Dental Insurance for Self-Employed

If you’re self-employed, you’re familiar with managing uncertainty and trying to make sure you don’t face unexpected expenses. Dental insurance offers peace of mind and the knowledge that your family’s dental care is in good hands. Still, there are many factors to consider, from the type of coverage to the deductibles and copays. You must read and understand the terms and conditions and weigh the costs and benefits. Choose the dental insurance that matches your budget and dental health requirements. 

What Is Self-Employed Dental Insurance?

Anyone who earns income independently without an employer is self-employed for tax purposes. There is no traditional employer-employee relationship. You may be a freelancer, an independent contractor or a business owner.

Self-employed dental insurance is similar to other types of dental insurance. Like any other insurance, you’ll pay your premiums to the insurance company. In return, the insurance company will cover an agreed percentage of your dental service costs. You are responsible for any deductibles, copays and coinsurance. 

Why Should You Invest in Dental Insurance? 

If you don’t have employer-funded dental insurance, you should consider investing in dental insurance. Here’s why:

• Reduced dental costs: Your health depends on regular dental care. Still, dental procedures can be expensive. Dental insurance helps lower out-of-pocket costs for preventive care and more complex procedures.
• Preventive care: Dental coverage encourages regular dental checkups. Early problem detection results in preventative actions that reduce the expense of more serious dental problems.
• Network discounts: You may receive in-network discounts on services from participating dentists.
• Unexpected dental costs: Even with good oral health, unexpected dental emergencies may arise. Dental insurance helps to manage these costs and avoid financial strain.
• Tax deductible: As a self-employed person, you can deduct your dental insurance premiums from your taxable income.

Types of Dental Insurance Coverage

There are three main categories of dental insurance for self-employed people.

DHMO Insurance Plan (Dental Health Maintenance Organization) 

DHMO plans focus on preventative dental care. Preventive care is often covered at 100% with no deductibles or copays. Typically you’ll know the cost upfront because of set fees for basic and major procedures. You must choose a dentist from the plan's network. To see a specialist, you may need a referral from your network dentist.

DHMO plans offer predictable costs. You may have lower dental expenses with a DHMO plan, especially if you prioritize preventive care. If you need regular checkups and cleanings but don't expect major procedures, a DHMO plan is a budget-friendly option.

On the downside, you must choose a dentist within the DHMO network, limiting your options. Some DHMO plans also have limitations on coverage for preexisting dental conditions.

DPPO Insurance Plan (Dental Participating Provider Organization)

A DPPO is more flexible than a DHMO plan, but dental costs may be higher. You can choose a dentist from the plan's network or go to an out-of-network dentist. Coverage and costs will differ. In-network dentists may be cheaper, and the insurance may cover more in-network costs. 

If you value flexibility in choosing a dentist but also want to enjoy in-network cost savings, a DPPO plan is a good compromise. If you already have a dentist not in a DHMO network, you can keep your dentist with a DPPO while still enjoying some in-network benefits.

The biggest advantage of a DPPO plan lies in flexibility and in-network coverage levels. Opting for out-of-network care can significantly increase your out-of-pocket expenses.

Coverage details can vary between DPPO plans, so carefully compare plans. There may be limitations on coverage for out-of-network services, and you may need preapproval for some procedures.

Dental Indemnity Insurance Plan 

With dental indemnity insurance, you pay the dentist directly for services rendered. The insurance company then reimburses you for an agreed percentage of the cost. You have the freedom to choose any dentist. Preventive care coverage may be limited or excluded from the plan.

Dental indemnity plans offer the most freedom in your choice of dentist. If you have a valued dentist who doesn't participate in managed care plans, you can continue to see them and receive financial reimbursement. Some dental indemnity plans require preapproval for some procedures.

If you only occasionally use dental services and prefer flexibility over preventive care coverage, this dental insurance may be an option.

With these plans, your out-of-pocket expenses may be higher than a managed care plan. You are responsible for upfront dental services payments, so you must have available funds.

How to Get Dental Insurance

You have two choices when it comes to getting dental insurance. 

Dental insurance with Your Health Insurance Plan

Many health insurance providers offer dental coverage as an optional add-on to their health insurance plans. This approach simplifies insurance benefit management and may be cheaper. To enroll in a health insurance plan with dental coverage, you must meet the eligibility requirements, complete the application process and wait for approval.

Stand-Alone Insurance

You may prefer standalone dental insurance so you can focus solely on your dental health.

Do your research and choose the insurance company that offers you the best coverage for your needs. Fill out the application and choose the relevant options. 

Factors to Consider When Choosing a Dental Coverage

Choosing the right self-employed dental insurance requires research and careful thought.  

Cost of the Plan

Most importantly, the plan must suit your budget. Understand the terms and conditions since the cost must include the premiums, deductibles, limits and copayments. If you have frequent dental procedures and treatments, a higher premium may be safer than higher deductibles and copayments. Weight your dental care needs against the costs.  

Coverage Included 

Know what your dental insurance covers. Most dental insurance will cover your basic services and preventative care. Does your insurance cover treatments like root canals and crowns? Is orthodontic care, like braces, included in your insurance coverage? 

Provider Network and Access to Preferred Dentists

Dental insurance plans offer differing flexibility levels. A DHMO plan will provide you with a network of dental service providers. You will have to use these services. They also require referrals for specialist services. 

DPPO plans will allow you to use dental services outside their network. Off-network dentists usually cost more, and you’re liable for the price difference. You do not need a referral for specialist treatments. 

If you have a dental indemnity insurance plan, you’re free to choose the service providers, but you’ll pay more.  

Deductibles and Copayments

A deductible is the amount you must pay for treatment before you’re covered. The coverage kicks in once you’ve covered your deductible for the year.

Annual Maximum Coverage Limit

Dental insurance plans have a maximum limit, the amount above which you are fully covered. Make sure that the maximum limit suits your financial plan. 

Coverage for Preexisting Conditions

Unlike medical insurance, dental insurance companies do not have to cover preexisting conditions. Most will exclude it, though some will offer coverage with limits. Alternatively, they may extend the waiting period. Consider a dental savings plan for such conditions. 

Waiting Periods for Specific Services

Most dental insurance policies will cover preventative dental maintenance from the start. Treatments and procedures, however, may be subject to a waiting period. This period is usually six months. Know your policy terms and conditions to avoid unexpected expenses. 

Get the Best Self-Employed Dental Insurance from Benzinga’s Top Providers

The table below is designed to help you quickly choose the best self-employed dental insurance.

Achieve Peace of Mind with the Best Dental Insurance for You

A dental insurance plan can provide peace of mind by covering routine checkups and unexpected dental procedures. The premiums are tax-deductible, so dental insurance is well worth exploring. Over the long run, dental insurance can provide financial security. Still, you must research your options and weigh the cost against the benefits to get the best from your dental insurance for self-employed people. 

Frequently Asked Questions