What to do when your employer doesn't offer dental insurance
If your employer doesn't offer dental insurance, you need to consider your options based on your anticipated costs and needs.
If you have a family, it's important to know that 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, says Amy Bach, executive director of United Policyholders, an insurance consumer advocacy organization in San Francisco.
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," 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 your agreeing to choose 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 says.
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.
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.
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.
Silver plans provide a good balance of monthly premiums with out-of-pocket costs. Coinsurance is 70% with a silver plan, meaning you will pay 30% of the costs after your deductible is met, up to the out-of-pocket limit. Silver plans are a good choice for people who are in generally good health but don't want high out-of-pocket costs if something goes wrong. Bronze plans are a popular choice with those who value low monthly premiums and are willing to pay more when they need care. Coinsurance is set at 60%, meaning you will pay 40% if you do need care, up to the out-of-pocket limit. Bronze plans are good for those who don't expect to need many services outside of preventative care throughout the year.
ACA platinum plans have the highest monthly premiums, but the lowest out-of-pocket costs. You'll pay more monthly in return for lower deductibles, copays and coinsurance amounts. Coinsurance with platinum plans is 90%, which means you pay 10% after the deductible, up to your out-of-pocket limit. Platinum plans are good for those who anticipate a lot of medical needs throughout the year.
Gold plans cost a little less than platinum plans, and come with higher out-of-pocket costs. The coinsurance amount on a gold plan is 80%, which means you pay 20% after the deductible, up to your out-of-pocket limit. A gold plan is a good idea if you think you'll need a lot of care throughout the year, but don't want to pay platinum premiums.Health insurance finder tool
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Employer-sponsored health insurance
Preferred-provider Organization (PPOs)
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.
Find out more about the differences between plansHealth maintenance organization (HMO)
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.
Find out more about the differences between plansHigh-deductible health plans (HDHPs)
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.
Find out more about the differences between plansExclusive provider organization (EPO)
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.
Find out more about the differences between plans
Learn more about individual insurance plans
Know more individual insurance / ACA 
Know more individual insurance / ACA 
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 notes 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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