What dental insurance helps pay for

Even a basic dental plan will cover regular checkups and plans with greater dental coverage can help pay for basic treatments as well. A full-coverage dental plan can cover major services and even some orthodontic care – which can be valuable if you have kids with crooked teeth. Every plan has somewhat different coverage, but here are some examples of the different categories of services that may be included.

Preventive care

Checkups, cleanings, routine x-rays, and sometimes, fluoride treatments

Basic care

Fillings, extractions, and other services

Major care

More complex treatments such as root canals, as well as crowns, bridges and dentures

Orthodontic treatment

Braces and other types of teeth aligners  

How dental insurance can help save you money

Pays for preventive care

Helps catch problems early

Helps pay for needed treatments

In-network discounts

Most plans pay all or most of the charge for checkups – so there's no reason not to see your dentist for regular preventive dental services.

Regular visits to the dentist help keep teeth and gums healthy. Catch and fix a minor issue before it turns into a bigger, more expensive (and painful) dental health problem.

A crown can cost $2,000 or more. A good full-coverage plan can lower that to under $700. *

Insurance companies negotiate discounts with their PPO network dentists (the average Guardian discount is 36%).

Dental care is important for your overall health

Guardian studies1 – and a growing body of third-party research2 – show that maintaining good oral health can help adults avoid or better manage serious health-related issues:

  • Diabetes Periodontal infections contribute to problems with glycemic control, which compromises the health of diabetic patients.
  • Heart disease The inflammation associated with periodontal disease has a high potential to contribute to coronary artery disease. Good oral health can lower that risk.
  • Pregnancy Studies have indicated that mothers with high levels of certain oral bacteria were found to have children with similarly high levels of bacteria, along with a higher risk of tooth decay.
  • Self-esteem Research shows that healthy teeth and gums are important to a person's self-esteem and how they feel about themselves.

Two kinds of dental plans. Two kinds of networks.

DPPO

DHMO

It stands for Dental Preferred Provider Organization. These dental insurance plans typically have an extensive network of dentists but also let you see out-of-network dentists. But when you stay in-network, you pay less and don't need to submit claims. Is your dentist in Guardian's network? Find out here.

It stands for Dental Health Maintenance Organization. These dental plans tend to offer lower premiums, but there's also less flexibility with a limited network of dentists. Similar to HMO health coverage, you choose a Primary Dentist and have to go through him or her for all your care, including specialist referrals. Many DHMOs have no deductibles or maximums – and while there are copayments for most non-preventive treatments, your overall costs will likely be lower.

And two more types of dental plans:

Indemnity plans let you see any dentist, but you have to pay the entire fee upfront. The insurance company reimburses a portion – usually between 50% and 80% of the "reasonable and customary" charge. These plans tend to have higher premiums and are harder to find.

Discount plans aren't really dental insurance – they're more like a warehouse club. There's an annual fee, and you're given a card that entitles you to reduced charges at participating dentists. The savings vary – but there's always an out-of-pocket charge. 

3 things to look for in a dental insurance company

1. A broad provider network   

The bigger the network, the more likely you are to find a dentist you like. That's why Guardian networks have over 120,000 dentists in 400,000 locations.

2. A range of plans

It's good to have choices. Depending on where you live, Guardian offers several Dental PPO plans plus DentalGuard, a Dental HMO option.

3. An easy way to buy online

If you're buying a dental insurance plan online, coverage and cost details should be displayed in a simple and straightforward manner to help you make a well-informed choice – like they are when you purchase coverage online with Guardian.

Dental insurance terms you should know

Premiums 

The cost of the dental plan – what you are charged each month for coverage

Deductibles 

The yearly amount you have to pay before dental insurance plans start to cover services

Coinsurance 

The percentage of costs you owe for services once you've met your deductible

Co-pay

Fees charged for specific services or treatments

Annual Maximums

A cap on what's covered; the most a plan will pay for dental services in a given year - you are responsible for all charges over the maximum 

Waiting Periods

Major procedures such as root canals usually have a waiting period (e.g., six or twelve months) before they are covered

A few things to think about before buying a plan

Where should you get dental coverage?

If you or your spouse can get dental benefits through your employer, that may be the way to go. Companies get lower group rates than individuals typically can. But if workplace dental benefits aren't an option, you can get affordable coverage directly online from an insurance company like Guardian.

What are your dental care needs?

If you have never had oral health issues, you may be able to save money with a basic dental plan. But if you have had oral health issues, you may save more in the long run with a plan that offers coverage for more dental services and treatments. 

Do you want to see a particular dentist?

If you have a dentist you want to stay with, look for a DPPO, then check with your dentist to see if he or she is part of the plan's network. But if cost matters more to you than loyalty to a specific dental professional, a DHMO might be a better value for you. 

Questions people ask about dental insurance

Can I purchase dental insurance on my own?

Yes, absolutely. If coverage isn't available through your employer, you can find an affordable dental insurance plan. Major insurance companies make it easy for individuals and families to compare and buy a plan directly online

What is the best dental insurance?

Different dental insurance plans offer various combinations of benefits, features, and coverage options. But generally speaking, the best dental insurance for an individual or family is the plan that lets them see a dentist they like and offers coverage for the treatments they're likely to need, at a price that fits their budget. 

How much is full coverage dental insurance?

There are many dental plan options available. Monthly insurance coverage starts at around $15/month per person for a good Dental HMO plan. It can go up to $50/month or more for a Dental PPO plan, depending on your age, the state you live in, the insurance company, dental benefits, and other factors.

Is a dental discount plan better than dental insurance?

One of the most important advantages of having dental coverage is that preventive checkups are usually covered at 100%. That encourages people to get regular dental care, which helps catch minor issues before they become major issues. Dental discount plans don't eliminate the cost of checkups, cleanings, routine x-rays, and the like, which may discourage some people from getting regular dental care.

Are you a dental professional? Find out how to join Guardian's growing network of dental benefit providers.

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Disclaimer

* Here's how we calculated: We'll assume you have a PPO dental plan that covers major procedures at 50%, you're past the waiting period, and your dentist's customary fee for the treatment is $2,000. With a 35% in-network discount, the fee goes down to $1,300. After paying your $50 deductible, the insurance company pays half of the remaining $1,250 charge, and you owe the other half ($625). You save $1,325, and your total out-of-pocket expense is $675. 

References:

1 "Stay in Good Company" Guardian Dental Health eBook

2 "Systemic manifestations of oral diseases," www.ncbi.nlm.nih.gov/pmc/articles/PMC3329699/

Links to external sites are provided for your convenience in locating related information and services. Guardian, its subsidiaries, agents and employees expressly disclaim any responsibility for and do not maintain, control, recommend, or endorse third-party sites, organizations, products, or services and make no representation as to the completeness, suitability, or quality thereof.

Guardian Direct plans are underwritten and issued by The Guardian Life Insurance Company of America or its subsidiaries, New York, NY. Products are not available in all states. Policy limitations and exclusions apply. In the event of a conflict between this document and the language stated in your Guardian insurance policy, the language of the policy shall control.

DentalGuard Insurance is underwritten and issued by The Guardian Life Insurance Company of America, New York, NY.  Products are not available in all states.  Policy limitations and exclusions apply.  Optional riders and/or features may incur additional costs.  Plan documents are the final arbiter of coverage.  This policy provides DENTAL insurance only.  Policy Form #GP-1-DG2000, et al.

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