Keeping your health at its best means keeping up with your dental health, so it's important to find the best dental insurance. About 114 million Americans are without dental insurance, leaving them vulnerable to a variety of medical problems due to poor dental health.
Research reveals an existing link between gum disease and other conditions such as heart disease, pre-term birth, stroke, and diabetes. Clearly, it's important to keep your teeth and gums clean, which you can achieve with twice yearly dental check-ups and cleanings.
This link between oral health and general physical health and well-being has both lifestyle and cost implications. A study by, Cigna - the leading dental insurance provider, followed by Avia and Careington shows a 27.5% medical savings when gum disease is properly treated.
Top Dental Insurance: What to Consider
Dental insurance products come in a variety of shapes and sizes. The primary distinction is the difference between traditional dental insurance and dental discount plans, and their coverage and cost structures. In both cases, the plan grants access to a network of affiliated dentists. For some shoppers, the key consideration is access to specific dental services such as orthodontia or crowns. For others, affordable dental insurance that covers routine care for multiple children may be the deciding factor.
Here are some of the main points I took into account when doing a dental insurance comparison:
- Cost of monthly premiums
- Type of plan (insurance or discount)
- Services covered
- Location and availability of participating providers
- Copays and other fees, such as charges for out-of-network providers
- Reimbursement policy (if applicable, such as for out-of-network services)
- Frequency of use and number of people needing coverage
- Future needs such as braces or dentures
In the end, you'll want a dental insurance product that works for you at a price you can afford from a reliable company. Here's an expansion of these points to consider as you shop the dental insurance marketplace:
Top Dental Insurance vs. Dental Discount Plans
With traditional dental insurance, you pay a monthly premium and a deductible amount before the insurance begins to pay. After you pay the deductible, policies do vary a lot on co-pay requirements. There are insurance products with no co-pay and others where you pay a high percentage for dental services. The highest-tier products offer the best dental care coverage, however, of I found these plans come with the highest monthly premiums as well.
There is often a coverage cap on dental insurance; my analysis showed that most people face a yearly cap of $1,200 to $1,500 per year. When you exceed that amount, you pay for dental care out of pocket. Expenses add up more quickly than you might think - the average root canal can cost over $1000. If you do buy dental insurance, there is the security of oversight from your state's department of insurance -good to know if you have a complaint.
To point out the obvious, the best deal on dental insurance is to have it covered, at least in part, by your employer, but that isn't always an option. According to Zenefits, a Human Resources services company, a wide variety of factors contribute to whether or not you have the option of buying dental coverage through your employer, these include:
- The size of the company: only around 50% of smaller companies offer dental insurance plans. Up to 90% of those with 500 employees or more provide this benefit.
- Location, location, location: I was surprised to find that the area of the country in which you reside makes a difference as well. Around 76% of employees in the Northeast can buy coverage through their employer, while just 63% of those in the South can say the same.
- Industry: if you work in the manufacturing industry you have a higher chance of being able to get a plan through your company than if you're in the service field.
Keep in mind, also, that just because a company offers a plan doesn't mean that it's the best dental plan or that it's the most affordable. In fact, it doesn't even mean that the company helps you pay for the coverage at all. One survey of members of the National Small Business Association showed that 23% of small companies don't make any contribution toward their employees' dental insurance premiums. This is why it's important to read the fine print when choosing a coverage option.
it's vital to analyze not only the copays you will be responsible for but the type and quality of care you will be receiving overall. Compare dental insurance to get the plan that's right for your circumstances.
Discount dental plans require payment of an annual membership fee, then provide subsequent access to discount services from providers in the plan's network. There are no yearly caps on coverage or deductibles, and no claim forms to fill out for reimbursement. You can use a discount plan for cosmetic dentistry, which is generally not covered by dental insurance.
PPO vs. HMO: What Is the Best Dental Insurance?
