NCHS Data Brief ■ No. 40 ■ June 2010

u.s. department of health and human services

centers for disease control and prevention

national center for health statistics

Dental Insurance for Persons Under Age 65 Years with

Private Health Insurance: United States, 2008

Barbara Bloom, m.p.a., and robin a. cohen, ph.d.

Key findings

Data from the National 

Health Interview Survey, 

2008

Among approximately 172 

million persons under age 

65 years with private health 

insurance: 

•	 The majority of persons 

(73%) had some type of 

dental coverage. However, 

approximately 45 million 

persons had no dental 

coverage.

•	 About 8 out of 10 persons 

with employment-based 

private health insurance had 

dental coverage compared 

with about 3 out of 10 persons 

with directly purchased 

insurance.

•	 Non-Hispanic black 

persons were more likely to 

have dental insurance than 

non-Hispanic white persons, 

non-Hispanic Asian persons, 

or Hispanic persons. 

•	 As income level increased, 

the percentage having dental 

insurance increased. 

A primary indicator of access to dental care in the United States is dental 

insurance. Previous studies have shown that persons with private dental 

insurance have more dental visits in the previous year than persons without 

private dental insurance (1). There are federal and state assistance programs 

for dental care but they are limited. The Children’s Health Insurance Program 

(CHIP) requires states to provide limited dental coverage for enrolled 

children up to age 19 (2). The Medicaid program requires states to provide 

limited dental services for most Medicaid-eligible individuals under the age 

of 21, but there is no assistance to provide dental services to individuals aged 

21 and over (3). This report analyzes dental insurance status for persons 

under age 65 years who have private health insurance because of the limited 

or nonexistent public coverage for dental care.

Keywords: National Health Interview Survey • single service • comprehensive 

• dental coverage

Among approximately 172 million persons under age 

65 years with private health insurance, the majority of 

persons (73%) had some type of dental coverage. However, 

approximately 45 million persons had no dental coverage.

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NCHS Data Brief ■ No. 40 ■ June 2010

■  2  ■

Among persons under age 65 years with private health insurance who had some type of dental 

insurance, about one out of two persons had dental coverage through a single-service dental plan, 

either alone or in addition to dental coverage through their comprehensive health insurance plan 

(Figure 1). 

About 8 out of 10 persons under age 65 years with employment-based 

private health insurance had dental coverage compared with about 3 out of 

10 persons with directly purchased insurance. 

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Among persons under age 65 years, persons with employment-based private health insurance 

were about two to three times as likely as persons with directly purchased insurance to have 

dental coverage through all types of plans, including a single-service dental plan only, a 

comprehensive plan only, or both single-service and comprehensive plans combined (Figure 2). 
NCHS Data Brief ■ No. 40 ■ June 2010

■  3  ■

Among persons under age 65 years with private health insurance, nonHispanic black persons were more likely to have dental insurance than 

non-Hispanic white persons, non-Hispanic Asian persons, or Hispanic 

persons.

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Among persons under age 65 years with private health insurance, non-Hispanic white persons 

were more likely than persons of other race/ethnicity groups to have dental insurance through a 

single-service dental plan only (Figure 3).

Non-Hispanic black persons were more likely than persons of other race/ethnicity groups to have 

dental insurance through a comprehensive health insurance plan only. 
NCHS Data Brief ■ No. 40 ■ June 2010

■  4  ■

Among persons under age 65 years with private health insurance, as 

income level increased, the percentage having dental insurance increased.

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Among persons under age 65 years with private health insurance, poor persons at less than 100% 

of poverty level were more likely than higher income persons at 400% or more of poverty level to 

have dental coverage through a comprehensive plan only (Figure 4). 

As income increased, the percentage having dental insurance through a single-service dental plan, 

either alone or in addition to a comprehensive plan, increased.
NCHS Data Brief ■ No. 40 ■ June 2010

■  5  ■

Adults with at least some college education were more likely to have dental 

insurance than those with less education among those aged 25–64 years 

with private health insurance.

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Among adults aged 25–64 years with private health insurance, as education level increased, there 

was an increase in the percentage of adults with dental insurance through a single-service dental 

plan only (Figure 5).

College graduates were less likely than adults with less education to have dental insurance 

through a comprehensive plan only.
NCHS Data Brief ■ No. 40 ■ June 2010

■  6  ■

Summary 

About three out of four persons under age 65 years with private health insurance had some type 

of dental coverage. Among persons with dental insurance, more than one-half had a single-service 

dental plan only, or in addition to dental coverage through their comprehensive health insurance 

plan. Non-Hispanic white persons were more likely to have dental insurance through a singleservice dental plan only than non-Hispanic black, non-Hispanic Asian, or Hispanic persons. Poor 

persons (less than 100% of poverty level) were more likely than higher income persons (400% or 

more of poverty level) to have dental coverage through a comprehensive plan only. 

