Marketplace vs. direct dental insurance: Which is right for you?
Last updated January 22, 2026
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According to recently published data, 27% of US adults — an estimated 72 million people — do not have dental insurance. That’s nearly three times the number that lack health insurance.1 That’s concerning because poor oral hygiene affects more than just your teeth: it can lead to serious systemic health consequences, including diabetes, heart disease, and even contribute to dementia.1
If you’re among the 72 million without dental coverage, enrolling in a plan makes sense.1 If work doesn’t offer coverage, you typically have two options: buy dental insurance at Healthcare.gov or directly from an insurer. This article will explain your options:
The potential pros and cons of buying dental at Healthcare.gov
The potential pros and cons of buying dental directly from an insurer
Which is the more affordable option for your circumstances
How to decide what’s right for you
What is marketplace dental insurance?
Marketplace dental insurance is coverage that you buy through the Affordable Care Act (ACA) Health Insurance Marketplace (healthcare.gov or your state’s exchange). It can be offered in two ways: either bundled with a medical plan, or as standalone dental coverage you pay for separately.
When shopping via the ACA online system, you’ll see the bundled and standalone dental plans that are available in your ZIP code. You’ll also find details on premiums, deductibles, copays, and covered dental services.
Is marketplace dental coverage subsidized?
One of the key advantages of purchasing health care through the ACA marketplace is that you may be eligible for subsidies that reduce the total cost of your premiums.
That said, it’s very important to note that, unlike the subsidies for adult health plans, subsidies for adult dental plans are limited and work differently: Basically, adult dental is only eligible for a subsidy if it is bundled with a health plan; adult dental coverage isn’t eligible for a subsidy if it is purchased as a standalone plan.
However, different rules apply to coverage for children. Pediatric dental (i.e., coverage for children under 18) is considered an essential benefit under the ACA, so all pediatric dental plans are eligible for subsidies, whether they are bundled with a health plan or offered as standalone plans.
What is direct purchase dental insurance?
Direct purchase dental insurance is coverage that is purchased directly from an insurance company, such as Guardian (i.e., not through an employer or the ACA Marketplace). You pay the insurer directly; the cost is not subsidized under the ACA; there is no employer involvement; and eligibility is not tied to your job. Typically, direct purchase dental is offered through the insurer’s own website or call center, and by a broker who is licensed and appointed to sell the carrier’s dental plans.
Typical pros and cons of marketplace dental plans
Advantages | Disadvantages |
|---|---|
Coverage can be bundled with a health plan which simplifies billing and payment. | To buy Marketplace dental, you may have to enroll in a Marketplace health plan. |
Pediatric dental is considered an “essential health benefit,” ensuring access to dental care for children under 18 years old. | Standalone adult dental plans aren’t eligible for ACA subsidies. |
Multiple plan levels exist (low-premium/high-deductible or high-premium/low-deductible), so you can select coverage that best aligns with your needs. | Coverage for major services (e.g., crowns, dental implants ) is often limited, as is the number of network providers or reduced co-pays. |
| no | Must enroll during annual open enrollment period. |
Why choose a Marketplace dental plan?
Generally speaking, you may be better off with a Marketplace dental plan if you qualify for subsidies, need pediatric dental coverage for children under 18, or want the convenience of bundling dental with a subsidized health plan.
Typical pros and cons of buying directly from an insurer
Advantages | Disadvantages |
|---|---|
You can enroll year round, and select from a range of insurers and plan designs. | No ACA subsidies, which may increase your premium costs. |
Typically, direct purchase plans offer larger provider networks than Marketplace plans. | Billing and premium payment is separate from health plan. |
Most individual plans cover preventive services (cleanings, exams, and basic X‑rays) at or near 100%, and provide partial coverage for basic and major services. | Plans differ widely in terms of deductibles, coinsurance, exclusions, waiting periods, and preauthorization rules, which may make it difficult to compare dental plans. |
Why choose direct-purchase dental coverage?
Generally speaking, a direct purchase dental plan may be preferable if you want year-round enrollment options, more control over plan features, or need adult dental coverage and services not currently offered or subsidized by the Marketplace.
Marketplace vs. Direct Purchase: Fast Facts
Where you buy it | Through Healthcare.gov, a broker, or a state ACA Marketplace website | Directly from an insurance company or an off exchange broker/website |
Link to medical coverage | May or may not be bundled with your Marketplace health plan | Completely separate from your medical insurance; can pair with any health coverage |
Subsidies | Subsidies may reduce the cost of the health plan and bundled dental (if you qualify); there are no subsidies for standalone adult dental plans | No ACA subsidies; you generally pay the full dental premium yourself |
Network providers | Generally, marketplace dental plans have smaller provider networks | Generally, direct purchase dental plans have more network providers |
Enrollment timing | Mostly limited to annual Open Enrollment period unless you qualify for a Special Enrollment Period | Typically available year‑round, with more flexibility to start or switch plans |
Plan and insurer choice | Limited to insurers and dental options that participate in your state’s Marketplace | Wider range of insurers and plan designs, including some not sold on the exchange |
Coverage | Coverage for major services (e.g., crowns, dental implants) is often limited. | Plans cover preventive services at or near 100%, and may also provide partial coverage for basic and major services |
How to choose a dental plan
Whether you focus on Marketplace dental plans or direct purchase plans, the following questions can help you find coverage that meets your needs and your budget.
What oral health services are covered (preventive, basic, major, orthodontia) and which are excluded?
Is your current dentist in‑network for the plan? Are out‑of‑network dentists covered at all? Are there enough in-network dentists in your area?
Are there waiting periods for major dental care, such as crowns and root canals?
What is the total yearly cost (12 months of premiums plus typical copays/ coinsurance) for each plan, based on the care you anticipate?
If using the Marketplace, do you qualify for any subsidies, and will they actually reduce your total cost?
What are the deductibles, coinsurance, and annual maximums for each plan?
If your income, job, or family situation changes, is it easier to keep continuous coverage using Marketplace dental or a direct purchase plan in your own name?
Frequently asked questions about getting dental insurance
Short answer: The decision to buy through the Health Insurance Marketplace or directly from an insurer depends mostly on your financial situation. If you qualify for subsidies, purchasing a bundled plan through the Marketplace may offer significant savings on dental care costs; otherwise, buying directly could provide more flexibility in terms of plan options and enrollment periods, while offering a greater choice of dental benefit providers.
Marketplace dental insurance (when bundled with or embedded in a health insurance plan) is often cheaper for individuals who qualify for federal subsidies. However, if you don’t qualify for subsidies, the monthly premiums are generally comparable to direct, off-exchange plans.3
Marketplace dental plans are sold through the ACA Health Insurance Marketplace and must usually be purchased during limited enrollment windows; and when bundled with a Marketplace health plan, coverage may be partially subsidized if you meet income guidelines. Off‑exchange “private” dental plans are bought directly from insurers or brokers, are typically available year‑round, and often offer a wider variety of carriers, benefit designs, and annual maximums, but without ACA subsidies.
Yes, you can get a dental insurance plan without having health coverage. Many private insurers offer standalone dental plans that you can purchase directly at any time of year, regardless of whether you have medical insurance. The Health Insurance Marketplace (HealthCare.gov) also lists standalone dental plans for purchase, but you generally cannot buy these plans through the Marketplace unless you are enrolling in a health insurance plan at the same time. It’s also important to remember that standalone plans may not be available in all areas and generally do not qualify for subsidies.