance plan will determine this. For instance, if you only get a preventative dental plan, you may not be covered for services like bridges, crowns, dentures, and root canals. Your insurance may not cover the following dental procedures:

All purely aesthetic procedures, such as teeth whitening and veneers.
Not all dental insurance policies cover orthodontic items like braces, aligners, or retainers. If you’re in the market for dental insurance that includes orthodontic coverage, it’s important to do your homework before committing to a provider. For instance, orthodontic services may have a different level of coverage than the actual orthodontic appliances themselves, such as braces or retainers.

Planning ahead for the dental care you and your family expect to need is the key to making sure your dental plan covers specific types of treatment.

What Are the Benefits of Having Dental Insurance?

Dental insurance may provide the following advantages:

#1. Reduced Out-Of-Pocket Expenses for Dentistry Other Than Preventative Care

If you don’t have dental insurance, you’ll have to pay out of pocket for any necessary dental work. The dentists who are part of your insurance network have agreed to cut their fees in exchange for a share of your premiums. This is how having dental insurance can save you money on the expensive treatment you need.

#2. The Benefits of Good Oral Hygiene Extend Beyond the Mouth

Maintaining a regular dental care routine might help detect developing health issues early on. Your dentist will do more than just clean and polish your teeth during your regular oral checkup; they will also look for signs of oral cancer and other problems in your throat and tongue. Maintaining good oral hygiene can help you avoid a number of life-threatening conditions, including heart disease. In addition, poor dental health has been linked to an increased risk of diabetes and cardiovascular disease.

#3. Free Routine Dental Checkups

Typically, dental insurance covers all aspects of preventive dental care. Each plan covers a semiannual dental checkup and cleaning, along with periodic X-rays. Preventive dental care for children may also involve the use of fluoride and other methods.

How Much Is Dental Insurance

According to research by Forbes Advisor, a complete dental insurance policy will set you back $47 per month on average. On average, a preventative health care plan would set you back $26 per month.

It’s difficult to give an “average” premium for adult dental coverage due to the considerable variation in available plans and the corresponding perks.

Generally speaking, a greater premium could mean less out-of-pocket expenses, a shorter waiting period, or a bigger benefit ceiling. To see this ‘cost to benefit’ relationship clearly, compare plans from the same provider.

It’s not unusual for dental insurance to pay for 100% of preventative care from in-network dentists, such as checkups, cleanings, X-rays, and sealants. However, there may be fees associated with these procedures not covered by your insurance plan if you have a plan with a relatively low premium. To avoid any unpleasant surprises, it’s important to study the fine print of each plan and determine exactly what each service will cost.

You may find that the preventive care benefits provided by the dental plan more than cover the plan’s cost, even if you don’t expect to use the plan for anything else. Costs for common dental procedures including checkups, x-rays, and twice-yearly cleanings can be obtained by contacting dentists in your region. Consider the cost of premiums you’ll pay for dental insurance and any out-of-pocket costs associated with your specific plan’s dental benefits.

Dental Insurance Costs by Plan Type

Preferred Provider Organization (PPO), Health Maintenance Organization (HMO), Point of Service (POS), Indemnity, and Exclusive Provider Organization (EPO) are the most common types of dental insurance plans offered through the Marketplace.

PPO plans. It has a more extensive dentist network and lets you pick from in- and out-of-network care. They typically have more premiums but smaller deductibles and copayments.
HMO plans. In exchange for cheaper monthly payments, these plans typically require you to select a main dentist from within the plan’s network. Specialist visits require referrals, and coverage for care received from providers outside of the plan’s network is limited or nonexistent.
POS plans. It’s a hybrid of HMO and PPO plans that gives customers the freedom to see doctors both inside and outside their insurance provider’s network. Specialists usually need a referral before they’ll see you. Unfortunately, the year 2023 did not provide any POS dental insurance options.
Indemnity plans. There are no limitations on dentists you can see, giving you the most flexibility possible. They pay for some of your dental care, but the premiums may be high.
EPO plans. It provides lower premiums than PPO plans but excludes coverage for visits to dentists who are not part of the plan’s network.

Similar to how health insurance is sometimes broken down into tiers, dental insurance may do the same. Dental insurance plans with higher precious metal tiers (Gold and Platinum) typically have greater costs but cover a wider range of medical expenses (at a lower deductible and out-of-pocket maximum). Also, dental insurance plans with lower metal levels (bronze and silver) have fewer monthly costs but greater out-of-pocket expenses.

Average Cost of Dental Insurance by Plan Type

Plan Type	Average Monthly Cost	Average Annual Cost	Average Deductible
HMO	$19	$223	$17
EPO	$20	$244	$50
PPO	$27	$323	$60
INDEMNITY	$37	$440	$54

How Much Is Dental Insurance Out of Pocket?

Whether you’re purchasing coverage for yourself or your whole family, how old you are, where you live, which insurance company you go with, and how much your deductible is all affect how much you’ll pay for dental care out of pocket.

