Which Insurance Options are Best for Major Dental Work?

Top Dental Insurance Plans for Major Dental Work

Most dental insurance plans cover preventive dental services like annual exams and cleanings. Only a select number of dental plans extend coverage to major dental procedures. 

Below, we’ve compiled a list of the top dental insurance plans for major dental work. Expect to pay a higher premium but receive more significant benefits for major dental care. 

1. Humana

Humana serves over 20 million members and a broad network of over 330,000 dentists.¹ Choose from plans such as: 

• DHMO
• PPO
• Discount 
• Value 

The Dental Loyalty Plus PPO plan is best for major dental work. You can visit any dentist you want. There are no waiting periods for any service, so coverage starts immediately. 

Dental Loyalty Plus PPO Plan 

The Humana Dental Loyalty Plus plan covers the following: 

• Root canals
• Crowns
• Dentures
• Braces 
• Oral surgery 

This Humana plan covers preventive services in full. Humana increases benefits with each year you hold dental insurance. Coverage percentages and annual maximums increase by the third year.

Humana covers basic dental services: 

• 40% in Year 1
• 55% in Year 2
• 70% in Year 3

Major service coverage is:

• 20% in Year 1
• 30% in Year 2
• 50% in Year 3

In addition, orthodontia for adults and children is subject to a potential discount.² 

Annual maximums start at $1,000 per person in the first year, $1,250 in the second, and $1,500 in the third. 

Costs vary depending on your age and location. The average nationwide Humana premium is around $40 monthly.

2. Delta Dental 

Delta Dental serves over 80 million customers. One of the largest dental insurance companies, it offers DHMO and PPO plans. However, the DeltaCare USA plan is the best choice for major dental work.³

DeltaCare USA DHMO Plan 

DeltaCare USA features no deductibles or annual maximums. This DHMO plan has the benefit of transparent costs. Fixed copayments allow you to budget precisely for a dental procedure based on the following ranges: 

• $20 for preventive care
• $25 to $120 for basic care 
• $240 to $400 for major care 

This Delta Dental plan offers broad coverage without waiting periods. You must choose a primary care dentist from a smaller network of providers. However, your monthly premium is lower. 

DeltaCare USA covers teeth whitening with a copay of $125. You can also obtain discounts for orthodontic coverage for adults and children. 

3. MetLife

MetLife’s Veterans Affairs Dental Insurance Program (VADIP) plan lets you access over 500,000 dentists.⁴ You must be enrolled in a Veterans Affairs healthcare program to qualify for this dental insurance policy. There are no waiting periods for preventive, basic, and major dental procedures. 

Basic Coverage Option 

Choose between Basic and High policies within the VADIP. The MetLife Basic policy costs under $35 for individuals, with an annual maximum of $1,300 in the first year. MetLife increases the annual maximum to $1,500 in the second year. 

In-network preventive care is of no cost to you. There are no annual deductibles for in-network dental care. Coverage is as follows:

• 100% for preventive
• 50% for basic
• 30% for major 

MetLife covers out-of-network care at a lower percentage. The out-of-network is $50 for MetLife’s Basic and High dental insurance policies.

High Coverage Option 

This top-tier policy mirrors the Basic option, adding orthodontic coverage. Premiums are under $75 monthly. Annual maximums are $3,000 in the first year and $3,500 in the second.  

• 100% for preventive
• 70% for basic
• 50% for major 

MetLife’s High dental insurance policy covers 50% of orthodontic care for young adults under 19. However, you must wait 24 months before coverage kicks in.  

4. Guardian Direct

Guardian Direct works with over 120,000 dentists.⁵ This dental insurance carrier offers several plans, but the Achiever and Diamond tiers cover most major dental services. 

Achiever Plan

The Achiever plan starts at $29 monthly and offers the following coverage: 

• 100% for preventive
• 70% for basic
• 50% for major

You must wait 12 months before the coverage for major services kicks in. Otherwise, preventive and basic dental services have no waiting period. 

