To find an in-network dentist, start with your plan type. A dental HMO usually covers only dentists in its network, while a dental PPO pays more when you stay in network. Next, search your carrier's dental directory, call the office to confirm, and ask for a pre-treatment estimate before major work. Those steps protect you from most surprise dental bills.
- Dental networks are separate from medical networks, even when one company sells both.
- A dental HMO (DHMO) usually pays nothing for routine care outside its network.
- Stand-alone dental plans are excepted benefits, so federal surprise-billing rules don't cover them.
- Dental care is an essential health benefit for children 18 and under, but not for adults.
- Many dental plans have waiting periods and a yearly maximum, so check both before you book major work.
How dental networks work
Dental plans build their own networks. So a dentist can take your medical insurer's name and still be outside your dental network. Before you search, find your plan type on your dental card or welcome packet. Our guide to how HMO and PPO plan rules differ explains the same ideas for medical plans.
- Usually no coverage outside the network
- Specialists usually need a referral
- Often no deductible and no yearly cap
- Some coverage outside the network
- No referral needed for specialists
- Usually a deductible and a yearly maximum
Some plans pay the same benefit whether or not the dentist is in network. Even then, an in-network dentist has agreed to the plan's set fees, while an outside dentist has not. Your plan summary shows which design you have. Next, compare options on our individual and family dental plans page.
5 steps to find an in-network dentist
The whole process usually fits into one short evening. First, keep your dental card nearby. Then work through these steps in order, because each one builds on the last.
- Know your plan and network name
Check your dental card for the plan name and network. Our guide on what each number on your card means can help.
- Search the carrier's directory
Filter by your exact plan, not just the company. We keep search links for each carrier on one page.
- Narrow by location and services
Filter by distance and hours. For braces, implants or oral surgery, also look for in-network specialists.
- Call the office to confirm
Give your member ID and plan name. Then ask whether that specific dentist, not just the practice, is in network.
- Request a pre-treatment estimate
Before crowns or root canals, ask the office to send an estimate to your plan. It shows what the plan expects to pay.
New dental plans often have waiting periods for basic and major care. So book your cleaning and exam first, since preventive care usually has no wait. Also, ask the office to note your plan name in your chart, which saves time at every visit.
Dentist search by carrier
Each carrier runs its own directory and uses its own network names. So use the plan name on your card when you filter. That small habit is the fastest way to find an in-network dentist with any carrier. Here is where to start with the carriers Vivna works with.
Cigna and UnitedHealthcare dental network search
Cigna still sells individual dental plans for 2027, even though it is leaving the individual medical market. It offers both DPPO and DHMO designs, so check which one you have. You can read more on our Cigna dental, vision and supplemental page. Meanwhile, UnitedHealthcare members should search by plan name, as shown on our UnitedHealthcare carrier overview.
Aflac and Ambetter dental network tips
Aflac dental plans can pay for care from dentists in or out of network, though staying in network usually costs less. See our Aflac coverage options for details. On the other hand, some Ambetter medical plans include pediatric dental. In that case, check the plan documents and our guide to Ambetter's doctor search first.
Children's dental coverage
Dental care is an essential health benefit for kids 18 and under. It may come inside a Marketplace health plan or as a separate dental plan. However, you can buy a Marketplace dental plan only when you also buy a health plan. Either way, check the pediatric dental network before the first visit.
Tell us your dentist's name, and a licensed Vivna agent will check which dental plans include them, at no cost to you.
Questions to ask the dental office
A directory listing is a good start, but directories can lag behind. That's why a quick call is the best way to find an in-network dentist you can actually see. Ask these questions, and write down the answers.
- Is this dentist in network for my exact plan name?
- Are you taking new patients on this plan?
- Do you send pre-treatment estimates to my insurer?
- Which of your specialists, such as oral surgeons or orthodontists, are in network?
- What will I owe today for a cleaning and exam?
Need help making sense of the answers? Call a licensed Vivna agent at 888-730-6031. For medical providers, the same idea applies, and our five-way doctor network check walks you through it.
