Oral health is important at every stage of life. Having a dentist you trust to look over your mouth at routine visits ensures that the health of your mouth is on track and any concerns can be dealt with before they turn into real problems.
Dental insurance allows patients to afford the dental care they need without having to pay for procedures out of pocket. But for young adults who are outgrowing their parents’ dental coverage, there may be a period of time when they are between individual dental insurance plans, leaving them vulnerable to paying for full, expensive dental bills. Because of their phase of life, young adults without dental insurance may even skip out on simple preventative dental care for fear of the cost.
Introduction to Transitioning Dental Insurance Coverage
Fortunately, dental insurance for young adults provides options that can help bridge the gap between their parents’ insurance coverage and their own as they approach the age when they can no longer stay covered by their parents’ plan. According to the U.S. Department of Labor, children can stay on their parents’ insurance until they turn 26 years old. This even applies to married young adults; as long as they are under the age of 26, they can remain on their parents' medical and dental insurance plans.
Dental care for young adults is crucial to avoid worsening oral complications. Around 90% of adults 20 years old and older have at least one cavity. Tooth decay can lead to loss of teeth, root canals, abscesses, and other infections, especially if left untreated.
Just because dental insurance can no longer be provided through your parents, it is essential to get the coverage you need so you can maintain your oral health. The most affordable way to get dental insurance is through your employer. By providing dental benefits, your employer can get more cost-effective coverage because of the number of employees on a group plan.
Understanding the Coverage Gap
While the thought of jumping from your parents’ dental coverage to an employer who provides dental benefits sounds like a smooth transition, it isn’t always realistic. In 2019, only 44% of US workers had employers who offered health care benefits. As you are finding a job, it is likely that you won’t have the option to get the dental coverage you need through your employer.
Dental emergencies can happen at any time in life. If you suddenly have a toothache or chip your tooth when you do not have dental insurance, you could have a large out-of-pocket bill to pay after you get the relief you need from your emergency dental situation. While you may physically feel better, having a sizeable dental bill looming over your head can be stressful.
Options for Dental Coverage After 26
Exploring dental coverage options after you have phased out of your parents’ dental insurance can help you find a plan that fits your needs. Insurance companies do not look at your credit score; therefore, whether you have good or bad credit will not affect your monthly insurance costs. There are a few ways to get dental insurance as a young adult.
Dental Insurance Through Your Employer:
If you started your current job before you were phased out of coverage from your parents’ insurance, you may have opted out of your employer’s benefits. Go back and ask if you can opt into receiving dental coverage, though you may have a waiting period before your benefits begin.
Dental Insurance Plans
You can use the Marketplace to find the right dental plan for you. If you have not needed extensive dental care in the past, you can opt for a low-coverage plan that allows you to pay a low amount each month but comes with a higher deductible and co-pays. An individual dental insurance plan will safeguard you from large dental bills after your deductible is met without straining your monthly budget.
Whether or not you obtain dental insurance through your employer or a private plan, you can also use a few different methods to make your dental care even more affordable.
Dental Discount Plans
By signing up for a discount dental plan with an individual dental practice or network of practices, you can unlock significant savings to help pay for your dental needs if you are uninsured, or you can use the discounts to help pay for co-pays and your deductible so you are paying less every time you go to the dentist.
Dental Payment Plans
Individual dentists or a specific network of dental practices can also offer a way for you to pay for large dental bills by breaking up the total amount over several months to make it more affordable. Be sure to ask your dentist questions about what types of payment plans they offer so you won't have to worry about paying a large dental bill all at one time.
Selecting the Right Dental Insurance Plan
As you are looking for the right dental insurance plan that fits your needs and your budget, it is important to shop around. Comparing different plans could really pay off in the end. Things to consider while you are shopping for a dental insurance policy are:
- The amount of your premium, which is the amount you pay each month for insurance
- The amount of your deductible, which is the amount you pay for dental care before the insurance company starts to pay for your dental costs
- The amount of your coverage maximum, which is when your dental costs reach a certain amount and the insurance plan no longer pays for your dental costs
- The type of coverage you need — whether for expensive dental procedures or just routine checkups, your insurance plan should reflect how often you will use your dental coverage
Before you sign up for a dental insurance plan, add up the deductible, twelve months of premium costs, and co-pay costs to see what you will potentially pay yearly for dental care. Then compare the monthly and yearly costs between the two policies you are looking at side by side to determine which is best for you.
