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Do insurance plans cover dentist appointments?

Generally, health insurance plans don't cover dental care. But starting in 2014 under the federal health care reform law, health plans sold through state insurance exchanges must cover dental care for children. Currently, some Medicare Advantage plans, which work like health maintenance or preferred provider organizations to provide Medicare benefits, include coverage for dental or vision care. Dental coverage is also available to eligible children in many states through the Children's Health Insurance Program, a state and federally funded program for low-income families.

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For the most part, though, you need dental insurance to cover dentist appointments. If you don't have dental insurance through work, you can get insurance quotes for coverage online.

Make sure you understand how different types of plans work before you choose one:

  • Dental HMOs provide comprehensive coverage, but you're limited to a specific network of providers.
  • Dental PPOs feature a network of providers who are contracted with the insurance company to provide services at a discount. You pay more out of pocket when you visit a dentist who is outside the network.
  • Dental indemnity plans let you see any dentist, and providers are reimbursed by the insurance company on a fee-for-service basis.

You might also run across dental discount plans. These programs are not insurance plans, so they are not regulated by state insurance departments. Typically in exchange for enrollment and monthly fees to a dental-discount company, you get a discount from certain providers on services, such as fillings, exams and routine cleanings.

Before signing up with any dental insurance plan, read the fine print. What services does the plan cover? What services are not covered? How much will you pay out of pocket? Which dentists are in the provider network?

For more, see Your options for dental insurance.

Last updated: Apr. 12, 2012
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