What in-network dental care costs
In-network dentists agree to the plan's set fees, so your share is easier to predict. Most PPO-style dental plans split care into three classes. For example, here is how one Cigna individual plan, Cigna Dental 1000, pays in network.
What each class of care includes
Preventive care covers cleanings and exams. Basic care usually means fillings and simple extractions, while major care includes crowns and dentures. Plan designs vary, so check your own summary. Also, compare bundles on our combined dental and vision plans page.
Example: a filling and a crown
Here is how the math could work on that plan, using made-up network fees for illustration. Say a filling has a $150 network fee. First, you pay the $50 deductible. Then the plan pays 80% of the other $100, so you owe $20 more, or $70 in total.
Later in the year, after any waiting period ends, you need a crown with a $1,200 network fee. Because crowns count as major care, the plan pays 50%, or $600, and you pay $600. So the plan has paid $680 of its $1,000 yearly maximum. Once the plan reaches its cap, you pay the rest of that year's dental bills yourself.
When your dentist isn't in your dental network
Sometimes the dentist you love isn't on the list. Your choices depend on your plan type, so start there. And if you decide to switch, use the five steps above to find an in-network dentist close to home.
You can stay with your dentist and pay more. The office may also bill you the gap between its fee and the plan's allowed amount.
Routine care outside the network usually isn't covered, so pick a new in-network dentist or switch plans later.
Get a written estimate from both offices, then compare your total share before you book.
Stand-alone dental plans are excepted benefits, so the federal No Surprises Act doesn't apply to them. As a result, an out-of-network dentist can bill you the difference between their fee and what your plan pays. Ask for the full price in writing before treatment.
If your dentist leaves the network mid-year, the steps look a lot like the ones in our guide on what to do when a provider exits your plan. In short, act early and keep notes.
Confirm the network before you book, and get an estimate before you drill.The rule our licensed agents repeat most
How to find an in-network dentist: FAQs
Is my dentist in network if my doctor is?
Not necessarily. Dental and medical networks are separate, even when the same company sells both. So a dentist may accept your medical insurer's dental plan but not the one you have. To find an in-network dentist, always search by your dental plan's exact name. Then confirm with the office by phone before your visit.
Do I need a referral to see a dental specialist?
It depends on your plan type. A dental HMO often requires a referral from your primary dentist before you see an oral surgeon or orthodontist. In contrast, a dental PPO usually lets you book a specialist directly. Either way, check that the specialist is in your dental network, because specialists often join different networks than general dentists.
Can I see a dentist outside my dental network?
With a dental PPO, yes, although an outside dentist usually costs more. Some plans even pay the same benefit in or out of network. With a dental HMO, however, you usually must use dentists in the network for routine care. Check your plan summary, since it spells out which rules apply to you.
What is a dental waiting period?
A waiting period is the time before a plan covers certain services. For example, preventive care often has no wait, while basic and major care may wait several months. During that time, you still pay premiums. Some plans waive the wait if you had dental coverage recently, so ask before you enroll.
Does Vivna sell dental insurance?
Yes. Vivna's licensed agents offer dental plans from carriers such as UnitedHealthcare, Cigna, Aflac and Aetna. We can also check whether your current dentist is in each plan's network first. Browse our answers to common dental plan questions, or call 888-730-6031 Monday through Friday, 9am to 6pm.
Vivna's licensed agents compare plans from 50+ carriers. Call Monday through Friday, 9am to 6pm.
Sources
- HealthCare.gov: Dental coverage in the Marketplace
- Aflac: DHMO vs. PPO dental insurance
- Cigna: Individual and family dental plan comparison
- 45 CFR 148.220: Excepted benefits in the individual market
- CMS: No Surprises Act training, including plans the rules don't cover
Vivna Insurance is a licensed, independent health insurance agency (NPN 19168641). We are not affiliated with HealthCare.gov or any government agency. Plan availability, networks and benefits vary by state and change over time. Dental plan designs, waiting periods and yearly maximums vary by plan and state.
Related guides
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