What Factors Influence Dental Plan Cost?

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  • Written By: N. Madison
  • Edited By: Jenn Walker
  • Last Modified Date: 27 January 2020
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An individual may notice great variations when it comes to dental plan cost, and there are many reasons for the differences. Among them are the type of services a plan covers and the percentage of each dental care fee a plan pays. The maximum amount an insurance company will pay a policy holder may influence cost as well. Likewise, the availability of coverage for such things as orthodontia and implants may contribute to higher rates. Additionally, the amount of deductible a person agrees to pay may make a difference.

One of the factors that influences dental plan cost is the coverage provided. Those that provide more coverage are typically more expensive. Likewise, the amount of coverage provided for each service or technique may also influence a plan’s cost. For example, if a dental plan pays for 50 percent of most dental care services, it is likely to cost more than a dental plan that only pays for 10 or 20 percent of the covered dental services.


Also among the factors that affect dental plan cost is the maximum benefit amount. Most dental plans set a maximum amount of coverage a policy holder may use in one year. In the event that the policy holder needs dental care that exceeds the pre-set maximum, he must either choose to forgo it or pay for the services he needs out of his own pocket. Generally, dental insurance plans that include higher maximum coverage amounts also require the policy holder to pay higher premiums.

Special coverage may also translate into an increase in dental plan cost. For example, dental plans that cover the cost of orthodontia may charge more than those that include only basic coverages. Likewise, dental plans that include crowns and dental implants may prove more costly as well. Additionally, some plans are more expensive if they provide emergency dental care coverage or allow the user to visit dentists who are not on the plan’s provider list. For instance, some plans may allow individuals to visit dentists who are not on the plan’s list while they are traveling or in emergency situations.

Deductibles may also affect dental plan cost. Deductibles are amounts policy holders have to pay before their insurance carriers will pay for covered services. Often, consumers opt for lower deductibles, as they prefer to avoid high out-of-pocket payments. Choosing a lower deductible, however, often translates into higher dental plan premiums.



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