Jeffrey Wade
Dental insurance helps cover the cost of treatments for your teeth and gums. There are three common categories of dental insurance: preventive, basic, and major. The type of insurance that covers a broken tooth depends on the plan and the type of surgery required. For example, a simple tooth extraction may be considered basic care, whereas oral surgery for a broken tooth may be considered a major service. The cost of dental insurance varies based on several factors, including where you live and the kind of plan you buy.
| Characteristics | Values |
|---|---|
| Dental insurance cost | $15–$50 per month |
| Dental insurance types | dental preferred provider organizations (DPPOs) or dental health maintenance organizations (DHMOs) |
| Dental insurance coverage | Routine teeth cleanings, dental exams, fillings, X-rays, oral screenings, tooth extractions, spacers, oral surgery, dentures, crowns, periodontal maintenance, periodontal scaling and root planing |
| Dental insurance waiting period | 3-6 months for basic procedures like fillings; 3 months to a year for major dental work such as crowns, bridges or fillings |
| Dental insurance for orthodontics | May be covered for children under 18 if deemed medically necessary; not typically covered for adults |
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What You'll Learn
Dental insurance waiting periods
A dental insurance waiting period is the length of time before your full dental benefits begin. During this time, your dental plan may not pay for certain dental services or procedures. Dental insurance waiting periods vary from plan to plan and can range from a few months to a full year. Some dental plans don't have waiting periods at all.
Most dental insurance plans don't include waiting periods for routine preventive care like teeth cleanings, check-ups, exams, and X-rays. These services are considered preventive and help keep your teeth healthy, preventing more costly procedures in the future.
For basic procedures like fillings, extractions, and root removals, some plans may have waiting periods from 3 to 6 months. Major dental work, such as crowns, bridges, implants, oral surgery, dentures, and fillings, typically has waiting periods from 6 to 12 months.
If you're switching dental insurance providers, your new provider may waive the waiting period if you can prove that you didn't have a break in coverage. Additionally, if you change employers but have the same benefits plan, there may not be a waiting period.
It's important to check with your dental insurer to understand your coverage during the waiting period, especially if you anticipate needing dental work during that time.
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Basic vs major dental work
Dental insurance helps cover the cost of treatments for your teeth and gums. There are three categories of dental insurance: preventive, basic, and major. Preventive care includes routine visits to the dentist for examinations, bi-annual cleanings, oral screenings, and routine X-rays. This type of care aims to prevent gum disease and tooth loss by identifying problems early on. Basic care treats minor to medium damage that has already occurred, such as toothaches and gum issues, and includes restorative work like fillings. Basic services are typically straightforward, non-surgical procedures that are simple to perform and do not require significant lab equipment. On the other hand, major dental services involve more extensive and elaborate treatments that may require dental laboratory expenses. Major services include complex dental work and surgical procedures such as implants, crowns, bridges, dentures, and orthodontic treatments. These procedures are often lengthy and complex and may require anesthesia or surgery.
The cost of dental insurance varies depending on factors such as location and the chosen plan. Most dental plans do not include waiting periods for preventive care, but basic and major procedures may have waiting periods ranging from 3 to 12 months. It is important to note that not all procedures are covered by insurance, and some plans may impose restrictions or have annual maximum coverage limits. Additionally, individuals may be responsible for out-of-pocket costs like copays and deductibles.
When considering dental insurance, it is crucial to understand the different types of procedures covered and the benefits provided. Basic dental services are typically covered at a higher percentage (70-80%) compared to major services (50%). However, individuals with a history of oral health problems or those requiring extensive work should opt for a plan that includes coverage for major dental services. By understanding the classification of dental services and the coverage provided, individuals can make informed decisions about their oral health and choose a plan that offers the best value for their needs.
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Preventative dental care
In addition to these basic services, preventative dental care can also include diagnostics such as dental x-rays and oral screenings to monitor oral health and identify potential issues. Sealants may also be applied to the molars to prevent decay, and orthodontic treatment may be recommended for children as their adult teeth begin to grow in.
