How Does Dental Insurance Work?

How dental insurance works

With dental insurance, you’ll pay premiums to an insurer and receive coverage for dental expenses, like exams, cleanings, and procedures. Depending on the dental insurance plan you have, you may be required to visit dentists in-network or have the freedom to receive care from any dentist, including those out-of-network.¹

Aflac offers primary dental insurance for individuals and families with a variety of coverage levels, including full coverage. You can also get supplemental dental insurance from Aflac to help with costs not typically covered by primary insurance. Additionally, we offer three types of coverage in one comprehensive plan with our Dental, Vision and Hearing Insurance. Consider getting our DVH Core or DVH Elite Plan to help with the cost of treatments.

Types of dental insurance

There are two primary types of dental insurance plans you may consider:

• Dental PPO: PPO plans are flexible insurance plans that allow you to choose your own dentist. However, they also offer discounted services through a network of preferred providers.
• Dental HMO: HMO plans require you to choose a primary dentist from a plan network. Although they have less flexibility, usually they offer lower premiums.

What does dental insurance cover?

In most cases, dental insurance covers three areas of dental care, including preventive services, basic services, and major services. Here’s how each of these services works:²

How much does dental insurance cost?

The cost of dental insurance can vary based on factors like your age, the state you live in, and the type of policy you get. The National Association of Dental Plans estimates that the average DHMO plan for individuals costs $13.83 per month, and the average DPPO plan for individuals costs $35.16 per month.³

While every dental insurance plan is unique, many of them have the following features:²

• Deductible: The out-of-pocket dollar amount you must pay for dental care before your dental insurance company starts to pay. If you have a $100 annual deductible, for example, you’ll be on the hook for $100 before your insurer kicks in and covers the rest.
• Copayment: Also known as a copay, this is the amount you’ll need to pay before you receive a covered service, even after meeting your deductible. For example, a plan may require a copay of $20 for a cleaning which you must pay out of pocket.
• Coinsurance: The remaining cost you pay for services after you reach your deductible, typically expressed as a percentage. Coinsurance typically ranges from 20 to 80% of a procedure.
• Annual maximum: Your plan’s annual maximum is the most it will pay toward your dental services within a given year. Although dental plans differ, annual maximums often range from $750 to $2,000.