In my assessment of the top dental insurance options, I also found that not only are there traditional coverage vs. discount plans, but there are differences within the categories as well. Traditional dental insurance plans are typically broken down into two types:
This stands for Participating Provider Option (also known as Preferred Provider Organization). When you choose this type of dental insurance plan, your dentist is paid for each procedure which she or he performs on you. This kind of coverage typically also allows a little more flexibility in provider choice, allowing you to visit out-of-network providers. The tradeoff, however, is that you may have to pay out of pocket and file for reimbursement.
A Health Maintenance Organization plan functions quite differently from a PPO. In this case, dentists and other oral health care professionals are paid per patient, rather than per procedure. This means that whether or not you go in for all of your exams and cleanings each year, your dentist gets paid the same amount regardless.
You're probably already familiar with the terms PPO and HMO when it comes to medical insurance. These options exist for dental care as well, and as you can see the way each type works is radically different. This is why it's vital to analyze not only the copays you will be responsible for, but the type and quality of care you will be receiving overall. Compare dental insurance plans with an eye toward details to make sure you're getting the type that's right for you.
The Best Dental Insurance Plans
It's no secret that the cost of dental services can add up quickly. This can be stressful for families, as well as individuals on a limited budget or fixed income. Fortunately, there are dental insurance and dental plan products available that are designed to deliver quality dental care at a fair price.
It's no secret that the cost of dental services can add up quickly. This can be stressful for families, as well as individuals on a limited budget or fixed income.
I found that when shopping for a dental insurance or dental plan product, many companies trumpet their plan as the highest quality dental insurance plan at the deepest discounts. It's important to keep your particular dental needs and budget in mind when shopping for a dental service product.
The Best Dental Insurance
Here are some of the best providers of dental insurance or dental discount plans in the country, each with its own offerings. The variety of coverage offered and range of prices means that you should be able to find a company that fits your dental service needs and budget.
Cigna Dental Insurance
- No claims process
- No referral needed for out of network visits
- Waive waiting periods if you have prior coverage
- Plans not available in every state
Cigna Dental Insurance offers dental preferred provider organization (PPO) plans to people of all ages. With a Cigna dental plan, you get coverage for many dental procedures and services, including routine cleanings, X-rays and much more. Cigna Dental has a large network of dentists who accept their insurance and they offer a choice of three dental insurance plans.
Avia Dental Plan
- Large network of dentists
- No waiting period before getting care
- Online sign-ups
- Cheaper than traditional dental insurance
- Only available in 21 states
Avia Dental Plan is a fee for service plan, providing it's members with considerable discounts on dental services. Avia has a large network of established dental practices that members can choose from, with these dentists offering discounts that at times exceed 50%. The service providers go through a credentialing process, meeting high quality standards to become a part of the Avia network.
- Affordable discount fees
- No waiting period or paperwork
- Cheaper than traditional dental insurance
- Not as much coverage as a traditional dental insurance
Careington Dental & Vision Plus discount plan helps reduce overall healthcare cost via substantial discounts on dental and vision care. Members take advantage of significant savings on a wide range of dental procedures. The Careington dental plan is accepted by one of the largest national dental networks, focused on neighborhood dentists. They offer a transparent pricing, with their fee-per-service price schedules.
Aetna Dental Insurance
- Affordable Premiums
- User friendly site
- Helpful online tools
- Large network of dentists
- No short term policy
Aetna Dental insurance offers several coverage options for individuals, families and groups. They have the nation's largest network of dentists for members to choose from, and their website offers a great user-friendly array of online tools to manage your account with, from choosing a dentist to managing your claims. Most people covered by Aetna Dental get access to their dental insurance plans via their employer.
United Concordia Dental
- Excellent customer service
- Wide range of plans
- Good available discounts
- Network not as wide as other providers
United Concordia Dental has over 40 years of expertise providing dental insurance. They help almost 7.5 million members nationwide access excellent dental health care. There are more than 97,000 dentists available at 302,000 access points via United Concordia. Members choose from flexible flexible dental coverage options, and can customize an affordable dental plan for themselves and their families.