There is usually a monthly payment, an annual deductible (the amount you pay out of pocket before the insurance coverage kicks in), and co-pays or co-insurance (a portion of the cost of the dental service that you are responsible for paying). Limits on how much dental care can be claimed each year or over the course of a person’s lifetime are included in some plans.

Before settling on a dental insurance plan, it is crucial to do some research into your options, compare plans’ prices and coverage, and think about your individual dental care needs. For more particular and tailored costs, you can consult dental insurance websites or insurance brokers.

How Much Is Dental Insurance in Texas?

Monthly Premiums and Policies Averaging Less Than $10

There is a large cost variation among the 38 dental insurance plans we looked at in Texas. The MetLife TakeAlong Dental HMO-Managed Care 350 (Low) had the lowest monthly premium of $7.03 in 2022 for a sample applicant aged 33, while the average premium was $40.83. The analysis found that the premiums for all HMO dental insurance plans and the single dental discount program analyzed (Careington 500 Series Dental Savings) were lower than the state average. Premiums for 16 out of 33 PPO and indemnity dental plans were lower than the research mean.

Out-Of-Pocket Fees for Covered Dental Services

Two-thirds (68%) of the 35 plans included basic dental cleanings without copayments. Most plans covered root canals and crowns for 32% of treatment costs in the first year. Certain dental plans enhanced this coverage percentage for customers who stayed for two or three years. HMO plans with flat-fee copayments charge root canals from $110 to $260, with an average cost of $192.50. The only dental savings program, Careington 500 Series Dental Savings, charged $320 for root canals.

With average insurance payouts averaging 45%, PPO and indemnity plans covered teeth extractions more than root canals and crowns. Fillings were much more expensive, with insurers paying 63%. HMO dental plans charge $25–$60 for fillings.

Also, 45% of plans in the study covered dental implants. After meeting the deductible, most implant plans cover 50% of the operation. Four implant plans covered 20% of treatment costs and one covered 10%. 65 percent of implant-covered dental plans needed a year of enrollment before crown coverage was provided. Delays in benefit access are called “waiting periods.” In 38 plans, waiting periods were widespread (particularly for more expensive dental care), with 37% having no waiting period delays for traditional dental coverage (orthodontics excluded).

All PPO and indemnity dental plans have yearly dental coverage limits. These plans averaged $2,014, up from $1,590 in 2022. NCD Nationwide 5000 had a $5,000 limit, two times the market average, while NCD Complete by MetLife had a $10,000 limit, five times the market average. In the study, HMO plans and dental discount programs had no annual insurer payment or client savings limits.

How Much Is Dental Insurance in Florida?

Competition in Florida’s dental insurance market is fierce because of the state’s high population density and plenty of dentists. The average monthly premium for a 33-year-old enrollee in one of Florida’s 37 dental plans for 2023 was $42.93. Despite having three fewer plans to compare, this average was still over 2% higher than what DentalInsurance.com saw in 2022. The average rate for dental insurance in California in 2023 was around 5% higher than in Florida, according to a similar analysis.

In comparison to the other PPO and indemnity plans we looked at, the Humana Extend 5000 had the highest premium at $99.99 per month, but its maximum benefit was double the market average. The Guardian Managed DentalGuard HMO plan, the least expensive traditional dental insurance option, costs $8.06 per month. The MetLife TakeAlong Dental HMO-Managed Care 350 (low) was a comparable HMO dental plan. The monthly cost of this plan was only $8.20.

Ameritas, Delta Dental, Guardian, Humana, MetLife, Nationwide, NCD, and Renaissance were among the eight insurance providers whose plans were used to calculate the average rate.

Individual deductibles, or the amount an enrollee must pay before the plan begins contributing to dental expenditures, varied from $0 to $150. Single-person deductibles averaged $53.38 in 2023, down from $65 in 2022, while 19% of plans had no deductible at all. Annual family deductibles were limited to $150 by several plans. Although the plan’s maximum deductible for a family was $450 per year, it would only charge that amount once, regardless of how long a family remained enrolled. The family deductible in certain plans was not limited and was $50 per person enrolled.

Comparison

Even for routine procedures like crowns, there was a wide variance in price among the many plans we looked at. In two of the plans, crowns weren’t covered at all. Crowns are often covered at a set rate by HMO policies. In the state of Florida, the average copayment was $358.75. Copayments ranged from $245 for the lowest tier to $430 for the highest tier. The plan only covered a portion of the crown’s cost; the patient was responsible for the balance. In the first year of coverage, PPOs and indemnity plans typically pay 30% of the entire cost of a crown. In the second and third years of continuous coverage, many plans increased their contribution towards crown costs.

The percentages of costs that the PPO and indemnity paid for fillings were higher than those for crowns. In the first year of coverage, such plans typically paid 62% of the total cost for traditional fillings. On average, only 42% of the expense of having teeth extracted was covered.

Waiting Period

In Florida, several dental insurance companies require patients to wait before receiving certain procedures. There may be a delay before the plan begins to pay for a certain dental operation due to a waiting period. The duration of a waiting period, which is typically between three months and a year, is calculated from the plan’s effective date. There was no waiting period for any of the benefits offered by 41% of the Florida dental policies (out of 34 total plans).

