What is not covered by a dental plan?

American Dental Association

Some dental plans do not cover pre-existing conditions, such as missing teeth. Others may not cover dental implants, specialist referrals and other dental needs. Even when you and your dentist agree on the appropriate treatment method for your condition, the contract provision of the dental plan may only pay a portion, or pay only for the least expensive alternative treatment (LEAT) as determined by the insurance company.

Continue Learning about Dental Insurance Plans

Dr. Michael Roizen, MD

Absolutely. Asking questions about your dental health coverage is incredibly important and a very s...

American Dental Association

Direct Reimbursement (DR) is a self-funded dental benefits plan that reimburses patients accordi...

American Dental Association

If you can't afford dental insurance, you're not alone. One option may be to see if you qualify for ...

American Dental Association

There are numerous models of dental plans. In general, they can be divided into two categories: ...

Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.

Dental Insurance Plans

You are at the dentist and have been asked to "open wide", only it's your wallet and not your mouth that is being asked to open. If this is a concern, various dental plans may come to the rescue. Like regular insurance, there are Health Maintenance Organization plans (HMO) and Preferred Provider (PPO) plans. Most work on a fee for service basis where a particular treatment is reimbursed at a standard rate. Plans often have annual limits on services, and may pay for cleaning only once or twice a year. Few plans cover cosmetic services like whitening. Many times major services need to be pre-approved. With most plans you can be assured of a standard level of payment for required basic services inside of a coverage network.

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