The annual maximum increases by $250 yearly. It starts at $1,000 in the first year and increases to $1,500 in the third. In-network care has no deductible, while out-of-network services have a $50 deductible. 

Guardian Direct’s Achiever plan covers orthodontics at 50% with a 12-month waiting period for children under 19. Any orthodontic care is subject to a $500 yearly maximum and a $1,000 lifetime maximum. Dental implants have a similar $1,000 lifetime maximum.  

Diamond Plan

If you want the benefits of the Achiever plan with the addition of teeth whitening, the Diamond plan offers 50% coverage. However, there is a 6-month waiting period for this service. Teeth whitening services have a $50 deductible and a $500 yearly maximum. 

Guardian Direct Diamond plans start at $37 monthly. Coverage for basic services increases from 70% to 80%. Aside from teeth whitening coverage, this percentage demonstrates the only difference between the Diamond and Achiever plans.

5. Ameritas 

We recommend Ameritas’ Primestar Access plan for major dental work.⁶ This plan gives you access to over 100,000 dentists and several key benefits, including:

• No waiting periods
• No deductible for in-network preventive care
• 100% coverage for preventive dental procedures
• $50 deductible for basic and major dental services
• Up to 50% orthodontic coverage for children under 19

Ameritas’ Primestar Access plan coverage increases in the second year of ownership. This plan covers basic dental services at 65% in the first year and 80% in the second year. Major services begin at 20% and increase to 50% in the second year. Ameritas includes teeth whitening in the major dental services category. 

Orthodontic coverage is low at 15% in the first year. However, the second year increases to 50% coverage, with a $1,000 lifetime maximum. Annual maximums are $1,000 in the first year and $2,000 in the second. 

Costs range between $30 and $50, depending on your age and living location. Ameritas also reduces coverage for all out-of-network dental care.

Why is Dental Insurance Important for Major Dental Work?

Dental insurance helps you avoid paying hundreds or thousands of dollars for various types of dental care. You’ll also find that dental insurance premiums are often more affordable than health insurance premiums.

Dental insurance can significantly reduce your out-of-pocket costs for dental care, depending on the type of coverage you select. Most dental insurance providers contract with dentist offices nationwide to reduce the costs of preventive, basic, and major services. 

How Does Dental Insurance Work?

In exchange for a monthly or annual premium, dental insurance companies cover a portion of the costs associated with dental care. You can obtain dental insurance from your employer or as an individual.

Dental Services Coverage

Dental insurance providers typically cover a percentage of the total cost of care: 

• 100% coverage for preventive services
• Up to 80% coverage for basic services 
• Up to 50% coverage for major services 

Common Dental Insurance Plan Features 

Most dental insurance plans include the following features: 

• Premiums — Like a subscription fee, these costs allow you to use your dental insurance coverage when you visit your dentist. 
• Deductibles — You must meet this pre-determined out-of-pocket limit before your dental insurance takes over paying for your dental care in full. Most deductibles are reset annually. 
• Waiting periods — You must wait for a set period before coverage for specific dental services applies. Waiting periods range from 0 days to 24 months.  
• Copayments — Due at the time of service, copayments (or coinsurance) represent your portion of dental care costs. These fees contribute to your annual deductible.
• Maximums — Most dental insurance plans include an annual maximum, which limits how much the dental insurance carrier contributes yearly. Lifetime maximums often apply to specific procedures and the lifetime of the policy. 
• Network providers — Dental insurance companies contract with specific providers who are considered in-network. Visit these in-network providers to save money since your policy may not cover some out-of-network provider costs. 

You can often receive discounts by bundling your dental and vision insurance plans.

What are the Costs Involved in Dental Insurance?

We can break down dental insurance costs into several categories: 

• Premiums — Most monthly premiums are less than $20 for individuals, while families pay around $100 to $150. 
• Deductibles — Annual deductibles range from $50 to upwards of $100, depending on your plan coverage. 
• Out-of-pocket maximums — Most dental insurance plans cap your dental care costs between $750 and $3,000 annually.  