Approximately 45 million persons under age 65 years with private health insurance did not have 

dental coverage in 2008. About 7 out of 10 persons who directly purchased their own private 

health insurance plan had no dental coverage compared with about 2 out of 10 persons with 

employment-based insurance. About 40% of persons with less than a high school education had 

no dental insurance of any kind.

Definitions 

Comprehensive plan: A health insurance plan or policy that covers a variety of medical services. 

These plans are designed to cover general medical expenses such as blood work or visits to a 

doctor’s	office	and	health	catastrophes	such	as	heart	attacks	and	cancer.

Comprehensive plan with dental coverage: A private health insurance plan that also has dental 

coverage based on a positive response to the following question: “Does [Plan name] pay for any 

of the costs for dental care?”

Directly purchased coverage: Private insurance that was originally obtained through direct 

purchase or through other means not related to employment. 

Employment-based coverage: Private insurance that was originally obtained through a present or 

former employer, a union, or a professional association.

Poverty status or percentage of poverty level: Is based on family income, family size, and the 

number of children in the family, and, for families with two or fewer adults, on the age of the 

adults	in	the	family.	The	poverty	level	is	based	on	definitions	originally	developed	by	the	Social	

Security Administration. These include a set of income thresholds that vary by family size and 

composition.	Families	or	individuals	with	income	below	their	appropriate	thresholds	are	classified	

as below the poverty level. These thresholds are updated annually by the U.S. Census Bureau to 

reflect	changes	in	the	Consumer	Price	Index	for	all	urban	consumers	(4).	Estimates	by	poverty	

status are based on both reported and imputed family income. Family income information was 

completely missing for 9.4% of persons, and family income information was only reported in 

broad categories for an additional 22.0% of persons in 2008. Therefore, family income was 

imputed for 31.4% of persons in 2008 using the National Health Interview Survey imputed 

income	files	(5).

Private insurance: Is indicated when respondents report they were covered by private health 

insurance through an employer, union, or individual purchase. Private health insurance includes 

managed care such as health maintenance organizations (HMOs). It does not include military 

health plans. 
NCHS Data Brief ■ No. 40 ■ June 2010

■  7  ■

Single-service dental plan: A private insurance plan that only pays for dental care.

Data source and methods

Data from the 2008 National Health Interview Survey (NHIS) were used for this analysis. NHIS 

is conducted continuously throughout the year by interviewers of the U.S. Census Bureau for 

the Centers for Disease Control and Prevention’s National Center for Health Statistics (NCHS). 

NHIS collects information about the health and health care of the civilian, noninstitutionalized 

U.S. population. Interviews are conducted in respondents’ homes, but follow-ups to complete 

interviews may be conducted over the telephone. Questions about health insurance coverage are 

asked of family respondents in the family component of the survey. In 2008, information was 

collected on a total of 65,495 persons under age 65 years on the family core component. For 

further information about NHIS, including the questionnaire, visit the NCHS website at: http://

www.cdc.gov/nchs/nhis.htm.

NHIS is designed to yield a nationally representative sample, and this analysis uses weights to 

produce national estimates. Data weighting procedures are described in more detail elsewhere 

(6) (http://www.cdc.gov/nchs/nhis/methods.htm). Point estimates and estimates of corresponding 

variances for this analysis were calculated using SUDAAN software (7) to account for the 

complex sample design of the NHIS. The Taylor series linearization method was chosen for 

variance estimation. All estimates shown in this report meet the NCHS standard of reliability 

(relative standard error less than or equal to 30%). Differences between percentages were 

evaluated using two-sided significance tests at the 0.05 level. Terms such as “higher than” 

and “less than” indicate statistically significant differences. Terms such as “similar” and “no 

difference” indicate that the statistics being compared were not significantly different. Lack of 

comment regarding the difference between any two statistics does not necessarily suggest that the 

difference was tested and found to be not significant. 

About the authors

Barbara Bloom and Robin A. Cohen are with the Centers for Disease Control and Prevention’s 

National Center for Health Statistics, Division of Health Interview Statistics.

References

1. Bloom B, Gift HC, Jack SS. Dental services and oral health: United States, 1989. National 

Center for Health Statistics. Vital Health Stat 10(183). 1992.

2. Centers for Medicaid & Medicare Services. CHIP dental coverage, overview. Available from: 

http://www.cms.gov/CHIPDentalCoverage. Downloaded January 27, 2010.

3. Centers for Medicaid & Medicare Services. Medicaid dental coverage, overview. Available 

from: http://www.cms.gov/MedicaidDentalCoverage. Downloaded January 27, 2010. 

4. DeNavas-Walt C, Proctor BD, Smith J. U.S. Census Bureau. Current population reports, 

P60–235, Income, poverty, and health insurance coverage in the United States, 2007. U.S. 

Government Printing Office, Washington, DC. 2008. Available from: http://www.census.gov/

prod/2008pubs/p60-235.pdf.
NCHS Data Brief ■ No. 40 ■ June 2010

ISSN 1941–4927 (Print ed.) 

ISSN 1941–4935 (Online ed.) 

CS213016 

T36641 (06/2010) 

DHHS Publication No. (PHS) 2010–1209