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?
This article provides:
- An overview of dental insurance called “full coverage”
- Out-of-pocket costs
- Orthodontia service exclusions
- A short list containing examples of full coverage dental insurance
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.
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.
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.
Many dental plans fail to cover orthodontic services. Among those plans that do offer orthodontic coverage, look carefully at- 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
- 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.
| State | Insurance Company | Plan |
| Alabama | Renaisssance | MAX Choice Plus |
| NCD Nationwide | 3000 Plan | |
| Alaska | Ameritas | Dallas Smile Plan |
| Arizona | Humana | Extend 2500 |
| Renaisssance | MAX Choice Plus | |
| Arkansas | Renaisssance | MAX Choice Plus |
| NCD Nationwide | 5000 Plan | |
| California | California Dental | Plan 595 |
| Dental Health Services | SmartSmile | |
| Colorado | Anthem Blue Cross Blue Shield | Essential Choice Incentive |
| NCD Nationwide | 5000 Plan | |
| Connecticut | Anthem Blue Cross Blue Shield | Essential Choice Incentive |
| Humana | Extend 5000 | |
| Delaware | Dominion National | Select Plan Basic |
| Dominion National | Select Plan Premium | |
| Florida | Humana | Extend 2500 |
| Ameritas | Dallas Smile Plan | |
| Georgia | Anthem Blue Cross Blue Shield | Essential Choice Incentive |
| NCD Nationwide | 3000 Plan | |
| Hawaii | Renaisssance | MAX Choice Plus |
| Ameritas | Dallas Smile Plan | |
| Idaho | Renaisssance | MAX Choice Plus |
| Humana | Extend 5000 | |
| Illinois | Humana | Dental Value Plan C550 |
| NCD Nationwide | 5000 Plan | |
| Indiana | Anthem Blue Cross Blue Shield | Essential Choice Incentive |
| NCD Nationwide | 3000 Plan | |
| Iowa | Renaisssance | MAX Choice Plus |
| NCD Nationwide | 5000 Plan | |
| Kansas | Humana | Extend 2500 |
| Humana | Extend 5000 | |
| Kentucky | Humana | Dental Value Plan C550 |
| Anthem Blue Cross Blue Shield | Essential Choice Incentive | |
| Louisiana | Ameritas | Dallas Smile Plan |
| NCD Nationwide | 3000 Plan | |
| Maine | Anthem Blue Cross Blue Shield | Essential Choice Incentive |
| Ameritas | Dallas Smile Plan | |
| Maryland | NCD Nationwide | 5000 Plan |
| Renaisssance | MAX Choice Plus | |
| Massachusetts | Ameritas | Dallas Smile Plan |
| Renaisssance | MAX Choice Plus | |
| Michigan | Humana | Extend 2500 |
| Humana | Extend 5000 | |
| Minnesota | Ameritas | Dallas Smile Plan |
| Renaisssance | MAX Choice Plus | |
| Mississippi | NCD Nationwide | 5000 Plan |
| NCD Nationwide | 3000 Plan | |
| Missouri | Ameritas | Dallas Smile Plan |
| Humana | Extend 5000 | |
| Montana | Delta Dental | Immediate Coverage Plan (The Immediate Coverage Plan lacks implant coverage) |
| Nebraska | Humana | Extend 5000 |
| NCD Nationwide | 5000 Plan | |
| Nevada | Anthem Blue Cross Blue Shield | Essential Choice Incentive |
| Ameritas | Dallas Smile Plan | |
| New Hampshire | Anthem Blue Cross Blue Shield | Essential Choice Incentive |
| Ameritas | Dallas Smile Plan | |
| New Jersey | NCD Nationwide | 3000 Plan |
| NCD Nationwide | 5000 Plan | |
| New Mexico | Renaisssance | MAX Choice Plus |
| NCD Nationwide | 3000 Plan | |
| New York | Empire BlueCross BlueShield | Essential Choice Incentive |
| Humana | Extend 2500 | |
| North Carolina | Renaisssance | MAX Choice Plus |
| NCD Nationwide | 5000 Plan | |
| North Dakota | Ameritas | Dallas Smile Plan |
| NCD Nationwide | 3000 Plan | |
| Ohio | Anthem Blue Cross Blue Shield | Essential Choice Incentive |
| Humana | Extend 5000 | |
| Oklahoma | Humana | Extend 2500 |
| Renaisssance | MAX Choice Plus | |
| Oregon | Dental Health Services | SmartSmile |
| Dental Health Services | Super SmartSmile | |
| Pennsylvania | Dominion National | Select Plan Basic |
| Dominion National | Select Plan Premium | |
| Rhode Island | Renaisssance | MAX Choice Plus |
| NCD Nationwide | 5000 Plan | |
| South Carolina | Ameritas | Dallas Smile Plan |
| Renaisssance | MAX Choice Plus | |
| South Dakota | Ameritas | Dallas Smile Plan |
| Tennessee | Humana | Dental Value Plan HI215 (The Dental Value Plan HI215 Plan lacks implant coverage)) |
| Texas | Humana | Extend 2500 |
| NCD Nationwide | 3000 Plan | |
| Utah | Renaisssance | MAX Choice Plus |
| Humana | Extend 5000 | |
| Vermont | Ameritas | Dallas Smile Plan |
| Renaisssance | MAX Choice Plus | |
| Virginia | Dominion National | Select Plan Basic |
| Dominion National | Select Plan Premium | |
| Washington State | No plans in inventory meeting coverage specification | |
| Washington D.C. | Dominion National | Select Plan Basic |
| Dominion National | Select Plan Premium | |
| West Virginia | NCD Nationwide | 3000 Plan |
| NCD Nationwide | 5000 Plan | |
| Wisconsin | Anthem Blue Cross Blue Shield | Essential Choice Incentive |
| Humana | Extend 2500 | |
| Wyoming | Ameritas | Dallas Smile Plan |
| NCD Nationwide | 3000 Plan | |