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Individual Dental Insurance

Red, swollen and bleeding gums are often a sign of gum disease.

Dental insurance is often described as an optional addition to your healthcare coverage; however, it is a vitally important part of any comprehensive health insurance plan. If you don’t receive dental coverage from your workplace, you may consider an individual dental insurance. We explore the ins and outs of individual insurance, including the things that you can expect to receive coverage for, the different types of individual dental plans which are available to choose from, and how much you can expect to save as a result:

What is individual dental insurance?

Individual dental insurance is a type of plan which is only intended to provide coverage for an individual, rather than multiple people. It’s an extremely common type of dental insurance which offers comprehensive coverage in all areas of oral healthcare.

What can you receive coverage for?

Individual dental insurance plans tend to offer coverage for three general areas of dental and oral care: preventative, basic and major.

Preventative procedures

  • Cleaning
  • Routine exams
  • X-rays
  • Fluoride treatment
  • Tooth sealants

Basic procedures

  • Emergency care
  • Routine tooth extractions
  • Fillings
  • Non-routine x-rays

Major procedures

  • Crowns
  • Implants
  • Root canals
  • Full or partial dentures
  • Complex oral surgery procedures
  • Anesthesia
  • Orthodontic treatments

Some individual dental insurance plans will have exceptions and limitations, so it’s best to check the specifics of a plan before you purchase. For example, many individual dental plans will not provide coverage for braces, cosmetic procedures, or for any pre-existing conditions that you might have.

Which type should I choose?

There are numerous different types of individual dental plans to choose from:

  • PPO – Probably the most popular type of individual dental insurance, a PPO gives you access to a large network of participating dentists. You’ll have to pay a deductible as well as an annual maximum, and you’ll pay a co-payment towards (some) dental procedures.
  • DHMO – This requires you to choose just one dentist or facility, but you don’t have to pay any deductibles.
  • Indemnity – You can choose from a wide selection of dentists, as there’s no need to stay within a network. You pay the full cost of your procedure upfront, and then submit a claim to your dental insurance provider.
  • Discount – These are the most basic types of individual dental plans. You don’t have to pay a deductible and there’s no annual maximum. Plus, you aren’t required to stay within a network. Instead, you simply pay a reduced fee. Remember, all costs come out of your own pocket.

When choosing which type of individual dental plan is best, you should go for the one which best suits your needs. PPO plans are best for people who tend to travel on a regular basis, whereas DHMO might be a better choice for those who spend most of their time in one city or place.

How much will I save?

Most individual PPO dental plans will cover 100% of your preventative procedures. You’ll have to pay a co-payment towards the cost of basic and major procedures, although the exact amount depends upon which plan you’ve got. In general, PPO plans offer a 100-80-50 cost breakdown, wherein the insurer pays 100% of preventative and diagnostic procedures, 80% of basic procedures and 50% of major procedures. In terms of deductibles, you probably won’t need to pay any more than $100, but this figure can vary between different providers, so it’s best to shop around for the best option if you do decide to get individual dental insurance.

Should I get individual dental insurance?

If you’re able to afford it, an individual dental plan is an excellent way to supplement your existing healthcare plan and ensure that you receive the very best dental care. They’re a particularly good choice if you find that your employer doesn’t provide you with a dental insurance package, or if you don’t yet need to purchase a family dental plan.

Need to find a dentist for your individual dental insurance plan? Get in touch with 1-800-DENTIST right away and book your next appointment!