How long has it been since your last trip to the dentist? If you’re like lots of people, it was more than the recommended six months ago. And we get it – it’s easy to put off the potential expense of dental care.
However, good dental health is important to your overall health, and minor dental issues now can develop into more serious ones down the road. So going to the dentist and having the right dental insurance plan can make a big difference.
Many opt into more comprehensive dental plans to ensure they get the care they need. But what is comprehensive dental insurance (also known as full coverage dental insurance)? And is it a good fit for you?
Let’s talk through how comprehensive dental insurance works, what it covers and how you can find the right plan for you and your family.
What is comprehensive dental insurance?
Comprehensive dental insurance, also known as full coverage, covers a broad spectrum of dental services. “Full coverage” refers to the range of dental services covered, such as checkups to fillings and even crowns. Full or comprehensive coverage doesn’t mean the dental insurance plan covers all service costs, but it will cover a portion. Comprehensive dental plans include deductibles, coinsurance and an annual maximum limit that the dental plan will pay for dental care during the year.
So, what exactly does a full-coverage dental plan cover? While each plan is different, comprehensive dental insurance typically covers most services, from preventive and basic care to major restorative care:
- Preventive care: As the name suggests, preventative dental care is designed to help you maintain optimal oral health and prevent larger dental issues, such as gum disease and cavities. These services usually include routine exams, cleanings and X-rays. Most comprehensive dental plans will cover all or most of the costs associated with preventive care, but there’s often a limit on how frequently you can receive these services within a calendar year.
- Basic care: Basic dental care refers to dental procedures and services that are considered routine and simple. It’s focused on treatment instead of prevention, addressing damage that’s already happened. Basic care often covers things like fillings, simple extractions and root canals, gum disease treatment, and other services like oral cancer screenings.
- Major restorative care: Major restorative care is a step up from basic care – these services are more intensive and treat damage that requires more than just a simple procedure. This can include services like bridges, complex root canals, crowns, larger extractions, oral surgery and dentures.
- Orthodontic care: Orthodontic care is a dental specialty focused on straightening your teeth and fixing bite abnormalities. It’s more likely available with a dental plan offered through an employer rather than an individual dental plan. Coverage is typically reserved for those under 18 or 19 years old depending on plan limitations. Services can include things like braces, retainers, palate expanders or clear aligners such as Invisalign®.
Many comprehensive dental plans have a waiting period
Many comprehensive dental insurance plans include a waiting period between when you first enroll in your plan and when full coverage begins for more extensive dental services. Insurance companies have this guardrail in place to deter enrollees from getting pricey dental care and then stopping coverage. This helps keep premiums affordable for everyone.
The length of a waiting period varies by plan, but they often last six to 12 months. During that time, you can still go to the dentist, but it’s important to know what services may or may not be covered. Typically, you’ll get coverage for preventive care, but things like basic and major dental care will be subject to the waiting period.
Not all plans have waiting periods. They can be waived if you’re coming off a plan through your employer or if you’re switching to a different dental insurance company and have had continuous coverage.
Comprehensive dental insurance vs more basic plans
Not all types of dental plans are full coverage – some insurance providers offer narrower options that cover only a few types of care, such as preventive and basic dental services.
These narrower options can be a great choice if you get a portion of your dental coverage through other programs. For example, a Medicare plan may only cover preventive services, such as routine checkups and cleanings, but not fillings or root canals. In that case, you can purchase a dental plan that only covers basic and major services, so you only pay for what you need.
Often, narrower plans can be more affordable with lower monthly premiums. However, if you don’t have partial dental coverage through another plan, a comprehensive dental insurance plan will help mitigate costs of care in ways a less extensive plan won’t. Dental care can get expensive quickly, and a full-coverage dental plan can help ensure you and your family are being taken care of no matter what happens.
The cost of full-coverage dental insurance
In the US, the average monthly premium cost for a comprehensive dental plan is around $52 for an individual. However, this price depends on your insurance provider and what your plan offers. Your plan’s yearly maximum and out-of-pocket costs, like your deductible, copays and coinsurance, can also affect your premium amount:
- Annual maximum: The highest amount your plan will pay for services within the calendar year. Once this is met, you begin paying for care out of pocket.
- Deductible: The amount you must pay out of pocket for care before your plan begins covering costs.
- Coinsurance: A fixed percent of your dental bill that you pay for services. Your plan covers the rest.
How to get full coverage dental insurance
There are many ways to shop for and enroll in comprehensive dental insurance. If your employer offers a full-coverage dental plan, you can typically enroll when you’re first hired or during the open enrollment period at the end of the year.
If you’re not offered dental insurance through an employer, you can look into buying a comprehensive plan from an independent health insurance company. This is a great choice for those who want to shop amongst a broad selection of comprehensive dental plans that feature different price points and additional benefits. Many dental plans purchased in this way, like some of those offered by HealthPartners as a nonprofit health care provider, don’t have an enrollment period, so you can enroll at any time.
Another option is looking for a dental plan on the health insurance marketplace. In Minnesota, the state exchange is called MNsure.
Comprehensive dental insurance for seniors
For seniors, regular visits to the dentist can help prevent or address dental issues seniors are more likely to experience, such as gum disease, tooth decay and enamel loss.
A solid comprehensive plan can help ensure you get the dental care you need, and seniors have plenty of options. There are many different types of private dental plans for seniors over 60 who aren’t yet eligible for Medicare. This can include plans that offer additional perks (like out-of-network coverage) and even some plans that can be integrated with your medical insurance so everything is all in one place. For those who are eligible for Medicare, you can also look into Medicare Advantage plans that offer dental coverage benefits or a Medicare supplemental dental insurance plan.
Have more questions about dental insurance?
If you have questions about your current dental plan, you can contact your insurance carrier. If you’re looking for an affordable plan for yourself or family, our experts are ready to help.