Estimating Your Dental Costs with Dental Insurance

dental costs

If you have dental insurance, your dental costs depend on several factors including your specific plan, the type of dental care you receive, and whether or not your dentist is in-network. Typically, dental plans tend to follow a similar structure and usually cover three levels of care.

Levels of Care

  1. Preventive and Diagnostic Care
    Preventive and diagnostic dental care is a category of routine services that keep your teeth healthy. This usually includes two oral exams (with x-rays and cleanings) per year, as well as fluoride treatments for children. Most dental plans cover 100 percent of preventive care, which means you won’t have to pay a thing!

  2. Basic Restorative Care

    This category of care includes basic oral procedures, like cavity fillings, tooth extractions, root canals, and emergency palliative care (i.e. short-term pain relief for injuries like a chipped tooth). Because these procedures are more expensive than preventive care, your insurance will typically only cover 80 percent of the costs. That means you’ll be footing 20 percent of the bill.

  3. Major Restorative Care
    This category is reserved for the most expensive procedures, like bridges, implants, dentures, and crowns. Most dental plans split the bill 50/50, so you’ll cover half of the costs.

A Few Things to Keep in Mind

When it comes to determining your dental costs, it’s important to remember a few things.

  • The least expensive dental plans are the simplest, meaning they may only cover up to a certain dollar amount each year and won’t cover extensive procedures at all. If you think you’ll be needing more than standard preventive care, you should consider a plan with more coverage.

  • Some insurance companies will increase how much they cover the longer you keep your plan. For example, during your first year, they may only cover 20 percent of costs, but the next year will cover 50 percent of costs.

  • Your plan may only cover dental services like orthodontics, fluoride treatments, and sealants if they’re used for children and young adults.  

How to Find out What a Service Will Cost

Ready to get dental care, and want to know exactly how much your plan will cover? See if your insurance company has a cost-estimator tool. Many major insurance companies let you use these tools to receive an estimate based on your specific plan. With a plan through Stride, you can even have your dentist submit a request for a pre-treatment estimate. Your proposed treatment will be reviewed, and you will find out the portion of the treatment cost you are expected to cover with your plan. Once you receive this, you can discuss this with your dentist and talk through other treatment options if necessary. This allows you to know the specifics ahead of time, evaluate your options, and start budgeting for your care!

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