Full Coverage Dental Insurance

There are many different types of dental insurance plans. Some cover the basics and others cover more extensive care and treatments, sometimes referred to as, “full coverage.” What is full coverage dental insurance? What does it cover, and what does a full coverage dental plan cost?

What is full coverage dental insurance?

Full coverage dental insurance includes plans that help cover you for preventive care, as well as basic and major restorative care, and in some cases orthodontic treatment. The term, “full coverage” means you’re getting benefits for a lot of different types of dental treatments and procedures. For example, you may have coverage for more costly things like root canals, bridges, and implants, as well as coverage for your preventive dental care. Full coverage does not mean your plan covers 100% of all costs, however.

What are the main types of full coverage dental plans?

Many types of dental plans provide coverage for services and treatments that go well beyond preventive care. These are considered full coverage. Dental PPO (DPPO), Dental HMO (DHMO), Dental EPO (DEPO), and Dental POS (DPOS), may all provide coverage for a wide range of dental services and treatments.

They can differ, though, in covered services, costs, and limitations, even between insurance carriers.

What types of services and treatment does a full coverage dental plan cover?

The services and treatments covered under a full coverage dental plan depends on the type of dental plan you choose.

Typically, full coverage plans go beyond preventive care. They may also offer coverage for the following:

• Basic restorative care: This usually includes things like fillings, extractions, and non-routine X-rays.
• Major restorative care: This includes things like bridges, crowns, and dentures.
• Orthodontic treatment: This includes things like space maintainers, braces, and other devices used to align your teeth.
• Preventive dental care: This includes regular teeth cleanings, routine X-rays, fluoride treatments and sealants as indicated by age and frequency. Many dental plans cover 100% for preventive dental services aside from a copay at the time of the visit.

When choosing a full coverage dental plan, read the details carefully. Dental plans can vary even between insurers.

Does full coverage dental insurance cover dental implants?

It depends. Dental implant insurance benefits are not standard in most full coverage dental plans, so how do you find a plan that covers you? To find a plan that covers dental implants you will need to shop carefully and read the plan details. Plan summary benefits often include language that clearly tells you what types of dental procedures and treatments are covered. They also include language about what’s not covered—these are also called exclusions and limitations. If you don’t see specific mention of dental implants in what’s covered, check the list of what’s not covered because they may be listed there.

When you find a plan that does cover dental implants, it will likely only cover a percentage of the cost. In addition, there may be other requirements you must meet. These could include a dental deductible, waiting period, and lifetime maximum (which is the most your plan will pay toward dental implants).

What's the cost for full coverage dental insurance?

Full coverage dental plans vary in cost depending on what type of plan you choose. For example, DPPO and DHMO plans may offer coverage for many types of dental services, but their costs can be quite different. The following items will impact how much your dental plan will cost.

• Deductible: This is what you pay before your plan begins to pay. Some dental plans—such as DPPO plans—have deductibles, while many DHMO plans do not.
• Coinsurance: This is the percentage of costs you and your plan share, typically once you’ve met your deductible. If your plan doesn’t have a deductible, like a DHMO, you will pay a flat fee for the services you receive.
• Copay: This is a flat fee that you may have to pay each time you go to your dentist or fill a prescription. Copays cover a portion of the costs for each visit or medication. Some dental plans—such as DHMO plans—have copays, while many DPPO plans do not.
• Annual Maximum: This is how much your plan agrees to pay toward your dental care in a plan year. If you go over this amount, you may be responsible for the out-of-pocket costs.
• Premium: This is what you pay monthly for your plan. Some plans, like DPPOs, tend to have a little higher premium because they offer you a lot of choice. DHMOs tend to have lower premiums because you are more limited.

You can learn more about the differences between copays, deductibles, and coinsurance.

Can you get full coverage dental insurance without a waiting period?

Yes, there are full coverage dental plans without a waiting period. A waiting period is the period of time between your plan start date and when you are actually covered to receive certain kinds of care.

Often a plan will cover you for preventive care right away, but ask you to wait a certain amount of time before it will cover you for more complex and costly care. So, for example, you may be able to get your teeth cleaned once your plan begins, but you may have a waiting period before you can get something like a crown.

Can you get full coverage dental insurance without a maximum?

Many types of dental plans set an annual maximum—this is the most your plan will pay for dental procedures and treatments over the course of the plan year. DHMOs typically do not have annual maximums. This means you don’t risk running out of benefits. DHMOs are a good fit for some people but offer fewer choices.

That said, you can shop for other dental plans with higher annual maximums, which means they cover you for a lot more. It’s important to anticipate what type of dental care you may need in the upcoming year and choose a plan with an annual maximum that’s right for you. You can also explore the value of a DHMO for a full coverage dental plan.

Where can you buy a full coverage dental plan?

You can get a full coverage dental plan in one of the following ways:

• Enroll in a dental plan offered through your employer. Your employer may offer you options in insurance coverage through a particular insurance carrier.
• If you don’t have coverage through an employer, you can buy a full coverage dental plan on your own through a private insurance carrier like Cigna Healthcare^SM. We offer a wide range of dental plans including basic preventive plans or those that include benefits for more extensive dental care.
• You can also shop for a dental plan through the Health Insurance Marketplace.

How do I choose the best full coverage dental plan for me?

The right dental plan for you will depend on multiple factors:

• Current dental needs: You’ll want coverage for the basics, such as routine dental cleanings and checkups.
• Potential future dental needs: Outside of regular dental exams, think about your dental history (and that of any family members covered by the plan as well). Have any of you been told you may need a particular treatment or oral surgery procedure?
• In-network dentists: Do you already have a dentist you like? Check to see if that provider is still in-network under the new dental plan.
• Budget: As previously mentioned, dental plans can vary in cost. Think about what you’d be comfortable paying for dental coverage and be sure to review each dental plan’s details carefully to understand any copays, deductibles, or premiums.

As with selecting any kind of insurance, always make sure to read the fine print of each full coverage dental insurance plan’s details. What does each plan cover? Are there limits on age and frequency? Is there an annual maximum that’s right for you and the dental care you expect to need during the plan year? Plans can vary by type, DPPO vs. DHMO for example, and also by insurance carrier. Before you enroll, make sure you understand how much your plan will cost and what it will cover.