What Is Full Coverage Dental Insurance?

Benefits, Out-of-Pocket Costs, and Plan Examples

Unlike Medicare Advantage plans and Affordable Care Act plans, dental insurance does not have a list of standard benefits shared among all plans. As a consequence, some dental plans have “bare bone” coverage while others have broad benefits. Given this disparity in benefit designs, consumers often ask, “What is full coverage dental insurance?” and where can I buy it?

Knowing the interrelationship between these issues will help a consumer find true full coverage insurance and ignore plans that claim wide coverage but pay for very little in actual practice.

Full Coverage Dental Insurance

As mentioned earlier, there is no standard definition of dental insurance benefits. With that said, consumers looking for a full coverage plan should seek a dental plan whose benefits include:

Preventive care

• At least two routine oral exams and teeth cleanings per year
• At least one dental x-ray per year
• At least two topical fluoride treatments per year

Filling coverage

• Fillings may have limits such as one per tooth per year or two years
• There is often different coverage for traditional fillings versus cosmetic white fillings

Extraction coverage

Crown coverage

• Crowns benefits may vary according to the type of crown such as:
• Porcelain/Ceramic substrate
• Porcelain with gold
• Porcelain with non-precious metal or a semi-precious metal
• The replacement of a crown may incur different costs than the initial implementation of a crown

Periodontics coverage

• Periodontics deals with the supporting structures of teeth such as the gums and the jawbone
• Care may be nonsurgical or surgical
• Root planing is an example of periodontic care

Bridge coverage

Endontics coverage

• Endontics deals with dental treatments within the interior of a tooth, such as a root canal
• Services such as a root canal may have a limit of one per tooth per lifetime

Oral surgery coverage

• This includes not only surgery but also related services such as deep sedation or anesthesia

There is an important issue associated with full coverage dental plans: waiting periods. Some plans have all the benefits attributed to “full coverage” but some of the dental services covered may have a dental insurance waiting period where a consumer must be enrolled for a specified period of time before the insurance plan will pay for the service. Usually waiting periods are associated with more expensive dental services such as dental implants.

Full Coverage Dental Insurance Cost

There are many dental plans that provide full coverage at affordable prices. While we have a list of full coverage dental plans at the bottom of the page, this article will also help you recognize which full coverage dental plans are bargains where you get more coverage for less money. You can see the dental plan options available in your zip code by visiting our dental insurance quote page.

Benefit Out-of-Pocket Costs

Benefits are only half the story of full coverage dental plans. The other half is the out-of-pocket costs charged for those benefits. For example, if a plan only pays for 10 percent of the cost of root canal, does that really constitute meaningful coverage of that benefit?

Dental costs come in four main forms:

• Deductible
• Copayments/coinsurance fees
• Maximum annual benefit
• Cost of uncovered care

Just as benefits are not standard among dental plans, neither are the out-of-pocket costs charged for their use. Deductibles, the out-of-pocket costs you pay before an insurance policy will begin sharing costs, average under $100. A very high deductible undermines the value of the dental insurance. With respect to coinsurance, where the enrollee pays a percentage of the total dental service charge, fees amounting to more than 50 percent of the service cost are often perceived as less than “full coverage” since the patient pays more for the care than the insurance company.

A dental plan’s maximum annual benefit, that is to say, the cap on the insurance policy’s benefit payments, is often around $1,500 annually. A full coverage plan is generally considered to have a maximum benefit of $2,500 or higher, though some full coverage plans may start with a lower maximum in the first year of coverage but satisfy the $2,500 threshold after a period of continuous enrollment.

Finally, there is the matter of uncovered care. If the limitations of the policy or the narrowness of the dentist provider network significantly increases the probability of uncovered care, then it is reasonable to question whether the dental plan truly constitutes comprehensive coverage.

Full Coverage Dental Insurance with No Waiting Period

Some dental plans have full coverage but delay more expensive benefits until you have been enrolled for a while (e.g. six months). This delay is known as a waiting period. If you need immediate dental work and can’t accept a delay on coverage, see our article on Dental Insurance with No Waiting Period.

Orthodontry?

We normally associate orthodontic care with the correction of misaligned teeth through the use of braces. While braces are certainly a matter of oral care, it is not a standard benefit within dental policies. Most privately purchased dental plans have no benefits regarding orthodontic services. In fact, a DentalInsurance.com nationwide study of dental plans found only 28 percent had some level of coverage for braces. This is unfortunate since braces, and its attendant orthodontist visits, can cost around $5,000, though these costs may exceed $10,000 in some cases.

• The maximum amount the plan will pay towards braces
• The waiting period before orthodontic care will be covered
• The oldest age a dependent child may be in order to qualify for orthodontic coverage
• Network limitations

Full Dental Coverage Plans

The information provided within this article provides a means by which to evaluate the breadth and quality of your dental benefits. If you find your dental coverage lacking, you should consider comparing other dental plans available in your area to establish how their benefit breadth and costs compare to your current coverage.

Full Coverage Dental Insurance Plans Examples by State

With a better understanding of full coverage dental insurance, you can make a more informed judgment about your options. To compare dental insurance prices in your area, you can visit our dental insurance quote page. For a quick review of dental plans considered to be full coverage, see the table below. Please make note that:

• This is not a exhaustive list
• Always review the plan details to verify the extent of coverage and its out-of-pocket costs. You can see this information on the plan pages linked below. You can also read a plan’s Summary of Benefits or get a comparison of your local plans using our plan comparison tool where every plan has a More Details link for additional information on the scope of each plan benefits. Once in the More Details section, you can click the Full Plan Information button within the More Details section.
• Check to see if there is a waiting period before a particular dental services is eligible for coverage

One last reminder - some plans listed may not be available in every region of the state in which it's offered.