This research found that most dental insurance plans in Florida have annual maximums on how much they will pay for dental care. The term “maximum benefit” describes this capped amount. No such cap was included in the study’s HMO dental policies, but the average cap for all other plans was $2,059. Compared to the yearly average of $1,640, this was a huge increase. The NCD Complete by MetLife plan, with a $10,000 maximum, and the Humana Extend 5000 plan, with a $5,000 maximum, were both introduced this year.

In many cases, a typical dental plan does not cover “cosmetic” procedures. Whitening teeth and veneers are included in these procedures. Seven of the 37 plans DentalInsurance.com looked at, or 19%, provided teeth whitening as a covered benefit.

Factors Influencing Dental Insurance Cost

Several factors can influence the cost of dental insurance:

Type of Plan. Dental insurance plans come in various types, such as HMOs, PPOs, and indemnity plans. Each type has different costs associated with premiums, deductibles, and out-of-pocket expenses.
Coverage Level. Plans with comprehensive coverage, including preventive care, basic procedures, and major dental work, tend to have higher premiums. Limited coverage plans may have lower premiums but higher out-of-pocket costs when you need dental services.
Deductibles. Plans with lower deductibles usually have higher premiums, while plans with higher deductibles often have lower premiums. A deductible is the amount you need to pay out of pocket before your insurance coverage begins.
Co-Pays and Co-Insurance. Co-pays (a fixed amount you pay for each dental service) and co-insurance (a percentage of the cost you pay) can significantly impact your out-of-pocket expenses.
Network Restrictions. Some plans require you to choose dentists from a specific network. Visiting an out-of-network dentist may result in higher costs or reduced coverage.
Age and number of insured individuals. Plans covering more family members tend to be more expensive. Additionally, some plans offer pediatric dental coverage for children, affecting the overall cost.
Location. Dental insurance costs can vary based on your geographic location due to differences in the cost of living and healthcare expenses in different areas.
Annual or Lifetime Maximums. Some plans have limits on the total amount they will pay for dental care within a specific time frame. Plans with higher maximums often have higher premiums.

In addition, when choosing dental insurance, it’s essential to consider these factors and evaluate your individual or family’s needs to find a plan that balances coverage and cost-effectiveness.

What Are the Cons of Dental Insurance?

The expense of dental insurance is the primary drawback. Some seniors and their families may be unable to afford the plan’s premiums because of its high cost. Some services may also have coverage restrictions. Root canals may not be covered at all, whereas crowns, bridges, and dentures may only be partially covered.

Cons include but are not limited to, high out-of-pocket costs and annual limits on coverage or reimbursements provided by the policy. Furthermore, the premiums required by some plans may exceed the cost of providing the amount of care that is sought. Some insurance companies require patients to see doctors and specialists in their network.

What Is the Best Insurance to Have for Dental?

The “best” dental insurance varies depending on individual needs and preferences. However, some reputable dental insurance providers are known for offering comprehensive coverage and a wide network of dentists.

Delta Dental: Delta Dental is one of the largest dental insurance providers in the United States, offering various plans and extensive dentist networks.
Aetna: Aetna provides a range of dental insurance plans with different coverage options and flexibility, catering to various dental needs.
Cigna: Cigna offers diverse dental plans, including preventive, basic, and major services coverage. They also have a large network of dentists.
Humana: Humana dental insurance plans often include preventive care with no deductibles and offer coverage for a variety of dental procedures.
MetLife: MetLife offers a variety of dental insurance plans with options for individuals, families, and employers, providing coverage for preventive, basic, and major dental services.

When choosing the best dental insurance, consider factors such as coverage for preventive care, the extent of coverage for basic and major services, out-of-pocket costs (premiums, deductibles, and copays), and the network of dentists available. You must carefully research the plans’ terms and conditions to ensure they meet your dental care needs and budget. Also, read TOP BEST DENTAL INSURANCE COMPANIES OF 2023

Is It a Good Idea to Invest in Dental Insurance?: Bottom Line

Because dental care is not often covered by universal health care plans, some people may find it worthwhile to purchase separate dental insurance. Dental insurance may be worthwhile for those who need frequent dental care and plan to have multiple operations done.

However, the deductible and copayment requirements of their dental plan will determine how much they will have to pay each year out of pocket. The trick is to choose a plan with a low premium, a short waiting time, and substantial yearly benefits.

Customers should think long and hard about the benefits and drawbacks of dental insurance before making a purchase.

Frequently Asked Questions

What is the best dental insurance for seniors?

Delta Dental, Aetna, and Cigna are reputable options for seniors, offering comprehensive coverage and extensive dentist networks.

Which type of dental plan is the most common?

Dental Preferred Provider Organization (PPO) plans are the most common, offering a balance between choice of dentists and cost savings.

Is Cobra dental insurance worth it?

Yes, COBRA insurance can be worth it for temporary coverage, especially if you need to maintain existing healthcare benefits after a job loss.