Dental Insurance

What does dental insurance cover?

Plans generally group care by service type. The ADA's guidance updated in 2026 describes this common design, not a rule every plan follows:

• Preventive care: Often covered at 100%, including oral evaluations, X-rays and sealants.
• Basic care: Often covered at 80%, including fillings, extractions and gum disease treatment.
• Major care: Often covered at 50%, including crowns, bridges and dentures.

Those percentages describe the plan's share of its allowed charge. Your share is called coinsurance. Plans can put a procedure into a lower-paying tier, so check the specific service, not just its category. Our guide to how dental insurance works explains the payment structure.

Annual maximums, deductibles and waiting periods

An annual maximum caps what the plan pays during its benefit year, not what you spend. NADP's 2025 overview reports that about 65% of dental PPOs have maximums of $1,500 or more. From 2014 to 2023, less than 5% of enrollees, on average, reached their annual maximum.

That doesn't make the cap unimportant if you need major work. A deductible is what you pay before certain benefits start. NADP's 2025 overview lists typical dental PPO deductibles of $50 to $100.

Individual and stand-alone plans may also have waiting periods, especially for major services. You still pay premiums while waiting for the affected coverage to begin. If you're putting off a crown, check its waiting period before enrolling.

Dental HMO, PPO or savings plan?

Before picking a plan type, check which dentists participate.

• Dental HMO: Uses published copays, usually set dollar amounts you pay for services. You must use network dentists, and annual maximums are rare.
• Dental PPO: Typically pays percentages of covered charges. Benefits are generally lower outside the network, leaving more for you to pay.
• Dental savings plan: Isn't insurance and pays nothing toward treatment. You pay the full discounted price yourself.

Before buying a discount plan, confirm your dentist accepts it and discounts the care you need. Compare dental plan costs with what you'd pay without a plan.

Where can you get dental coverage?

If work offers dental benefits, ask for the plan booklet. Otherwise, you can look for an individual policy. Individual policies generally cost more than group coverage and may have more limits.

The Marketplace offers health plans with dental benefits and separate dental plans. You can buy a stand-alone Marketplace dental plan only while buying a health plan, and it has a separate premium.

Children's dental coverage must be available through the Marketplace, but you don't have to buy it. Medicaid and the Children's Health Insurance Program, called CHIP, provide dental benefits for enrolled children. Adult Medicaid dental benefits depend on your state. Compare dental insurance rates by state before choosing.

How much does dental insurance cost?

NADP's 2025 overview estimates national average monthly individual premiums at $15.14 for dental HMOs and $41.76 for dental PPOs. These are averages, not prices you'll necessarily pay.

The premium isn't your total cost. Include deductibles, copays or coinsurance, and charges the plan won't pay. Our dental insurance cost guide goes deeper.

How to choose a dental plan

Start with your dentist and the treatment you expect, then ask:

• Is my dentist in the network?
• How is my planned procedure covered, and what's excluded?
• Will a waiting period or annual maximum limit payment?
• How does the total cost compare with paying directly?
• How do I cancel if I no longer want the policy?

Use the benefit booklet rather than the premium alone. When you're ready, compare dental insurance quotes against those needs.