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Family Dental Insurance Plans

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Family Dental Insurance


By Insurance Industry Expert & Author
Updated on

Family dental insurance is dental coverage for multiple individuals belonging to the same family. Like individual dental insurance, the policy is privately purchased by the family, as opposed to group dental coverage that is obtained through a job or a union.

Benefits for family dental insurance vary among plans. They also have different delivery networks such as PPO and HMO as well as indemnity.


Premium Comparisons

The general tendency for dental premiums is to increase when the number of applicants increases. To illustrate this trend, we’ve used four different dental plans offered in California and presented the premiums for an individual, a couple, a couple with one child, and a couple with two children.

Single CoverageCoupleCouple + 1 ChildCouple + 2 Children
Plan A$26.83$53.65$85.84$85.84
Plan B$50.75$101.50$152.25$203.00
Plan C$59.93$112.11$164.28$164.28
Plan D$94.79$172.93$244.46$244.46
The above prices were from 2021 plans that assumed adult applicants who lived in the Los Angeles area and were 30 years old as of May 1, 2021. Child applicants were assumed to be born in 2010 and 2011 respectively.

As the above table illustrates, premium increases for adding family members to a dental policy are not consistent across dental plans. For example, in three cases, we found no increase in premium when moving from a family with one minor child to a family with two minor children.

Let’s look at the same table but change the figures to reveal the percentage increase associated with the additional covered lives.

Single CoverageCoupleCouple + 1 ChildCouple + 2 Children
Plan A[Base premium]100% increase from base premium220% increase from base premium220% increase from base premium
Plan B[Base premium]100% increase from base premium220% increase from base premium300% increase from base premium
Plan C[Base premium]87% increase from base premium174% increase from base premium174% increase from base premium
Plan D[Base premium]87% increase from base premium158% increase from base premium158% increase from base premium

In the above table, the greatest premium increase when moving from single coverage to couple coverage was 100 percent but the least increase was 82 percent. The greatest premium increase when moving from single coverage to coverage for a couple with a child was 220 percent while the least was 158 percent.

What do all of these numbers mean? You need to do your homework when shopping for family dental insurance. First, get premium quotes specific to ALL your family members. You cannot extrapolate the cost of family coverage from knowing only the cost of single coverage. Second, don’t assume the price trends you see in one plan apply to any others.


Family Deductibles

A deductible is the amount that must be spent out-of-pocket by a plan enrollee for covered dental services before the insurance company begins to assist with payments. Dental plans have a variety of deductible options. One option that is common is to set the deductible by the number of enrollees in the dental plan.

Annual Deductible: $50 per person

In the above scenario, a family of three has a total deductible responsibility of $150 each year while a family of five using the same plan would have a total deductible of $250.

In some cases, a plan that increases the deductible with the number of enrollees may cap the maximum family deductible amount.

Annual Deductible: $100 deductible per insured person (a maximum of 3 deductibles per family)

In the above scenario, a family of three, six, or even nine, would have the same $300 deductible. In contrast, a couple using this plan would have a $200 annual deductible between the two enrollees.

In some cases, certain dental services may be excluded from the deductible.

Annual Deductible: $50 per person, up to $150 per family. Deductible is waived for diagnostic and preventive services in network only

This scenario means that an enrollee receiving diagnostic or preventive services from an in-network dentist would not need to satisfy a deductible when paying for those services.

In some cases, a dental plan may have more than one deductible.

Annual Deductible: Combined Deductible for Diagnostic, Basic and Major Procedures: $50 per person per calendar year. Orthodontia Deductible: $100 lifetime

This deductible scenario has separate deductible amounts based on whether the services are traditional dental work or orthodontic work. Additionally, the dental deductible resets every year while the orthodontic deductible applies to the total time the enrollee is within the dental plan.


Orthodontic Benefits

Some family dental plans have orthodontic benefits. Orthodontry includes not only traditional braces but other services such as palatal expanders, which expand the size of a child’s upper jaw to reduce the potential for crowding among the child’s teeth. Most dental plans, whether for an individual or a family, do not cover orthodontia. However, a minority of dental plans do offer orthodontic benefits so it is important to review the benefits statement for a dental plan before enrolling, especially if you or your children may need braces in the future.

For more information, see our articles “Braces and Dental Coverage” and “Orthodontics”.