What does dental insurance cover and how much does it cost?

At the end of 2022, more than 293 million Americans — 88% of the population — had dental coverage, according to the most recent data from the National Association of Dental Plans (NADP). Employer-sponsored plans remain the most common source, covering about 54% of insured individuals, based on data from the Kaiser Family Foundation (KFF).

Oral health is a vital part of overall well-being, and today’s dental insurance options reflect that. Whether you’re evaluating a Dental Preferred Provider Organization (DPPO), Health Maintenance Organization (HMO/DHMO), fee-for-service or discount plan, each type offers different cost structures and service levels. 

Understanding these options can help you find the best match for your budget and dental needs.

What is dental insurance?

Dental insurance helps cover the cost of preventive and restorative dental care. Most plans pay for routine services like cleanings, exams and X-rays, and partially cover more involved procedures such as fillings, crowns, root canals and oral surgery.

Just like health insurance, dental insurance typically involves a monthly premium, an annual maximum benefit limit and cost-sharing through deductibles, copays or coinsurance. Coverage levels vary by plan type, but the goal is the same: to reduce out-of-pocket costs and make regular dental care more affordable.

Understanding your dental insurance options

Dental insurance isn’t one-size-fits-all. There are several types of plans available, each with its own cost structure, provider network and level of flexibility. Understanding the differences can help you choose the plan that best fits your dental care needs and budget. Here’s a breakdown of the most common types of dental insurance plans:

• Dental Preferred Provider Organization (DPPO). One of the most common dental insurance plans, DPPOs offer flexibility when choosing a dentist. You’ll save the most by staying in-network, but you can see out-of-network providers at a higher cost. These plans usually include a deductible, annual maximum and coinsurance, and they don’t require referrals to see specialists.
• Dental Health Maintenance Organization (DHMO). DHMOs are typically the most budget-friendly option, with low premiums and fixed copays. You must choose a primary dentist from a limited network and get referrals to see specialists. While they offer less flexibility, they usually don’t have deductibles or annual maximums.
• Fee-for-Service (Indemnity) Plans. Indemnity plans let you visit any dentist you choose. You pay the provider directly and submit a claim for reimbursement, based on your plan’s coverage. These plans tend to have higher premiums and deductibles, but are ideal if you want full control over which dentist you see.
• Dental Discount Plans (Dental Savings Plans). These are not insurance plans but membership-based programs. You pay an annual fee to access discounted rates from participating dentists. There are no deductibles, copays or claims, making them a good fit for those without major dental needs who want to save on out-of-pocket costs.

What does dental insurance cover?

A robust dental insurance plan pays for a wide range of services, from routine checkups to major procedures like root canals, crowns and even dentures. While no dental insurance covers every expense in full, the most robust plans typically include:

• Preventive care (exams, cleanings, X-rays) at 100%
• Basic procedures (fillings, extractions) at around 80%
• Major work (crowns, bridges, oral surgery) at about 50%

Coverage may also include orthodontics or implants, but those are often optional benefits or only available through premium plans.

Keep in mind, you’ll still have out-of-pocket costs, like deductibles and copays, and annual maximums (usually between $1,000 and $2,000). 

How much is dental insurance?

Dental insurance premiums vary by provider and plan, but Humana estimates that most people pay between $20 and $50 per month, while family plans typically range from $50 to $150 per month. Your exact rate depends on the level of coverage you choose and where you live.

To give you a sense of starting rates from major providers:

• Spirit Dental plans start as low as $13.35 per month
• Cigna offers plans starting at $20 per month
• Aetna PPO plans start around $22 per month
• Aflac dental coverage begins at about $35 per month

Shopping around and comparing benefits can help you find the best value for your dental care needs.

