Dental Insurance Atlanta, GA
Dental insurance is a form of health insurance designed to cover some of the costs of standard dental care. Fortunately, compared to health insurance, dental insurance is relatively easy to understand. Dental insurance is also available either as a standalone policy or part of a larger medical insurance plan.
If you are looking for a new dental insurance plan, make sure you know the different options before making your final decision. No matter what choice you make, we at Midtown Smile Center are here for you. We are proud to serve patients in Atlanta and the surrounding area. Call us today at (678) 904-8750 to schedule an appointment or learn more about our services.
Understanding Dental Insurance
Dental insurance gives people coverage to help pay for certain types of dental work. Having this coverage is the best way to prepare for any unexpected dental problems that might arise. Each month, people will pay a set dollar amount, called a premium, to pay for coverage. The monthly premium will depend on the insurance company, the location, and the chosen plan. Depending on the insurance plan, it can cover some or even all of the costs of certain dental treatments.
In many cases, the dentist's office will bill the insurance plan directly for care provided, and the patient will only need to pay a copay for each visit or treatment. A dentist can not answer questions about a specific dental insurance plan or predict what level of coverage for a particular procedure will be. People should contact their employer's benefits department, dental insurance plan, or the third-party payer of a health plan for any questions about coverage.
“Depending on the insurance plan, it can cover some or even all of the costs of certain dental treatments.”
Finding the Right Dental Plan
When selecting a dental insurance plan, people should consider several factors to find a plan that best suits their needs. The first step to finding the right dental plan involves evaluating needs. Young, single adults with good dental health and no family history of oral problems will have different dental insurance needs than a family with a parent who has a family history of gum disease. The likelihood of more frequent visits to the dentist and more extensive treatments indicates the need for a more comprehensive dental insurance policy. Making a generalized list of dental and oral health needs can serve as a good benchmark for evaluating policies and anticipating overall costs.
It is also important to understand the different types of dental insurance plans since each will have varying out-of-pocket costs, benefits, deductibles, and more. Typically dental plans are divided into Preferred Provider Organizations (PPO), Dental Health Maintenance Organization (DHMO), discount dental plans (DDP), and Managed Fee-for-Service Plans. Once people determine the available plans, they should also consider their budget and the covered procedures, waiting periods, and annual limits. Taking the time to evaluate dental needs, budget, and anticipated level of care can make choosing the right dental plan easier.
“When selecting a dental insurance plan, people should consider several factors to find a plan that best suits their needs.”
Dental Coverage
No matter what dental plan a patient chooses, it is essential to double-check what services are included. Some of the most common dental services patients want are routine preventative care and orthodontic services. Though most dental plans cover routine services, they may also require a copay or a fixed amount a patient pays for a health service after meeting their deductible.
However, not all dental plans include coverage for orthodontic services and other specialized services. Therefore, it is imperative to read the details of each plan carefully. Patients who are unsure of the details of their plan should call their insurer to clarify any questions they may have so they are prepared for all scenarios.
“…not all dental plans include coverage for orthodontic services and other specialized services.”
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Affordable Care Act (ACA) Online Enrollment
Dental coverage is available through the Marketplace in two ways: as part of a health plan or on its own as a separate, standalone plan. However, it is essential to note that patients cannot buy a Marketplace dental plan without purchasing a health plan at the same time. Additionally, not every Marketplace health plan includes dental coverage. Purchasing an individual dental plan also necessitates paying another additional premium. While dental coverage is not considered an essential health benefit for adults, it is regarded as an essential health benefit for children.
Marketplace dental plans are split into two categories: high and low. High coverage level plans have lower copays and deductibles but higher premiums. Accordingly, low coverage level plans have higher copayments and deductibles but lower premiums. Comparing dental plans in the Marketplace gives the most details about each plan's copayments, costs, deductibles, and services covered.
“Dental coverage is available through the Marketplace in two ways: as part of a health plan or on its own as a separate, standalone plan.”
Questions Answered on This Page
Q. How does dental insurance work?
Q. What factors should people consider when choosing a dental insurance plan?
Q. How can I find out if my employer's plan covers dental treatments?
Q. What are co-pays and deductibles?
Q. How can I tell what is included in my dental coverage?
Q. Is dental coverage available through the ACA Marketplace?
People Also Ask
Q. What are the pros and cons of an HSA?
Dental Insurance Through Employers
Most dental insurance plans follow the 100-80-50 coverage structure. That means the plan covers preventative care at 100%, basic procedures at 80%, and major procedures at 50%. Sometimes major procedures have a larger copayment. Some dental plans do not cover some procedures, so people must check with their insurance provider for more information.
Employer-sponsored health insurance is the primary source of coverage for people in the United States. People should carefully read the details of an employer's dental insurance plan to determine whether the care they require is covered and at what percentage. Call the insurance provider directly with any questions or concerns.
Dental Insurance Fees
Like health insurance plans in the United States, dental insurance plans come with costs, such as deductibles and copays. A deductible is a minimum amount that a person must pay before the insurance policy pays for anything. The deductible will vary depending on the type of dental insurance. Once the patient pays the deductible, their insurance plan will pay for the remaining costs.
Patients may also have to pay a preset amount, called a co-pay, before receiving a service or treatment covered by your insurance provider. The co-pay is usually due to the dentist at the time of the service. People will have to pay it even after they reach their deductible.
“If your employer provides dental insurance, carefully read the details of your plan to determine if the care you require comes covered by the plan, and at what percentage.”
Frequently Asked Questions
Q. Is dental health really that important?
A. Yes. Many people mistakenly underestimate the importance of oral health. However, it is intrinsically linked to overall health. Neglecting one's oral health may have disastrous effects overall.
Q. Do I actually need a dental insurance plan?
A. Yes. Dental healthcare can be costly without insurance, especially if you are keeping up with your routine checkups and cleanings. Choosing the right dental insurance plan can help patients afford preventative dental care.
Q. What questions should I ask while looking for the right dental insurance plan for me?
A. There are a few things to keep in mind when looking for dental insurance plans. For example, if you anticipate needing a procedure in the future, make sure to ask whether it will be covered under your insurance. You should also ask if you can see any dentist of your choosing or if you must select one within the provider network, whether you can change dentists once you are enrolled, and how many people the plan will cover. Other pertinent information includes the deductible and copay costs and whether the plan is rated highly by an independent rating firm.
Q. What is a discount dental plan (DDP)?
A. A discount dental plan (DDP) is an untraditional insurance plan where the patient pays the cost of treatment at the contracted rate as determined by the plan. This type of plan does not involve any claim forms. However, patients must make monthly or annual payments to receive care from providers within the dental network at discounted prices and on a set fee schedule.
Q. Who should I talk to about my dental insurance plan's benefits or a claim?
A. Contact your insurance carrier for any questions and concerns you may have about your benefits or claims. They can access your account to review your benefits, claims activity, and eligibility.
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Dental Terminology
Call Us Today
Dental insurance can help you offset the cost of dental care. Midtown Smile Center can help you learn more about what your plan covers. Call us today at 678-904-8750 to learn more about our services or schedule an appointment.
Helpful Related Links
- American Dental Association (ADA). Glossary of Dental Clinical Terms. 2026
- American Academy of Cosmetic Dentistry® (AACD). Home Page. 2026
- WebMD. WebMD’s Oral Care Guide. 2026
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