Jane Dotson
Dental insurance is an additional benefit that can be included in private health insurance plans. It covers oral health and maintenance, including routine treatments such as check-ups, scaling, and polishing, as well as complex treatments like oral surgery, tooth extraction, and fillings. The cost of dental insurance varies depending on factors such as age, gender, and the level of cover chosen. Some providers offer different tiers of dental cover, with the most expensive option typically providing the most comprehensive protection. It's important to note that dental insurance usually does not cover pre-existing conditions, and there may be waiting periods for certain benefits.
| Characteristics | Values |
|---|---|
| Dental insurance providers | Bupa, AXA Health, Simplyhealth, Vitality, Denplan |
| AXA Health cover levels | Core, Premium |
| Bupa cover levels | Dental Cover 20 |
| Simplyhealth cover levels | 4 levels |
| Average cost of dental insurance | £10-11 per month |
| Factors affecting cost | Dental health history, age, gender, level of cover, location |
| Treatment covered by dental insurance | Routine check-ups, dental x-rays, hygiene treatments, emergency care, restorative or remedial dental treatment, oral surgery, orthodontics, oral cancer cover, cosmetic dentistry, implants |
| Treatment not covered by dental insurance | Pre-existing conditions, preventative dental care, treatment identified as necessary before joining |
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What You'll Learn
Dental insurance providers
Dental insurance can help lower your costs if you need extensive treatment, prefer private care, or want to insure against dental emergencies. It covers the cost of routine and essential treatments, such as check-ups, fillings, and X-rays. Typically, you pay for treatment upfront and then claim the cost back from your insurer, up to an annual limit.
Some of the dental insurance providers in the UK include:
Bupa Dental Insurance
Bupa has over 360 dental practices across the UK. It offers a wide range of treatments, from check-ups and cosmetic dentistry to implants and oral surgery. Bupa also provides comprehensive oral cancer cover and up to a 20% discount on treatments.
Denplan
Denplan is a dental payment scheme rather than insurance. You pay a monthly fee to your dentist, and treatments are covered directly under your plan. Denplan is the UK's leading dental plan provider, supporting over 6,600 member dentists and around 1.4 million patients across the UK.
SimplyHealth
SimplyHealth offers dental insurance plans that cover dental check-ups, examinations, treatment, anaesthetic fees, and scale and polish. It also provides worldwide accident and emergency cover. If you are diagnosed with primary mouth cancer, you will receive a one-off payment of £5000.
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What dental insurance covers
Dental insurance is designed to cover dental health and care, which is an important aspect of overall health. There are many different types of dental insurance plans, with some covering the basics and others offering more extensive care and treatments, known as "full coverage". The type of dental insurance plan you choose will depend on your individual and family needs.
Full coverage dental insurance includes plans that help cover the costs of a wide range of dental treatments and procedures, including preventive care, basic care, major restorative care, and sometimes, orthodontic treatment. Preventive care includes routine dental cleanings, checkups, X-rays, and fluoride treatments, which are covered at 100% by most dental insurance plans. Basic restorative care includes fillings and tooth extractions, while major restorative care includes root canals, bridges, crowns, and dentures. Some full coverage plans may also cover a percentage of the cost of dental implants, although this is not standard. It's important to carefully read the details of any plan you're considering to understand what is and isn't covered.
In addition to full coverage plans, there are also basic dental plans that cover preventive care and some basic restorative services. These plans typically have lower premiums but higher copayments and deductibles, meaning you'll pay less every month but more when you need dental services. Direct reimbursement programs pay a predetermined percentage of the total amount spent on dental care, regardless of the treatment category, and allow you to choose your dentist. UCR programs pay a set percentage of the dentist's fee or the plan administrator's "reasonable" or "customary" fee limit, whichever is less, and also usually allow you to choose your dentist.
Dental insurance can be purchased as part of a medical insurance health plan or as a separate policy through a dental insurer, the Health Insurance Marketplace, or a private insurance broker or carrier. It's worth noting that cosmetic dental procedures, like teeth whitening, are rarely covered by dental insurance, and some policies may not cover pre-existing conditions or select procedures such as orthodontics. Additionally, Medicare, a government-funded health insurance plan for people aged 65 and older, typically does not cover dental services.
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Cost of dental insurance
The cost of dental insurance varies depending on the provider and the level of coverage. In the UK, the average person can expect to pay around £10 a month for dental insurance. This can vary depending on factors like your dental health history, age, gender, and location. The level of cover you choose will also affect the cost. For example, choosing NHS or private treatment will impact the price.
In the US, the cost of individual dental insurance typically ranges from $16 to $70 per month. A typical premium amount for a dental plan may be $20–$50 per month for an individual or $50–$150 per month for a family. The premium is a monthly amount that you and/or your employer pay for insurance. This amount may vary between insurance companies and plans.