Practicing good oral hygiene habits at home is also an important aspect of preventative dental care. This includes brushing teeth with a soft-bristled toothbrush at least twice a day and flossing regularly to remove plaque and bacteria. Maintaining a healthy diet and limiting sugary foods and drinks can also help to prevent tooth decay.
By combining regular dental visits with good oral hygiene practices at home, individuals can help maintain their oral health and prevent more serious dental issues from developing. Preventative dental care is particularly important for children as they grow and develop their permanent teeth, as it can help prevent complications that could affect their oral health in adulthood.
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Supplemental dental insurance
The cost of supplemental dental insurance varies depending on factors such as location, type of coverage, and insurance provider. In 2025, the average cost of supplemental dental insurance ranged from $20 to $50 per month for an individual and $50 to $150 per month for a family. It is important to carefully evaluate the savings offered by a supplemental plan against the additional costs of insurance to determine if it is a financially viable option.
When considering supplemental dental insurance, it is recommended to consult a broker to ensure that the specific dental treatments and procedures an individual requires will be covered by the chosen plan. By combining a primary dental insurance plan with a carefully selected supplemental plan, individuals can achieve greater peace of mind and financial security when it comes to maintaining their dental health.
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Cost of dental insurance
The cost of dental insurance varies depending on several factors, including the type of plan, the level of coverage, and the number of people covered. Basic dental plans through Cigna Healthcare start at around $20 a month, while Delta Dental of Washington offers individual plans ranging from $31 to $88 per month. According to Investopedia, the average cost of monthly premiums can vary between $7 and $87.
Most dental insurance plans fall into three categories: preventive, basic, and major care. Preventive care includes routine cleanings, exams, and X-rays, and is typically covered at 100%. Basic care covers minor to medium damage, such as toothaches and fillings, and is usually covered at 80%. Major care includes crowns, root canals, and gum disease treatment, and is generally covered at 50%.
It's important to note that there are different types of dental insurance plans, such as Dental Preferred Provider Organizations (DPPOs) and Dental Health Maintenance Organizations (DHMOs). DPPO plans offer a wider choice of dentists but tend to be more expensive, while DHMOs have lower premiums and copays but a smaller network of dentists.
In addition to monthly premiums, other costs associated with dental insurance include copays, deductibles, coinsurance, and annual maximums. Copays are the amount you pay each time you visit the dentist, while deductibles are the amount you need to pay before your insurance coverage kicks in. Coinsurance is the portion of the dental costs you pay after meeting your deductible, and the annual maximum is the yearly limit on how much your plan will pay.
Supplemental dental insurance is also an option to enhance your benefits. It can be paired with a primary dental plan or Medicare Advantage plan to lower out-of-pocket costs for dental work.
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Frequently asked questions
Humana's dental insurance plans cover treatments to your teeth and gums. Depending on the plan, it may cover preventive, basic, and major services. Preventive care includes routine teeth cleanings, exams, and X-rays, while basic care covers minor to medium damage like toothaches and gum issues. Major services include oral surgery, dentures, and crowns.
A broken tooth may be considered a medical necessity under Humana's insurance plans when it requires immediate treatment to alleviate pain, prevent infection, or restore function. The specific criteria for determining medical necessity may vary based on the plan and the severity of the condition.
Yes, Humana's dental insurance plans may have waiting periods for certain treatments. For basic procedures like fillings, the waiting period can range from 3 to 6 months. For major dental work such as crowns, bridges, or dentures, the waiting period can be from 3 months to a year. However, some plans offer no waiting period for certain procedures.
The cost of Humana's dental insurance varies depending on factors such as your location and the chosen plan. Americans typically pay around $360 per year or $15 to $50 per month for dental insurance. In addition to monthly premiums, there may be other costs such as copays, deductibles, and coinsurance.
