What is dental insurance coinsurance?

What is dental insurance coinsurance


What exactly is coinsurance? Dental coinsurance, along with deductibles, is one of the ways you and your dental insurance carrier share costs. If your dental insurance plan covers a percentage of the cost for certain services, you pay the remainder of the bill directly to your dentist. The amount you pay is called “coinsurance.”



How dental coinsurance works

On your dental insurance benefits summary, coinsurance is typically listed as a percentage. 20%, 30%, or 50% are all common coinsurance percentages. Keep in mind that in most cases, dental coinsurance kicks in after you meet your deductible.

As an example, say your coinsurance for fillings is 20% and you need one filling, costing a total of $200. *

  • • Your deductible is $50. You pay this up front, out-of-pocket.
  • • On the remaining $150, coinsurance comes into play:
  • • Your coinsurance is 20%, so you pay 20% and your insurance pays 80%.
  • • 20% of $150 = $30 coinsurance
  • • Your total cost: $50 deductible + $30 coinsurance = $80

*This is just an example. Actual costs for dental services vary depending on the provider.

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Is dental coinsurance the same for all procedures?

The percentage of coinsurance varies depending on your dental insurance plan.

Some dental insurance plans offer the same coinsurance percentage across the board for all procedures. Other plans offer different coinsurance percentages depending on the procedure.

As an example, this comparison chart shows our Individual & Family Plan coinsurance as a percentage: https://www.deltadentalwa.com/our-plans/individual-and-family-plans/individual-dental-insurance-plans

Whatever the case, your dental insurance benefit summary should list all coinsurance percentages clearly. If your summary doesn’t list out your coinsurance, or if you have other questions related to your out-of-pocket costs, contact your dental insurance carrier directly.