Stand-alone adult dental coverage generally has a benefit cap somewhere in the range of $500 to $2,500 per year, although caps of $1,000 to $1,500 tend to be the most common. For most routine dental work, this will generally be plenty. But if you end up needing extensive dental work — such as multiple implants — you may find that your needs exceed the benefit cap.
On any adult dental plan, preventive services (cleanings, exams, x-rays) will typically be fully covered. For basic services, such as fillings, extractions, and root canals, it’s common to see 70% or 80% coverage. And the cost of more substantial services, such as crowns, bridges, and implants, is often split 50/50 between the dental plan and the patient, up to the plan’s benefit caps.
Some adult dental plans will increase your benefit cap over time, or reduce your coinsurance rate over time. For example, you might get a plan that initially has a $1,000 benefit cap, but it grows to $1,250 in the second year and $1,500 in the third year. Or you might find a plan that requires you to pay 50% of the cost of certain services in the first year, 40% in the second year, and only 20% in future years.
If you’re planning to continue to have dental insurance over the long run and you’re happy with the dental network that the plan offers, this type of plan will reward your loyalty with enhanced benefits over time.