Dental costs are one of the most confusing parts of healthcare, partly because dental insurance works almost nothing like medical insurance. The good news for Maryland patients: a major 2023 expansion added comprehensive dental coverage for adults on Medicaid, and Montgomery County has a deeper bench of lower-cost options than most people realize. Here is how to make sense of it.

How dental insurance actually works

Most dental plans follow a “100/80/50” structure: once any deductible is met, the plan covers roughly 100% of preventive care (exams, cleanings, routine X-rays), about 80% of basic work (fillings, simple extractions), and around 50% of major work (crowns, bridges, dentures). The logic is to make the cheap, prevention-focused visits free so you never skip them.

The number that surprises people is the annual maximum — the most the plan will pay in a year, typically $1,000–$2,000. Unlike medical insurance, there is no out-of-pocket cap that protects you; the cap protects the insurer. Once you hit it, you pay 100% of everything else until the plan year resets (Delta Dental).

The 100/80/50 dental coverage model A bar chart showing typical dental plan coverage: about 100 percent for preventive care, 80 percent for basic procedures, and 50 percent for major procedures, all subject to an annual maximum. What your plan typically pays 100% Preventive exams · cleanings 80% Basic fillings 50% Major crowns · dentures
All of it sits under an annual maximum, usually $1,000–$2,000. Preventive care is "free" by design — use it.

The practical takeaways: book the preventive visits your plan already pays for in full, and if you face a big-ticket year, ask your dentist to sequence treatment across two plan years so two annual maximums apply instead of one.

What changed for adults in Maryland (2023)

This is the local insight most patients miss. Effective January 1, 2023, Maryland added a comprehensive adult dental benefit to Medicaid through the Maryland Healthy Smiles Dental Program. Adults 21 and older with full Medicaid benefits are covered for checkups, cleanings, X-rays, fillings, extractions, and more — with no premiums, deductibles, or copays for covered services, and no annual dollar cap (Maryland Healthy Smiles; Maryland Dental Action Coalition). Most cosmetic treatment and some dentures are excluded.

If you are on Medicaid and have been putting off dental care, this benefit is real and underused. You need a dentist enrolled in the Maryland Healthy Smiles network; the program’s customer service line can help you find one.

Lower-cost options in Montgomery County

Even without insurance, several genuinely affordable paths exist locally:

  • Montgomery County Dental Health Services operates clinics — including one at 1401 Rockville Pike in Rockville — and the Montgomery Cares program offers sliding-fee care based on income for uninsured residents (Montgomery County DHHS).
  • The University of Maryland School of Dentistry dental-hygiene clinic at the Universities at Shady Grove in Rockville provides cleanings and preventive care at reduced cost, performed by supervised students (USG patient care). The school’s main predoctoral clinic in Baltimore offers fuller treatment at below-private-practice fees (UMSOD fees).
  • Federally Qualified Health Centers such as CCI Health Services serve Montgomery and Prince George’s counties on a sliding scale regardless of ability to pay (CCI Health Services).
A dentist reviewing care with a patient in a dental office
Ask about fees before treatment. A trustworthy office will quote costs clearly and stage non-urgent work to fit your budget. (Image: Pexels)

Questions worth asking any office

Cost transparency is itself a sign of a good dentist. Before major work, ask:

  • Is this treatment necessary now, or can it wait and be monitored?
  • What is the fee with and without my insurance, and what will I owe out of pocket?
  • Do you offer an in-house membership plan or interest-free payment plan?
  • Can we stage treatment across two benefit years to use two annual maximums?

Patients across the area single out honesty on exactly these questions. Dr. Maria Wood in Chevy Chase is praised above all for straight feedback on what you do and don’t need, and Dr. Deborah Tabb has delivered advanced care in Bethesda at a reasonable cost for four decades. A dentist who will tell you to wait is worth keeping.

Where to start

Sources & further reading