Tips for a Smooth Transition
If you are coming up on your 26th birthday, and you know your parental dental coverage is about to end, it is important to start thinking about what you will do next and if you have dental care available to you through your employer. You do not want to miss any enrollment deadlines for starting your own insurance policy if it occurs before you actually turn 26.
If you have already passed your 26th birthday and you also missed the enrollment period for getting your own insurance policy, or you are in a lengthy waiting period before your coverage actually kicks in, using a discount dental plan can help smooth over the costs of dental care until your new dental policy is up and running.
Navigating Costs and Budgeting
Now that you are no longer under your parents’ medical and dental insurance, you are truly out of the nest. Creating a budget for all of your monthly expenses will help you to see clearly where your money is going each month and how you will work your dental insurance premiums into your monthly expenses without feeling overwhelmed by bills.
Tips for creating a budget:
- Make realistic limits for expenses like groceries, gas, and miscellaneous spending.
- List all bills that come out of your paychecks each month, including your dental premiums.
- Have an emergency fund savings goal. Once you meet this goal, you can use the amount you budget for savings to save for a bigger purchase.
- Decide where you can tighten your spending as well as how you will accomplish this. A few ways to reduce your spending are:
- Cancel all but one streaming subscription
- Grocery shop on a designated day to prevent yourself from eating out all week
- Give up grabbing coffee on one day a week
- Create meatless meals for one or two days a week to save money
Choose one weekend a month to stay home and not spend money to save on gas, eating out, and shopping.
In addition to regular dentist visits, do not slack on simple but crucial dental hygiene habits. Brushing your teeth for two minutes every morning and evening, as well as flossing once a day and swishing with a therapeutic mouthwash, will help keep your teeth and gums healthy so you can save money on restorative dental care.
Finding a Local Dentist
As you transition to your own dental coverage, finding a new dentist in network with your insurance plan that also offers helpful payment plans or dental discount plans can give you a boost as you start managing your dental care on your own. To find a dentist in your community as you transition to your own dental insurance plan, check out Smile Generation's Find a Dentist tool today.
- "Cavities." CDC, 31 Aug. 2023, https://www.cdc.gov/oralhealth/fast-facts/cavities/index.html#:~:text=Untreated%20cavities%20can%20cause%20pain,in%20rare%20cases%20fatal%2C%20results.
- "Forty-four Percent of Civilian Workers had Access to Dental Care Plans in March 2018." Bureau of Labor Statistics, 8 Apri. 2019, https://www.bls.gov/opub/ted/2019/forty-four-percent-of-civilian-workers-had-access-to-dental-care-plans-in-march-2018.htm
- "Health Benefits and Coverage." HealthCare.Gov, 31 Aug. 2023, https://www.healthcare.gov/coverage/dental-coverage/
- "Young Adults and the Affordable Care Act: Protecting Young Adults and Eliminating Burdens on Businesses and Families FAQs." U.S. Department of Labor, Dental emergencies Dental insurance 31 Aug. 2023, https://www.dol.gov/agencies/ebsa/about-ebsa/our-activities/resource-center/faqs/young-adult-and-aca
Smile Generation blog articles are reviewed by a licensed dental professional before publishing. However, we present this information for educational purposes only with the intent to promote readers’ understanding of oral health and oral healthcare treatment options and technology. We do not intend for our blog content to substitute for professional dental care and clinical advice, diagnosis, or treatment planning provided by a licensed dental professional. Smile Generation always recommends seeking the advice of a dentist, physician, or other licensed healthcare professional for a dental or medical condition or treatment.