How Does Dental Insurance for Individuals Work?

Posted on October 13, 2023 in Insurance

If you are retired or your employer does not offer dental benefits, you should consider purchasing an individual plan to get the coverage you need. To find the right plan, it’s important to research what’s available and get a good sense for the type of plan that best fits your needs.

If you’re new to individual insurance, then the first place to start is to learn how dental insurance for individuals works.

What is individual dental insurance?

The easiest way to think about individual dental insurance is as a contract between you, the plan holder, and your benefits carrier (Delta Dental of Iowa). Individual dental insurance helps pay for some of the out-of-pocket costs of dental services.

An individual dental plan is similar to insurance coverage you might get through an employer, but is purchased on your own, so it’s up to you to pay premiums and to follow the plan's rules.

As the benefits carrier, Delta Dental of Iowa has the responsibility to pay your dentist for services covered by your insurance plan at rates they’ve worked out in advance.

Why do I need dental insurance?

Dental care is an important part of your overall health and wellness routine. A regular dental exam can identify early signs of diseases and chronic health conditions before they become more serious and harder to treat. It’s important to take care of your daily dental needs like brushing and flossing as well as seeing your dentist twice a year for exams and cleaning.

Having dental insurance isn't something that should be overlooked. Dental insurance helps keep otherwise costly, necessary procedures affordable. In addition to the confidence that comes with a healthy smile, avoiding the pain and stress of an emergency dental issue can give you peace of mind. The average cost of a root canal is more than $1,000 based on the Delta Dental of Iowa average claims data from 2022. That’s a big chunk of money that you may not have allocated in your budget.

Plus, when you have individual dental insurance, you’re a part of the plan’s network. Visiting an in-network dentist has added benefits such as lower out-of-pocket costs because the network dentists have agreed to accept reduced fees. Additionally, balanced billing is not allowed, because participating dentists agree to accept the plans fee and the patient co-payment or deductible (if applicable) as full payment.

Factors to consider when looking for individual dental insurance plans

Since there are so many options to choose from when it comes to individual policies, a few major factors to consider are deductibles, network dentists, services covered, and cost to you.

If you are practicing good oral habits, like brushing twice a day, and flossing once a day, look for a dental plan that covers preventive care for 100 percent of the premium.

The size of the dentist network is also an important factor when selecting an individual plan. If you’ve had dental insurance previously, you probably already have a dentist that you and your family are comfortable with. If you choose a dental plan with a large network of dentists, you may be able to keep your dentist with an individual policy.

Choosing an individual plan

Choosing dental insurance for individuals requires research to make an informed decision about your plan. Don’t know what to look for in an individual plan? Follow these steps to ensure you find the right coverage for your needs: 

1. Research trustworthy carriers: Begin your search by identifying insurance carriers. Consider things like coverage options, network, waiting periods, and costs to help with your decision.
2. Understand the terminology: Get familiar with specific dental benefit terms as they are used in your plan. This will help ensure there are no surprises in how your coverage works down the line.
3. Check the enrollment period: Once you've picked a plan, the next step is to check the carrier's enrollment period. You can usually find the start and end dates for enrollment on your preferred carrier's website, as well as instructions for how to enroll. Note these dates on your calendar to make sure you don't miss it. Some enrollment periods are year-round, but impact when coverage can start.
4. Enroll in your chosen plan: When the enrollment period opens, follow the carrier's online instructions to choose your plan. Pay close attention to the start date of your coverage and begin enjoying the benefits of your dental insurance!

Learn more about Delta Dental of Iowa individual plans here.