How to get dental insurance if your employer doesn't offer it

What to do when your employer doesn't offer dental insurance

If your employer doesn't offer dental insurance, consider your options based on your anticipated costs and needs. Compare individual dental insurance, discount plans, and out-of-pocket costs to find the best fit. Start by estimating your annual dental expenses, including routine cleanings, X-rays, and any planned treatment.

ACA plans must include dental coverage for children up to age 19. If you plan to get your health insurance through the marketplace, this option is available. However, you will still need to find coverage for anyone over 19.

There are three main approaches to paying for dental care if you don't have access to a plan through your employer.

Private dental insurance plans

Individual plans advertise costs of around $200 to $300 annually, which is higher than many group plans charge, according to Amy Bach, executive director of United Policyholders, an insurance consumer advocacy organization in San Francisco. Actual premiums depend on the plan, location, and coverage level.

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

Plans may also restrict coverage for pre-existing conditions or exclude preventive 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," says Elizabeth Risberg, a spokesperson for Delta Dental. "And a lot of the time, the deductible doesn't apply for those preventive services."

Plans with higher deductibles often offer lower premiums. Other plans offer greater affordability in exchange for choosing services from a more restricted network of dentists.

In some cases, you may be able to purchase 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, Risberg notes.

Discount dental plans

Discount dental plans charge a membership fee in exchange for reduced rates from participating dentists. Unlike insurance, these plans don't pay claims or reimburse you for treatment. You pay the dentist directly at the discounted rate.

The fee, which typically is paid once a year, is likely to be less than the cost of private dental insurance, per 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.

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.

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 not covered by standard insurance, such as cosmetic dentistry. So if you're planning aesthetic work soon, a discount plan could be cost-effective.

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.

Pay-as-you-go dental care

Paying out of pocket eliminates insurance premiums and membership fees, but you pay the full cost of every dental service. This approach may suit people with good dental health who need only routine care, provided their expected expenses are lower than the cost of coverage.

Amy Bach notes that skipping dental coverage is unlikely to put you at the same degree of financial risk as skipping health insurance.

However, Risberg warns that a dental crisis could still leave you facing big, unexpected bills without 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," she says.

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

"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.

FAQ: Dental insurance without employer coverage

What happens if you need a root canal but don't have dental insurance?

You pay the full cost of the root canal unless you qualify for a discount or payment arrangement. Ask your dentist for a treatment estimate and discuss payment plans or lower-cost alternatives before scheduling the procedure.

Is it cheaper to pay for dental care out of pocket?

Paying out of pocket may cost less if you need only routine cleanings and X-rays. However, fillings, crowns, and root canals add up quickly. Compare your expected annual dental bills with insurance premiums and out-of-pocket costs before deciding.

How do you find affordable dental care without insurance?

Contact local dental offices to compare self-pay rates, ask about payment plans, and request written estimates. Dental schools and community health centers also offer lower-cost services in some areas, depending on eligibility and availability.

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