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The Ohio Dental Insurance Ultimate Guide

Looking for Ohio dental insurance?

Dental insurance in Ohio works about the same way health insurance works. You pay a monthly premium to receive specific dental care benefits that typically include x-rays inside the mouth, regularly scheduled teeth cleanings, and other services that encourage dental health. Some plans offer comprehensive dental coverage, while other plans provide services based on the amount of your monthly premiums. You can also pay for Ohio dental insurance if you want to cover costlier services such as dental implants and oral surgery.

Why is dental insurance in Ohio important? Did you know that there is a direct correlation between your dental health and your overall health? Health issues that arise in the mouth can negatively impact other parts of the body. What was once considered an insurance option should be an integral part of your health insurance policy.

What Is Dental Insurance?

The short answer to the question is dental insurance helps policyholders accurately budget for the cost required to maintain healthy gums and teeth. Most dental insurance in Ohio is simple to understand. A policy lists the procedure covered by dental insurance, as well as the monthly premium you have to send to receive the listed services. Dental insurance in Ohio can be part of a group health insurance plan or be a standalone policy that covers just the cost of dental care.

Here are three points to remember about dental insurance:

  • If you see a dentist that is in your insurance company’s network, you can save money by continuing to make appointments with the same dentist

  • When you do not have a dentist, you save money by choosing a dentist listed in your insurer's network

  • If your dentist is not in your insurance company’s network, you can expect to pay more in monthly premiums

The amount of your monthly premium depends on the plan, where you live (cost of living), and how the insurance company prices its policies.

Here are the factors to consider before buying Ohio dental insurance. One of the Ohio-licensed agents at Wilson Insurance Group can explain what each of the factors means for calculating a monthly premium.

  • Waiting period

  • Deductible

  • Co-pay

  • Coinsurance

  • Categorizing the costs associated with different procedures

  • Annual coverage maximums

Medicare and Ohio Dental Insurance

One of the most frequent questions we get concerning dental insurance in Ohio is whether Medicare includes dental coverage. Medicare does not cover common services like cleanings, fillings, dentures, and tooth removal. However, under Part A of Medicare, a patient in a hospital can receive a limited number of dental services that are considered emergency procedures. For example, Medicare might cover a procedure to save a tooth after a car accident to prevent an infection.

Inpatient dental care includes procedure performed at the following types of hospitals:

  • Acute care

  • Critical access

  • Rehabilitation

  • Long-term care

  • Research

The bottom line is Medicare insurance does not cover a vast majority of dental care services.

Types of Dental Insurance

There are numerous types of dental insurance that include the dental insurance offered to federal employees as mandated by the 2004 Federal Employee Dental and Vision Enhancement Act. Nonetheless, you should narrow your research to five common types of dental insurance in Ohio.

  • Preferred Provider Organization (PPO)

  • Health Maintenance Organization (HMO)

  • Dental Indemnity

  • Exclusive Provider Organization (EPO)

  • Point of Service (POS)


As one of the most common types of dental insurance in Ohio, a PPO lists a network of providers the insurance company approves for its policyholders. You have the option to go outside the provider network, but you can expect to pay more in monthly premiums.


Considered one of the most affordable dental insurance plans, an HMO does not include an annual deductible. Most preventive dental care, such as x-rays and cleanings, receive 100 percent coverage under an HMO dental insurance plan.

Dental Indemnity

Written with coinsurance and an annual deductible, a dental indemnity policy requires policyholders to pay for dental care out of pocket until they reach the deductible limit. You do not have to select a primary care dentist from a designated network.


To receive full dental care coverage, an EPO policy requires you to see dentists in the network established by your insurance company. You do not have to choose a primary care dentist, nor do you need insurance company referrals to make appointments with specialists.


As a blend of PPO and HMO policies, a POS dental insurance policy allows you to see dentists outside the insurance company network. However, you save money by seeing dentists inside the network. POS policies give you more flexibility to raise the annual deductible.

Why Ohio Dental Insurance Is A Good Idea

As we mentioned at the start of this page, healthy teeth and gums form the foundation for a healthy body. That is just one of the many reasons why Ohio dental insurance is a good idea.

Pays for the Little Things that Prevent Bad Things

From regularly scheduled cleanings to thorough x-rays that detect teeth and gum issues, most dental plans cover the little things that prevent major problems from developing inside your mouth. You have heard how a balanced diet and consistent exercise can prevent health issues. Well, apply the same principle to dental insurance in Ohio.

