The Independent Worker’s Guide to Dental Insurance
As part of your overall health, it's important to stay on top of your oral health, too! Taking care of your teeth, gums, and mouth as well as practicing good dental hygiene can help prevent against a plethora of gum and teeth complications as you grow older.
If you know you'll be needing a few dental procedures done, or don't want to pay a ton out of pocket for a cleaning every 6 months, you might want to consider your options for dental insurance. Dental insurance is designed to reduce your costs associated with routine preventive care, as well as other necessary care that might arise throughout the year.
This short guide is meant to provide answers to some common questions we get about dental insurance. If you have more questions, we're here to help!
Is Dental Included in My Health Insurance Plan?
It's unlikely. The majority of major medical plans do not include adult dental – you'll usually have to purchase a separate dental plan. However, under the Affordable Care Act, all health plans must provide benefits for children's dental insurance.
What's Usually Included in a Dental Insurance Plan?
Most plans tend to cover three levels of care: preventive and diagnostic care, basic restorative care, and major restorative care.
Preventive and Diagnostic Care: This is the least expensive and least time intensive of the three types of care. With that said, dental plans tend to cover a larger percentage of costs associated with preventive care, usually 100 percent! Wondering what preventive care includes? It generally includes things like cleanings and oral exams two times per year. In addition, it includes x-rays, as well as fluoride treatment for a specific subset of the population. Remember, this care is usually covered at 100 percent by your carrier, meaning these services are free to you.
Basic Restorative Care: This includes procedures like fillings, extractions, root canals, and emergency palliative care, as well as other basic procedures. These types of procedures generally require a bit more time on the provider’s part and are more costly. An average dental plan will cover 80 percent of these costs, leaving you to pay the remaining 20 percent.
Major Restorative Care: Major restorative care includes crowns, bridges, implants, dentures, and other major procedures. These kinds of procedures generally require the largest time investment on your dentist’s part and cost the most. A common dental plan will cover 50 percent of these costs, leaving you to cover the remaining 50 percent.
Be sure to keep in mind that most plans don’t cover cosmetic dental procedures. Cosmetic dental procedures include things like veneers, teeth whitening, and, usually, orthodontia. You will be required to cover all of these procedures out of your own pocket.
Stride tip: These are just general outlines for how some plans operate. Be sure to read all the coverage details when you evaluate and choose a plan because they will likely be slightly different than these details. For instance, plans through Stride cover different percentages than outlined above.
What's the Difference Between an HMO and PPO Dental Plan?
Similar to health insurance, you have to choose a plan network when picking dental insurance. The difference between an HMO and PPO dental plan are very similar to what you see with health plans.
If you're looking into a dental plan that is an HMO (health maintenance organization), you'll have to choose a dentist or dental facility that will oversee all of your oral health care and needs. If you try to visit a dentist "out of network" of your HMO plan, your plan won't cover any of the visit, and you'll be expected to pay out of pocket.
A PPO (preferred provider organization) dental plan offers much more flexibility. PPO plans usually have a broader network of dentists and facilities. Unlike an HMO, you don't need to stick to one dentist. PPO plans prefer that you stay in their network, but they'll still provide coverage, albeit less, if you go outside of the network.
Can I Find Dental Insurance Options Through Stride?
You bet! Stride offers custom dental plans. You can get started here, and yes, it's a PPO plan!
What Comes with Stride's Dental Plans?
No waiting periods — start using your plan immediately!
Simple & affordable — plans start at less than $30/month
Take advantage of the PPO network — our plans are accepted by over 300,000 dental locations nationwide.
Easy enrollment — picking and enrolling in a plan takes less than 10 minutes!