Private dental insurance plans

In some cases, you may be able to purchase a group dental insurance on your own even if you can't get coverage through your employer. 

Group dental insurance typically costs less than individual insurance. In some states, organizations such as AARP and businesses like Costco offer dental plans at group rates to members, says Elizabeth Risberg, a spokesperson for Delta Dental.

If you don't qualify for group coverage, consider buying individual dental insurance. Individual plans advertise costs of around $200 to $300 annually, which is higher than many group plans charge, says Amy Bach, executive director of United Policyholders, an insurance consumer advocacy organization in San Francisco.

Risberg says there are ways to lower those costs. Plans with higher deductibles often offer lower premiums. Other plans offer greater affordability in exchange for your agreeing to choose services from a more restricted network of dentists.

Dental insurance plans may have restrictions on certain services, such as orthodontic work, Bach says. Many dental plans also have a maximum benefit of around $1,000 to $2,000 per year.

Plans also may restrict coverage of pre-existing conditions or won't cover preventative care options such as dental sealants or fluoride treatments. But most preventative services are likely to be covered.

"With dental insurance, procedures such as cleanings and x-rays are encouraged, so they're usually covered for no or low cost," Risberg says.  "And a lot of the time, the deductible doesn't apply for those preventive services."

Discount dental plans

Discount dental plans are an alternative to dental insurance. These plans require participants to pay a fee to access a network of dentists who offer services at reduced prices.

The fee, which typically is paid once a year, is likely to be less than the cost of private dental insurance, says Bach. In fact, many plans advertise annual costs of about $100 a year for individuals, less than half the annual premium of many insurance plans, she says.

With discount dental plans, you typically pay less than full price for preventive services, such as cleanings and x-rays, as well as other procedures, including root canals and orthodontia, says Bach.

Unlike dental insurance, you'll probably have to pay at least some money out of pocket for cleanings and other preventative services.  On the other hand, discount plans may offer reduced rates for services that aren't covered at all under standard insurance, such as cosmetic dentistry. So if you're planning to have aesthetic work done in the near future, a discount plan could be cost effective, Bach says.

However, if you're not familiar with your dentist under a discount plan, remain on guard.

"You may think you're getting a deal with a discount plan, but if the participating dentist prescribes a bunch of services you don't actually need, you could end up paying more," Bach says.

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COBRA

Consolidated Omnibus Budget Reconciliation Act
People who lose their employer-sponsored health insurance may qualify for a COBRA plan. COBRA lets you keep your former employer's health plan, but you're responsible for paying all of the costs, including your former employer's portion.
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Medicare

People who are 65 and over qualify for Medicare. You can choose Original Medicare (also called Parts A and B), which is offered by the federal government, or Medicare Advantage (also called Part C), which private insurers provide. The average annual premium for Original Medicare is about $1,600. Medicare Advantage's average yearly premium is $336, but you may have higher out-of-pocket costs than Original Medicare.
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Medicaid

Low-income Americans qualify for Medicaid. Thirty-eight states expanded Medicaid eligibility, so lower-middle-class Americans may also be eligible in those states. Medicaid offers comprehensive benefits, but at little to no cost depending on your income. Each state has its own eligibility. Some states are flexible with Medicaid eligibility for people who are pregnant, a parent or disabled. If your household income is below 138% of the federal poverty level, you're likely eligible for Medicaid if you live in a Medicaid expansion state. That level is $17,609 for an individual, $23,791 for a family of two, $29,974 for a family of three and $36,156 for a family of four. Non-Medicare expansion states have stricter income guidelines. Check with your state's Medicaid program to see if you qualify.
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Parent's employer-based health insurance

The Affordable Care Act lets children stay on a parent's health plan until the age of 26. Having a child on a parent's health plan may or may not increase premiums. It depends on whether you already have family coverage when adding the child to the plan. If a parent already has family coverage, adding a child won't likely increase premiums. However, going from single or couple to family coverage could cause premiums to skyrocket. The average single coverage employer-sponsored plan premium is $1,186. The average family plan is $5,447.
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Spouse's employer-based health insurance

Most employers allow employees to add spouses to their health insurance. Going from single health coverage to a family plan may triple or quadruple your premiums. The average single coverage employer-sponsored plan premium is $1,186. The average family plan is $5,447. Not all jobs allow for spouse's coverage, so you'll want to check with your employer to make sure it's an option.
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Employer-based health insurance

Most people with private health insurance get their coverage through a job. employer-sponsored health insurance is usually cheaper than individual health insurance unless you qualify for Affordable Care Act subsidies. Job-based plans are generally less expensive because businesses often pick up more than half of employer-sponsored health insurance premiums. Kaiser Family Foundation estimates the average premiums for a single coverage employer-sponsored health plan is $1,186 and the average family plan is $5,447 annually.
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Preferred-provider Organization (PPOs)

