Maintaining good oral health is an important part of overall wellness, but understanding dental insurance can often feel confusing. Many Colorado residents assume dental coverage is automatically included with health insurance, only to discover that dental benefits are handled differently than medical benefits.
The good news is that Colorado residents have several options for obtaining dental coverage, whether through a stand-alone dental plan, employer-sponsored benefits, or pediatric dental benefits included with certain health plans.
Is Dental Coverage Included with Health Insurance?
Sometimes.
For adults, dental coverage is often purchased separately from health insurance. While medical insurance helps cover doctor visits, hospital care, and prescription medications, routine dental care is frequently handled through a separate dental insurance plan.
Medical insurance generally covers adult dental treatment only when it is medically necessary.
Examples may include:
- Treatment related to an accident or injury
- Certain oral surgeries performed in a hospital setting
- Medical conditions affecting oral health
Routine adult dental care is typically handled through a dental insurance plan rather than a medical health plan.
For children, the situation is different.
Pediatric dental benefits are considered an essential health benefit under the Affordable Care Act, meaning dental coverage is generally available for children enrolled in Colorado individual and family health plans.
What Does Dental Insurance Typically Cover?
Dental plans may help cover a variety of preventive and restorative services, including:
- Preventive Care
- Routine dental exams
- Cleanings
- X-rays
- Preventive screenings
- Basic Services
- Fillings
- Simple extractions
- Treatment for cavities
- Major Services
Depending on the plan, coverage may also include:
- Crowns
- Root canals
- Bridges
- Dentures
- Oral surgery
Benefits, waiting periods, and annual maximums vary from plan to plan.
Do You Need Separate Dental Insurance?
The answer depends on your specific needs. Separate dental insurance may make sense if you:
- Visit the dentist regularly
- Anticipate major dental work
- Have children who require ongoing dental care
- Want help managing dental expenses
For some people, paying directly for routine dental services may be sufficient. For others, dental insurance can provide valuable financial protection.
Questions to Ask Before Choosing a Dental Plan
When comparing dental coverage options, consider asking:
- Which dentists are in-network?
- What preventive services are covered?
- Are there waiting periods?
- What is the annual maximum benefit?
- How are major procedures covered?
- What are the monthly premiums?
- Are orthodontic benefits available?
Understanding these details can help you choose the option that provides the best value.
The best dental plan depends on your expected dental needs, budget, and preferred providers.
Rather than focusing solely on monthly premiums, it’s important to consider:
- Covered services
- Provider networks
- Annual maximums
- Waiting periods
- Out-of-pocket costs
Evaluating the full picture can help you avoid unexpected expenses and make a more informed decision.
Save Time. Gain Peace of Mind.
Still unsure about dental insurance plans, or whether your preferred Dentists and dental services are covered? Schedule a free consultation and we’ll help you compare your Colorado dental insurance options with confidence.
Additional Resource:
Explore our Colorado Health Insurance Learning Center for answers to common coverage questions.