It's important to note that dental insurance usually covers oral health and maintenance, including routine treatments (check-ups, scaling, and polishing) and complex treatments (oral surgery, tooth extraction, crowns, fillings, and bridges). Most dental plans will include categories such as premiums, copays, coinsurance, deductibles, and annual maximums. The copay is the amount you pay for a dental treatment, after which your insurance covers the rest. Coinsurance determines the percentage of the service your insurance will cover. For example, if the insurance coinsurance is 90%, you will pay the remaining 10%. The annual maximum is the total amount your insurance will pay each year.
Additionally, some dental insurance plans may offer coverage for a portion of the cost of dental implants, while others may not provide any coverage. It is important to carefully review the details of your dental insurance plan to understand the level of coverage and potential out-of-pocket costs.
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How to claim on dental insurance
Dental insurance is an affordable way to ensure you get the oral care you need without having to pay unexpected large fees. It covers a broad range of treatments and procedures, from regular check-ups and dental x-rays to complex treatments like oral surgery, tooth extraction, and root canal fillings.
Most dental insurance plans in the UK follow a reimbursement model, meaning you need to pay for the cost of the treatment upfront and then claim it back from your insurer. Some providers, such as Bupa, offer an Instant Claim service where you can settle your claim at reception.
Understand your policy
Before making a claim, it's important to understand what your dental insurance policy covers. Different insurers offer varying levels of coverage, and some treatments may be excluded. For example, cosmetic dental treatments, pre-existing conditions, and surgical implants are often not covered. Check your policy documents or contact your insurer to clarify what is and isn't covered.
Inform your dentist about your insurance
If you are using Bupa dental insurance, you must inform your dentist and provide your membership number prior to your appointment to benefit from the cover. Other insurance providers may have similar requirements, so it's important to check with them directly.
Pay for the treatment upfront
As mentioned earlier, most dental insurance plans in the UK follow a reimbursement model. Therefore, you will need to pay the dentist for the treatment upfront.
Submit your claim
After receiving the treatment, you can submit your claim to your insurer to reimburse the cost. This can often be done through an online portal or a mobile app, such as My Bupa for Bupa insurance customers. You will typically need to provide details of the treatment and submit an itemised receipt. Some insurers may also allow you to submit claims by post. Claims should be submitted as soon as possible, usually within 12 months of the treatment date.
Receive reimbursement
Once your claim has been approved, your insurer will reimburse you for the cost of the treatment, up to your benefit limit. The reimbursement amount may be paid directly into your bank account.
It's important to note that there may be waiting periods for certain treatments, and pre-existing conditions may not be covered. Additionally, dental insurance does not usually cover cosmetic dental treatments or surgical implants.
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Dental insurance and pre-existing conditions
Dental insurance is an affordable way to ensure you get the oral care you need without paying unexpected large fees. However, dental insurance does not usually cover pre-existing conditions. Pre-existing conditions are dental issues that existed before the policy's start date. Most insurers won't cover pre-existing conditions, but each insurer defines 'pre-existing conditions' differently. For example, if you had treatment for a root canal and it returned after your cover began, many insurers would view this as a pre-existing condition and might not cover it.
There are still ways to secure dental insurance coverage if you have pre-existing oral health issues. Firstly, it is important to research various dental insurance providers and their policies concerning pre-existing conditions. Some plans offer coverage or waiting periods that may match your specific requirements. Group dental insurance plans, which are often provided by employers, tend to be more accommodating when it comes to pre-existing conditions. These plans sometimes offer immediate coverage for pre-existing conditions or shorter waiting periods.
Waiting periods for pre-existing conditions vary from plan to plan. Some plans have no waiting period for preventive or diagnostic services such as routine cleanings and basic exams. Conversely, your dental plan may have a 6- to 12-month waiting period for restorative services such as filings and non-surgical extractions, with a 12-month waiting period for major services such as crowns or dentures. It is important to check with your dental insurance administrator to determine your applicable waiting periods.
To make informed decisions about your coverage, it is crucial to understand the pre-existing dental condition clauses in your policy. These clauses define how insurance providers handle pre-existing dental issues and can result in waiting periods before certain treatments are covered. Ultimately, these clauses aim to balance providing coverage for immediate needs and controlling costs for both policyholders and insurance providers.
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Frequently asked questions
Private medical insurance does not usually cover dental, but it can be added on as a separate health plan.
Dental insurance covers oral health and maintenance, including routine treatments such as check-ups, scaling, and polishing, as well as complex treatments like oral surgery, tooth extraction, crowns, fillings, and bridges. It can also cover dental emergencies and injuries.
The cost of dental insurance depends on factors such as your dental health history, age, gender, and the level of cover you choose. The average person in the UK can expect to pay around £10 a month, but premiums can start from £11 per month.
With most dental insurance, you pay your dentist for any treatment received and then claim the money back from your insurer.
Some providers of dental insurance in the UK include Bupa, AXA Health, and Simplyhealth.
