Individual & Family · Dental
Your medical plan almost certainly doesn't cover your teeth.
Major medical steps in for dental emergencies — and little else. Cleanings, fillings, crowns, and extractions come out of your pocket unless you carry a dental plan. Here’s how those plans actually work.
The structure nobody explains
100 / 80 / 50
Nearly every dental plan sorts care into three buckets and pays a different share of each. Learn this and you can read any plan on the market:
100%
Preventive
Cleanings, exams, and X-rays — usually covered in full, in network, from day one.
80%
Basic
Fillings, simple extractions, and similar repairs — the plan pays most, you pay the rest.
50%
Major
Crowns, bridges, root canals, dentures — covered at about half, which is where annual maximums start to matter.
Two numbers decide whether a plan is worth it: the annual maximum (the ceiling on what the plan pays each year) and the waiting period before bigger work is covered. Premiums get all the attention; these two do the damage.
Know what you’re buying
Four kinds of dental plan
DPPO
Preferred Provider Organization
Lowest costs in network, freedom to go out of network at a higher share. Deductible and an annual maximum apply. The most common shape.
DHMO
Dental HMO
Prepaid: set copays per procedure, usually no deductible or annual maximum, but you stay inside the network. The most predictable option.
Indemnity
Fee-for-service
Any dentist you like; the carrier reimburses a percentage of charges. Maximum freedom, typically the highest out-of-pocket.
Discount
Not insurance
Discount or referral plans negotiate reduced fees with member dentists — you still pay 100% of the (reduced) bill. Useful for some budgets; just know what you are buying.
Fika makes it easy
Tell us what’s coming, and we’ll match the plan.
A plan that’s perfect for cleanings twice a year is the wrong plan if you need a crown in March. We compare maximums, waiting periods, and whether your dentist is in network — and pair dental with vision when bundling comes out ahead. Free, no pressure, no spam.
FAQs
Dental questions, answered
Most plans cover preventive care immediately, but make you wait before they’ll pay for bigger work — commonly a few months for basic services and up to a year for major ones. Some carriers waive or shorten waiting periods, especially if you’re coming off prior dental coverage. If you already know a crown is coming, that detail decides which plan is worth buying — tell us up front and we’ll aim you at the right one.
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