How to get affordable dental insurance

If you’re trying to find budget-friendly dental coverage, here are several ways to get quality care at a lower cost:

• Look into employer-sponsored dental plans. If your employer offers dental insurance, it’s often your most affordable option. Employers typically cover part of the premium, and plans may include higher benefit caps, lower deductibles and broader coverage than individual plans.
• Consider a DHMO plan. Dental Health Maintenance Organization (DHMO) plans tend to have the lowest monthly premiums. You’ll need to stay within a specific network and may need referrals, but they offer predictable costs and affordable care.
• Explore dental discount plans. These aren’t insurance, but they offer reduced rates on dental services for an annual membership fee. If your needs are mostly routine cleanings and checkups, this can be a low-cost alternative.
• Compare all plan features carefully. The cheapest plan isn’t always the best deal. Be sure to compare coverage details, waiting periods, provider networks, and annual benefit limits to find real value based on your dental needs.
• Shop the individual market. If employer coverage isn’t an option, you can buy an individual plan through private insurers or health insurance marketplaces. Look for preventive care coverage, compare monthly premiums and factor in deductibles, annual caps and coinsurance to find the best deal.

Does health insurance include dental coverage?

Dental insurance is often not included in standard health insurance plans, especially for adults. If you’re buying health insurance on your own, whether through the federal marketplace or directly from an insurer, dental coverage usually isn’t included. Instead, it’s often offered as a separate add-on or a stand-alone plan.

However, there are a few important exceptions:

• Children’s dental coverage is included in health plans sold through the Affordable Care Act (ACA) marketplace. Pediatric dental services are considered an essential health benefit under the ACA, meaning qualified health plans must either include dental or make it available as an optional add-on.
• Some employer-sponsored health plans bundle dental as part of a larger benefits package. In these cases, dental coverage may come automatically with your health insurance or be available at a discounted group rate.

If you need dental insurance and it’s not part of your health plan, you can purchase a stand-alone dental policy from a private insurer or through your state’s exchange. Be sure to compare options carefully—premiums, deductibles, provider networks and coverage limits can vary widely between dental plans. 

What is the best dental insurance?

The best dental insurance depends on your needs, but three providers consistently stand out: 

Humana

Humana offers a wide range of dental plans, including PPO, DHMO, and discount options. Most plans cover preventive care at 100% with no waiting period, and some have no deductibles or annual maximums. With fast activation and flexible options, Humana is a strong choice for affordable basic coverage, though annual benefit caps may limit protection for major procedures.

Cigna

Cigna offers several dental insurance options tailored to different needs. Its low-deductible plans start around $20/month and include $0 preventive care, $0–$50 deductibles and up to $1,500 in annual benefits, with orthodontic coverage available on select plans. The Dental 3000 plan provides more robust coverage — up to $3,000 in benefits — for those who want higher annual limits.

Cigna also offers bundled plans that combine dental, vision, and hearing benefits, with coverage for implants available on some options. You can see any dentist, but you’ll save more by staying in-network.

Spirit Dental

Spirit Dental offers individual PPO plans with no waiting periods and coverage that scales with your needs. The Preventive Plus PPO is a budget-friendly option focused on preventive care, offering up to $1,000 in annual benefits, 50% basic, and 20% major coverage, plus two cleanings per year. For more robust protection, the Preferred PPO covers major services starting at 20% in year one and includes dental implants and hearing benefits, with annual maximums up to $3,000.

The Pinnacle PPO is Spirit’s most comprehensive plan, featuring up to $5,000 in annual benefits, coverage for implants, child orthodontia and higher major service coverage as your plan matures.

Is dental insurance worth it?

Yes, especially considering that oral health is closely tied to overall health. Regular dental visits can help prevent gum disease and tooth decay and even spot early signs of conditions like diabetes and heart disease. Dental insurance makes it easier to stay on top of cleanings and exams, which are typically covered at 100%.

If you need more than basic care, insurance can help offset the cost of procedures like fillings, crowns or root canals. Remember that most plans have annual benefit limits and waiting periods, so timing and plan choice matter. For many people, dental insurance pays for itself with just preventive care alone, and can offer peace of mind if something more serious comes up.

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