Most monthly dental insurance premiums and yearly deductibles are inversely proportional. With higher premiums come lower deductibles and vice versa.

What Does Dental Insurance Typically Cover?

Coverage for Basic Dental Procedures

Most dental insurance plans cover the following basic dental procedures: 

• Simple extractions — Baby teeth that require more force fall into the category of simple extractions.
• Cleanings — These bi-annual or annual cleanings support oral health by removing plaque and diagnosing underlying issues such as gum disease or cavities.
• Fillings — Dentists use various materials to repair cavities and broken, cracked, or chipped teeth.
• Tooth pain — Pain in your teeth can stem from gum irritation, the food you’ve recently eaten, a broken tooth, or even a bacterial infection.

Coverage for Major Dental Procedures

Dental insurance plans typically classify the following as major dental procedures: 

• Bridges — A dental bridge consists of crowns and artificial teeth that replace natural teeth to improve oral health.
• Crowns — These artificial caps cover damaged teeth and last between 5 and 15 years.
• Root canals — This treatment removes infected pulp from the inside of your tooth, disinfects the interior, and seals the tooth to prevent further infection. 
• Implants — Dentists replace lost teeth with artificial teeth secured by metal screws. 
• Dentures — These removable devices replace missing teeth. 
• Complex extractions — A common example of this dental procedure involves removing wisdom teeth before they become impacted. 
• Other oral surgery procedures — These advanced procedures can include bone grafting, TMJ surgery, dental implant replacement, and ridge augmentation. 

Dental insurance providers typically classify cosmetic procedures as separate services. Services like teeth whitening, orthodontia, and Invisalign treatments may only be partially covered. 

How to Choose the Right Dental Insurance for Major Work

Distinguishing between dental insurance plans can be challenging, especially considering available options. Here are a few factors to consider to help you choose the best dental insurance plan for major dental work.

Plan Type 

Dental insurance plans typically fall under one of the following categories:⁷ 

• Dental health maintenance organization (DHMO) — Dentists and dental insurance companies agree upon discounted rates for select services. You may pay nothing for basic and preventive dental care depending on your chosen coverage. However, you must stick with a primary dental provider, who can issue referrals if necessary. 
• Preferred provider organization (PPO) — Dental insurance carriers contract with a network of dentists. Policyholders can visit these in-network dentists to pay less or visit out-of-network dentists with reduced coverage. 
• Indemnity — Also known as “fee-for-service,” indemnity plans allow you to choose your dentist. Dental procedures come with a maximum allowance per your policy. 
• Discount plans — These discount plans are technically not dental insurance. However, they can offer you discounted rates on common dental procedures without worrying about filing a claim.

DHMO and PPO dental insurance plans are typically best for major dental work. DHMO plans can help you find a specialist if necessary, while PPO plans give you more freedom in choosing who you see. 

Cost 

Dental insurance costs anywhere from under $20 to over $100 monthly. Rates will depend on the type of coverage you select, where you live, and if you choose an individual or family plan.

Find premiums and deductibles you can handle that balance well with annual and lifetime maximums. While you may have to pay more upfront, the best dental insurance plans for major work cover most of your costs after this initial amount. 

Coverage

Most dental plans that cover a large portion of major dental work offer preventive coverage. If you don’t want to pay in full for orthodontia, teeth whitening, or Invisalign, seek policies covering these services. 

Network

Establishing a relationship with a dentist can help you overcome the fear of the dentist’s chair. However, it’s often easier to find a plan that suits you if you aren’t loyal to a specific dentist’s office. 

Waiting Periods

A proactive approach can help you obtain timely dental care coverage. Establishing a policy early on can help you get any waiting periods out of the way and cover more of any future dental care necessary.  

Immediate care is often a priority for major dental work. Aim for policies that offer coverage for major services in 6 months or less. Waiting any longer could potentially threaten your overall health with complications due to heart disease or diabetes.⁸  

Customer Service 

Look for dental insurance carriers with an excellent customer service team. Coverage for major dental work can get complicated, so it helps to have a dedicated team ready to assist you.