Does Health Insurance Cover Dental Care? (2024)

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Health insurance doesn’t generally cover dental care, but there are exceptions when a health plan may pay for dental work.

You usually need to buy a separate dental insurance plan to get covered for routine dental work like crowns, tooth extractions and cleanings. Dental insurance is typically much cheaper than health insurance, but dental plans often come with maximum coverage benefits and waiting periods, and may not cover all types of dental work.

Key Takeaways

  • Health insurance doesn’t usually cover dental care.
  • Health insurance may cover dental work if it’s connected to an emergency or a medical condition.
  • You must buy a dental insurance policy to cover dental care like preventive care, fillings, X-rays, dental implants and root canals.

When Does Health Insurance Provide Coverage for Dental Procedures?

Health insurance may cover dental care in specific instances, such as:

  • Emergencies that affect your mouth, such as injuries following a car accident.
  • Dental procedures involving a medical condition.

If your dental work is related to a car accident, check with your auto insurance company about whether your policy will pay for a portion of the dental work. The liability insurance, personal injury protection (PIP) or medical payments (MedPay) coverage on your car insurance policy may pay for your injuries, depending on your coverage and the cause of the accident.

Health insurance doesn’t typically cover standard dental work, including:

  • Braces.
  • Bridges.
  • Dental implants.
  • Dentures.
  • Fillings.
  • Preventive care.
  • Root canals.
  • X-rays.
  • Teeth whitening.

You instead need separate dental insurance to get those services. Make sure to read the policy information to see exactly what the dental policy covers and what isn’t covered. For instance, one dental insurance policy might not cover dental implants, braces, teeth whitening or major care like root canals, while another policy may cover some or all of those services.

You should also read about the waiting periods for the dental plan. Many policies have a dental insurance waiting period for some services. Most dental policies don’t make you wait for preventive care, but dental insurance may require a 6-month or 12-month waiting period for other services.

Dental Insurance Options

There are multiple ways to get dental insurance, including from your job or directly from an insurer.

Employer-Based Dental Insurance Plans

Your employer may offer dental insurance as part of its benefits package. Dental plans through an employer are usually much cheaper than health insurance.

An employer will likely only offer only one dental insurance option, unlike health insurance, where companies usually offer multiple choices. Pay close attention to a dental policy’s premiums, deductibles, waiting periods, coverage maximum and coverage percentages so you can decide whether it’s worth buying a policy through your job.

Marketplace Dental Plans

The Affordable Care Act, also called Obamacare, requires that health insurance companies on the health insurance marketplace offer dental insurance for children. Adult dental care isn’t required, but you may find a company that offers dental insurance on the marketplace.

Dental plans on the marketplace are similar to other types of dental policies. They offer the same type of coverage, monthly premiums, deductibles and coverage maximums.

If you’re buying a dental insurance plan through the health insurance marketplace, you can compare offerings side by side through the marketplace website.

Dental Insurance Through Private Insurers

You can buy dental insurance directly through a dental insurance company. Many dental insurance companies offer free online quotes, which let you enter your information and get a monthly quote for coverage.

Our research found that dental insurance costs an average of $52 monthly for comprehensive care and $26 for preventive care plans.

Major dental insurance companies include Ameritas, Delta Dental, Denali Dental, Guardian and Spirit Dental. Some health insurers that offer their own dental policies include Anthem, a Blue Cross Blue Shield company; Cigna; Humana; and UnitedHealthcare.

Medicare and Medicaid Dental Plans

Original Medicare, also called Parts A and B, doesn’t cover dental care except for dental services if you’re hospitalized for a dental procedure connected to a medical condition or serious procedure. These services must be connected to the medical treatment you receive in the hospital.

However, Medicare Advantage (Part C), offered by private health insurance companies, may provide dental insurance as part of their offerings. Medicare Advantage dental insurance policies are similar to plans you get directly from a dental insurance company. There are premiums, coverage maximums, deductibles and waiting periods.

While Medicare is mainly for people 65 and older, Medicaid eligibility is based on household income and family size. The federal/state health insurance program differs by state.

Medicaid requires that all states provide dental insurance for eligible people 21 and under. There is no requirement for adult dental coverage, but states or companies may choose to offer those services to adults.

How Does Dental Insurance Differ From Health Insurance?

Health insurance covers your overall health, while dental insurance only pays for dental care.

There are many other ways that the two types of insurance differ:

  • Dental insurance often has waiting periods; health insurance does not.
  • Dental insurance typically has coverage maximums; health insurance does not.
  • Dental insurance may have lifetime coverage caps for specific services like dental implants; health insurance does not have caps for specific services.
  • Health insurance has out-of-pocket maximums, which is the most you’ll spend for in-network care in a year; dental insurance does not have those caps.
  • Health insurance is required in some states; dental insurance isn’t required.

How Do You Pay for Dental Work?

There are multiple ways to pay for dental work:

  • Dental insurance: A dental insurance policy may pay for part or even all of dental services. For instance, dental insurance usually pays 100% of preventive care costs like cleanings.
  • Discounts: Some companies offer dental discounts. It’s not insurance; instead, the company works with dentists to offer discounted rates to members. You don’t get help paying for services; instead, you get a reduced rate from participating dentists.
  • Financing plan: Dentists often have financing plans to spread the cost burden for services.
  • Pay out of pocket: You can pay for dental services yourself. Even if you have dental insurance, you’ll likely have to pay a portion for most services. If you don’t have dental insurance, your dentist may give you a discounted rate to help offset costs.

Find The Best Dental Insurance Companies Of 2024

Learn More

Does Health Insurance Cover Dental Frequently Asked Questions (FAQs)

Does Medicaid insurance cover dental procedures?

All state Medicaid programs must provide dental insurance to those 21 and under who are eligible for Medicaid. Adult dental insurance isn’t required, but states and companies may offer that coverage.

How can I ensure my health insurance covers dental work?

Health insurance doesn’t typically cover routine dental care but may cover dental work related to an emergency or medical condition. Your best bet is for you or your doctor to contact the health insurance company, explain the situation and see if the company will cover the dental procedure.

Does Health Insurance Cover Dental Care? (2024)
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