Insurance Vs Benefits | MouthHealthy - Oral Health Information from the ADA

What's the Difference Between Dental Benefits and Dental Insurance?

A white question mark on a light blue background.

When shopping for a dental plan, you’ll probably see the term “dental benefits” more often than “dental insurance.” That’s because even though most people refer to the plan that pays for their dental care as insurance, it’s technically a different type of healthcare plan. This can lead to confusion and frustration when patients find their dental plan doesn’t cover procedures in the same way their healthcare plan does for their other health needs

Here’s the difference. An insurance plan is designed to reimburse you for a loss. For example, your car insurance pays you the value of your car if it’s totaled in a crash, and your health insurance covers the cost of your hospital stay if you’re injured in that crash. In an insurance plan, the insurer carries the risk.

A benefit plan, on the other hand, is only set up to cover certain costs. Your dental benefit plan will only cover some procedures fully, and then pays a percentage of other procedures. You may find some procedures your dentist recommends aren’t covered at all, so it’s important to check with your plan administrator to find out if a procedure is covered.