Dental Insurance Calculator
Choose your carrier, deductible and remaining annual maximum to see what your plan pays and what you owe. Most dental PPO plans cover preventive care at 100%, basic work at 80% and major work at 50% — but the annual maximum, usually $1,500, is what actually limits the payout on expensive treatment. Free, no sign-up.
Dental Cost Estimator
Based on typical San Francisco Bay Area fees and standard PPO plan structures.
Select a treatment and insurance to see your estimate
*This is an estimate only. Actual costs may vary based on your specific insurance plan, deductibles, and clinical needs. Please contact our office for a precise quote.
How dental coverage tiers work
Dental plans classify every procedure into one of four tiers, and the tier decides the percentage. This is the structure nearly all PPO plans in California follow.
| Tier | Plan pays | Examples |
|---|---|---|
| Preventive | Typically 100%, deductible usually waived | Exams, X-rays, cleanings, fluorideThe only tier most patients pay nothing for. Skipping it is what turns a filling into a root canal. |
| Basic restorative | Typically 80% | Fillings, extractions, root canals, deep cleaningDeductible normally applies before the plan starts paying. |
| Major restorative | Typically 50%, capped by the annual maximum | Crowns, bridges, dentures, implantsThe annual maximum — not the 50% — is usually what limits the payout. |
| Cosmetic | Not covered | Veneers, composite bonding, whiteningExcluded as elective, so the full amount is out-of-pocket. Financing is available. |
The annual maximum is the real limit
On major work, the percentage matters less than the cap. A plan that covers implants at 50% with a $1,500 annual maximum pays $1,500 towards a $5,000 implant, not $2,500 — and a crown earlier the same year would have already spent part of it. The maximum resets January 1 on most plans, which is why phasing treatment across a year boundary is sometimes worth planning.
In-network changes the base fee
Coverage percentage is applied to the contracted fee, not the practice’s full fee. Being in-network therefore lowers your share even when the percentage is identical. Denvida is in-network with Delta Dental and Cigna and accepts MetLife, Aetna, Guardian and other PPO plans.
Frequently Asked Questions
What does dental insurance actually cover?
Most dental PPO plans follow a 100-80-50 structure: preventive care (exams, X-rays, cleanings) at 100% with the deductible usually waived, basic restorative (fillings, extractions, root canals) at 80%, and major restorative (crowns, bridges, dentures, implants) at 50%. Cosmetic treatment such as veneers and whitening is excluded entirely. All payouts are capped by an annual maximum, typically $1,500.
What is a dental annual maximum and why does it matter so much?
The annual maximum is the total your plan will pay in one benefit year — commonly $1,500, and it has not risen much in decades while dental fees have. It matters more than the coverage percentage on expensive work: on a $5,000 implant, a plan that covers 50% would owe $2,500 but will only pay up to the remaining maximum. Anything else treated that year draws on the same pool. The maximum resets January 1 on most plans.
How does a dental deductible work?
The deductible is the amount you pay before the plan starts contributing — commonly $50 individual or $150 family per benefit year. It usually applies to basic and major work but is waived for preventive care, which is why a checkup and cleaning are typically free even when you have not met it. The calculator subtracts any deductible you have not yet met.
Does dental insurance cover implants?
Many plans now do, as major restorative at around 50%, but the annual maximum caps the payout so most of an implant's cost stays out-of-pocket. Some plans also apply a waiting period of 6–12 months for major work on a new policy, or a missing-tooth clause excluding teeth lost before coverage began. Denvida checks your specific plan before treatment and provides a written estimate.
Can I use two years of benefits for one treatment?
Often, yes. If treatment spans a year boundary, phasing it deliberately — for example extraction and grafting in December, implant placement in January — can draw on two annual maximums instead of one. It only works when the clinical timeline allows it, and healing time for implants frequently does. We plan this with you rather than after the fact.
Which insurance is Denvida in-network with?
Denvida is in-network with Delta Dental and Cigna, and accepts MetLife, Aetna, Guardian and other PPO plans — 7 carriers are modelled in this calculator. Being in-network means the fee is set by the contracted schedule rather than the practice's full fee, which lowers your share even where the coverage percentage is the same.
We will check your plan for you — free
Bring your insurance details to a free consultation and Denvida verifies your remaining benefits, then puts what the plan pays and what you owe into a written treatment plan before anything begins. Mandarin & Spanish spoken.