  • Pay higher premiums with a lower deductible
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Preferred-provider organization (PPOs) plans are the most common type of employer-based health plan. PPOs have higher premiums than HMOs and HDHPs, but those added costs offer you flexibility. A PPO allows you to get care anywhere and without primary care provider referrals. You may have to pay more to get out-of-network care, but a PPO will pick up a portion of the costs.
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Health maintenance organization (HMO)

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  • Restricted network of providers with lower premiums
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Health maintenance organization (HMO) plans have lower premiums than PPOs. However, HMOs have more restrictions. HMOs don't allow you to get care outside of your provider network. If you get out-of-network care, you'll likely have to pay for all of it. HMOs also require you to get primary care provider referrals to see specialists.
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High-deductible health plans (HDHPs)

  • Pay lower premiums with a higher deductible
High-deductible health plans (HDHPs) have become more common as employers look to reduce their health costs. HDHPs have lower premiums than PPOs and HMOs, but much higher deductibles. A deductible is what you have to pay for health care services before your health plan chips in money. Once you reach your deductible, the health plan pays a portion and you pay your share, which is called coinsurance.
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Exclusive provider organization (EPO)

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Exclusive provider organization (EPO) plans offer the flexibility of a PPO with the restricted network found in an HMO. EPOs don't require that members get a referral to see a specialist. In that way, it's similar to a PPO. However, an EPO requires in-network care, which is like an HMO.
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Individual insurance/Affordable Care Act
The Affordable Care Act created insurance exchanges that allow people to compare plans. The health law also requires insurers to accept everyone and not charge them exorbitant rates. People who make below 400% of the federal poverty level qualify for subsidies to help pay for an ACA plan.
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Individual insurance/Affordable Care Act
The Affordable Care Act created insurance exchanges that allow people to compare plans. The health law also requires insurers to accept everyone and not charge them exorbitant rates. People who make below 400% of the federal poverty level qualify for subsidies to help pay for an ACA plan.
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People who would prefer to pay lower premiums with a higher deductible may want the below plans
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Silver is the second most popular plan in the ACA exchanges, with 35% of people with a Silver plan. Silver has lower premiums than any plan except for Bronze. However, it has lower out-of-pocket costs than Bronze. Silver plans pick up 70% of the costs, while members pay 30% The average single coverage in a Silver plan is $481 monthly and $1,179 for a family plan.

Bronze is the most popular type of plan in the ACA exchanges, with 41% of members with a Bronze plan. These plans have the lowest premiums, but also the highest out-of-pocket costs in the exchanges. Bronze plans pick up 60% of the costs, while members pay 40%. The average single coverage monthly cost in a Bronze plan is $440 and $1,080 for a family plan.

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Individual insurance/Affordable Care Act
The Affordable Care Act created insurance exchanges that allow people to compare plans. The health law also requires insurers to accept everyone and not charge them exorbitant rates. People who make below 400% of the federal poverty level qualify for subsidies to help pay for an ACA plan.
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Platinum plans have the highest premiums but the lowest out-of-pocket costs. So, you pay more for the coverage initially but less than other plans when you need health care services. Platinum plans pick up 90% of the costs, while members pay 10%, Not many health insurers offer Platinum plans. Only 2% of members in ACA plans have a Platinum plan, so you may have trouble finding one. The average monthly premiums for single coverage in a Platinum plan is $706 and the average family coverage costs $1,460.

Gold plans have lower premiums than Platinum, but higher premiums than Silver and Bronze. Gold also has lower out-of-pocket costs than Silver and Bronze, but higher than Platinum. Gold plans pick up 80% of the costs, while members pay 20%. The average monthly premium for a single Gold plan is $596. Family coverage averages $1,426 per month.

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Pay-as-you-go dental care

You may be tempted to skip insurance coverage or a discount plan and simply pay for services as they are needed. After all, as Bach points out, skipping dental coverage is unlikely to put you at the same degree of financial risk as skipping health insurance.

However, Risberg reminds you that a dental crisis could still leave you facing big, unexpected bills if you don't have insurance.  

"You don't always know what type of dental situation you're going to have," she says.  "You might have an emergency, or crack a tooth and need a crown.  That's not ever something that you can plan for."

Before going coverage-free, Bach suggests adding up the costs of routine services you and your family would likely need in a year, such as cleanings and x-rays, and comparing them to the out-of-pocket costs of dental services in your area.

"If you're a single adult and you're in good dental health, it may be unlikely that private insurance is worth it, after you do the math," says Bach.

If you forgo coverage and a problem arises, use your lack of insurance to try to negotiate lower fees with your dentist, she says. 

"Find a dentist whom you trust, tell him or her that you don't have insurance, and then see if you can work out an agreement for a lower rate on services," she says.

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