Unaffordable Dental Services

Without dental insurance, you will pay out of pocket for every procedure. Even a simple teeth cleaning session can set you back more than $100. Having to pay for costly dental services out of pocket often delays the minor procedures that prevent the major problems from arising. Moreover, you have to consider the incredibly high cost of dental services, such as crowns, dentures, and dental implants.

Financial Protection for Emergency Care

Murphy’s Law, which is ‘What can go wrong will go wrong” must have been written for dental care. In general, insurance is referred to as protection against an unforeseen event like paying for the cost of the damage caused by an auto accident, Dental insurance gives you the peace of mind to know you are covered financially if an emergency forces you to seek immediate dental care.

Money Saved by PPO Discounts

Many dental insurance plans utilize the PPO model of working with dental professionals that are part of an insurer’s network. Although the PPO model limits your dental care options, it also saves you a considerable amount of money. Let’s assume a cleaning costs $125 outside the PPO network. Your dental insurance carrier might offer a discount if you reach out to a dentist that offers the same service for $75.

Pro Tips & Important Notes

If a throbbing toothache has ever kept you up all night, then you understand the importance of receiving high-quality dental care when you need it the most. However, you should avoid paying out of pocket by purchasing dental insurance in Ohio.

Let’s review a few tips to ensure you sign up for the dental insurance policy that is right for you.

Start by Looking for Group Insurance

The phrase “Power in numbers” has many applications, but its greatest relevance pertains to the power in numbers when talking about purchasing power. For example, co-ops combine the financial resources of several companies to produce more purchasing power. For dental insurance, power in numbers refers to group health insurance.

The majority of dental insurance policyholders obtain their plans from participating in a group insurance program. Group insurance is frequently offered by employers to attract the best talent. The Affordable Care Act (ACA) marketplace operates using the group insurance model as well.

Here are a few other types of group insurance that can help you find an affordable policy:

  • Medicaid

  • Children’s Health Insurance Program (CHIP)

  • Level Funded

  • Multiple Employer Welfare Arrangement (MEWA)

Understand Your Dental Care Needs

You need to assess your dental care needs, as well as what each family member requires for dental care. Children receive specialized types of dental care meant for younger people, from fluoride treatments to the application of sealants. Adults face different problems like gum disease and overly sensitive teeth that require a comprehensive Ohio dental insurance policy. Seniors might develop health conditions that need to be addressed through preventive dental care procedures.

Learn What Types of Plans Insurers Offer in Your Area

Online research has made finding the right dental insurance in Ohio much easier to do. Search for available dental insurance plans by state, county, zip code, and eventually your city. Insurance companies do not offer the same services in every area where the companies operate. This is especially true for dental insurance in Ohio.

The More Dentists and Dental Practices, the Better

The more choices you have for dentists and dental practices, the more likely you will find a policy that covers the services that you need at an affordable price. You also have to consider the location of the dentist and the hours of operation. A small number of dental practices might limit when you can see your dentist.

Increase the Deductible

Just like with any other type of insurance policy, the more you pay for the annual deductible, the cheaper the monthly premium. You have to consider the health of your teeth and the dental health of the rest of your family. Raising the deductible should not be an exercise in gambling. You have to analyze every possibility that might require major dental work.

Know Every Treatment That is Covered

Do not assume that every dental treatment that you consider to be routine is covered by every policy. Some plans do not cover basic treatments like dentures and teeth whitening. Make sure to read the fine print as well as to ensure you are not on the financial hook for more money than you can afford.

Ask About Short-Term Dental Insurance in Ohio

COBRA health insurance acts as an insurance bridge between policies. Is there a dental insurance option that provides short-term coverage? If your insurance needs are just for a few months before long-term dental insurance kicks in, then you should try to bridge the gap with short-term dental insurance. Make sure to understand the cancellation policy implemented by the insurance company before you sign on the dotted line.

The dental insurance experts at Wilson Insurance Group can help you navigate the dental insurance buying process. Call our office or submit the short online Contact form to learn more about Ohio dental insurance.


Dental insurance in Ohio represents the most effective way to prevent dental issues from harming both your overall health and your checking account. Seniors, adults, and children that receive dental care benefits are more likely to visit the dentist twice a year for preventive procedures such as x-rays and cleaning. Remember that saving a few dollars today can cost you hundreds of dollars down the road because of costly dental procedures.

P.S. If you're a business owner, did you know that we offer MEWA group health plans? Click here to learn more about this potentially amazing solution for your business.


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