How Dental Insurance Works
Most dental insurance plans follow the "100-80-50" model:
| Service Type | Typical Coverage | Examples | Subject to Deductible? |
|---|---|---|---|
| Preventive | 100% covered | Cleanings, X-rays, exams | Usually No |
| Basic/Restorative | 80% covered | Fillings, extractions | Yes |
| Major | 50% covered | Crowns, bridges, dentures | Yes |
| Orthodontia | 50% (if included) | Braces, Invisalign | Lifetime max applies |
2026 Dental Insurance Costs
$15/mo
Individual basic plan
$45/mo
Individual premium plan
$55/mo
Family plan (2 adults)
$1,500
Typical annual maximum
| Plan Type | Individual/Mo | Family/Mo | Annual Max | Waiting Periods? |
|---|---|---|---|---|
| Preventive Only | $8–$15 | $20–$35 | $750–$1,000 | None for preventive |
| Basic PPO | $18–$28 | $45–$65 | $1,000–$1,500 | 6–12 months (basic) |
| Comprehensive PPO | $35–$55 | $80–$120 | $1,500–$2,000 | 12 months (major) |
| Dental HMO (DHMO) | $10–$20 | $25–$45 | No annual max | None |
| Dental Discount Plan | $8–$12 | $16–$22 | Not insurance | None |
PPO vs HMO vs Discount Plans
| Type | Choose Your Dentist? | Coverage | Best For |
|---|---|---|---|
| PPO | Yes (any in-network) | True insurance | Most people who want flexibility |
| HMO/DHMO | Must use network | True insurance | Low-cost, in-network users |
| Discount Plan | Must use network | Discounts only (not insurance) | No-waiting-period option, budget shoppers |
Avoiding Waiting Periods
Most dental plans impose waiting periods for major services (6–12 months). To avoid them:
- Dental HMOs often have no waiting periods for any covered services
- Discount plans (not insurance, but immediate discounts) are available same-day
- Some PPOs offer "no waiting period" plans at slightly higher premiums — useful if you need major work soon
- Employer dental usually has no waiting periods for existing employees
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