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Individual Dental Insurance

By Insurance Industry Expert & Author
Updated on

One of the first challenges consumers face when shopping for insurance is the collection of unfamiliar terms cropping up across the plan comparisons and benefit descriptions. One of those phrases is “individual dental insurance.” In this article, we’ll cover:

  • What is individual dental insurance?
  • How is individual dental insurance different from employer dental benefits?
  • What are the benefits included in individual dental insurance?
  • What are some of the major considerations when buying individual dental insurance?
  • What is the cost of individual dental insurance?

By the end of the article, the reader will have sufficient background to begin their shopping process with confidence.

What Is Individual Dental Insurance?

“Individual dental insurance” refers to dental insurance purchased by a private person to cover him or herself. Within the dental insurance industry, it is viewed as distinct from group plans purchased by employers or by unions.

How is Individual Dental Insurance Different than Employer Dental Benefits?

Fundamentally, the difference between individual and employer dental insurance is that the employer-variety of dental coverage is likely a group plan, i.e. a policy that covers multiple employees while the individual plan covers only a sole enrollee. Group plans have the advantage of scale to obtain more favorable premiums than is the case for single enrollees within the individual dental plan market. Insurers also like groups because they are likely to be more predictable with respect to annual claims (in other words, there is less fluctuation expected between predicted dental claim expenses and actual claims).

Another important difference between individual and employer dental insurance is that the enrollee pays the full premium for individual dental insurance, while an employer may subsidize a portion of the premiums for workers enrolled in employer dental insurance. A subsidized dental plan lowers the premiums for the workers who choose to enroll.

What are the Benefits Included in Individual Dental Insurance?

There is no standardization of benefits among dental insurance plans, which makes shopping more work, unfortunately. With that said, many dental plans cover services such as:

  • Annual oral exams & cleanings
  • X-Rays
  • Fillings
  • Simple tooth extraction
  • Surgical tooth extraction
  • Root canal
  • Crown

Benefits often missing in individual dental insurance include:

  • Cosmetic dentistry
  • Braces

What Are Some of the Major Considerations when Buying Individual Dental Insurance?

When comparing dental plans available in your area, here are a few questions a consumer should ask of each plan you are considering:

  • What is the annual cost of premiums and the plan’s deductible?
  • What are the out-of-pocket costs for the services I expect to use?
  • Are there are any delays (i.e. “waiting periods”) before the plan will cover the dental services I need?
  • Is the plan accepted by the dentist I use?
  • How much will I pay for major services such as a crown or a root canal or a denture?
  • What is the maximum the plan will pay toward dental services in a year?

For more detailed information on shopping for a dental plan, you can review our article Dental Insurance 101.

What are the Costs of Individual Dental Insurance?

Dental insurance is typically much less expensive than medical insurance. With respect to deductibles, the typical amount ranges from $50 to $100 according to Consumer Reports. Premiums (the monthly fee you pay for coverage) varies considerably, but there are many plans available for less than $50 a month for individual coverage. Below are some premium trends has observed in different states:

  • California- Our 2021 review of 39 dental plans in California found the lowest available premium within that group was $6.95 for an individual and the highest was $85.44, with the average monthly premium being $39.30
  • Texas - Our 2021 review of 30 Texas dental plans observed an average premium of $32.50. The lowest monthly premium of the 30 plans reviewed was $7.03 and the highest was $68.72 for an individual
  • New York - Our 2021 review of dental plans in New York observed a price span ranging from a low of $5.10 (MetLife's “TakeAlong Dental HMO-Managed Care 350 (Low)") to $68.72 (Nationwide Classic 2000 Indemnity). Benefits differed considerably among plans. For the plan year 2021, the average premium across plans was $38.03 for single-person coverage
  • Florida - An analysis of 30 dental benefit options in the state for 2021 found the average monthly premium for an individual was $35.45. This average was almost 11 percent lower than the case for California but over eight percent higher than Texas. The most expensive premium among the plans examined was $68.72 (Nationwide's Classic 2000 Indemnity). The least expensive was $8.06, a DHMO dental plan from Guardian named “Managed DentalGuard.”
  • North Carolina - Our 2021 study of 18 plans from the state of North Carolina found the average premium within that group was $34.78. Premiums were as inexpensive as $8.95 a month for a single enrollee and as high as $68.72.

This website may also be used to compare prices for plans available within your state.