Top Dental Insurance - Networks
Each insurance company or discount plan maintains its own network of dental practitioners providing services for members at prices they agree to honor. These dental networks vary in size and quality. Some of the networks are regional, some are national, and in the case of Cigna Dental Insurance, their network is international. As you consider dental insurance and dental plan companies and products, conduct a check to see if they have network dentists available in your area.
With both insurance companies and dental discount plans, your dental bills are cheaper when you visit providers within their network. Some plans limit care to their network only, while others allow you to visit providers outside the network. Check to see if a referral or prior approval is necessary to visit a dentist out of the network.
For those with dental insurance visiting a dentist outside the network, you pay the dentist at the time of service, and the insurance company reimburses you. Some insurance companies are stingy with these reimbursements and look for reasons to disallow them.
Top Dental Insurance - Coverage Options
A typical dental insurance plan may offer complete coverage for basic preventive dentistry, including two annual oral exams, cleanings, and X-rays, plus fluoride treatments for kids and older adults. Specific dental procedures such as fillings or specialty dentistry are covered in part by the insurance company, with you paying the difference.
Discount Dental Plans usually list the services covered and their prices at their website, allowing you to see what their fees are before you sign up. If the fee schedule is not available online, request a copy before you buy.
Coverage options vary widely, especially with dental insurance products. It is critical to carefully research and understand what services are covered prior to enrolling in a plan. It is also important to verify that your preferred dentist is a provider for the plan you are considering.
The Best Dental Insurance Plans - Costs and Fees
Dental insurance typically costs $166 to $326 per person yearly, and $325 to $667 a year for an individual and family, according to the National Association of Dental Plans. In some cases, employers provide access to dental insurance and pay part of the monthly premium.
The dental insurance industry is known for a coverage structure termed 100-80-50. This means that the typical plan will cover 100 percent of basic preventive care (cleanings and checkups), 80 percent of standard procedures such as fillings and root canals, and 50 percent for crowns and other major specialty procedures. I have found, in my research, that this is just a general guideline and may vary by provider. There are also other structures available, depending upon the company and what you decide is the best dental coverage allocation for you.
Dental insurance tends to offer a discount on orthodontia, rather than full coverage. The higher-tier products cover more of the expense of visiting the orthodontist, but you pay higher monthly premiums for such plans.
Dental discount plans charge an annual fee that runs from about $95 to $120 per year. Members then gain access to dental care at rates that are discounted from 10 to 60 percent, with the dental plan providing a list of prices for specific procedures. You pay the discount fee at the time of the service. Orthodontia typically comes at a 20% discount.
Top Dental Insurance - Specialty Providers
Dental insurance plans may or may not provide coverage when it comes to specialty dentistry services like periodontal maintenance or root canals. Some insurance companies require prior approval or a referral to visit a specialty dental service provider. A waiting period may apply before members can visit specialty providers.
Dental discount plans usually provide access to specialty dental practitioners. It's important to confirm the fee prior to the visit for service. The advantage of the discount plan over insurance is that there is no waiting period for specialty services; you just make your appointment and go.
Top Rated Dental Insurance - Reputation & Service
Are you ready to buy a dental insurance or dental discount plan product? Be sure you check the reputation of their network dentists that you plan to visit. It's also important to look into the customer service record of any company you are considering. Do they pay their claims? A great way to answer these questions is to look at independent consumer reviews of both dentists and the companies themselves.
If you want specific information on a dentist in the network, contact your state board of dental examiners. You will be able to find out if there have been official complaints filed or any disciplinary action administered by a given provider. This is a wise step to take if you're dealing with a particularly small pool of available participating dentists in a plan you're considering. It adds another thing to your research list, however you want the best dental care possible for your family.
The Best Affordable Dental Insurance: Effects of the ACA
The Patient Protection and Affordable Care Act (or "Obamacare") has impacted the availability of cheap dental plans in a number of ways. The most significant effect of the ACA is on children, because pediatric oral health is now considered an EHB - or Essential Health Benefit. This means that all private and small group insurance plans must offer the option of oral health coverage for kids. There is an exception - this requirement does not apply to stand-alone dental insurance plans. In other words, only coverage which is offered as part of an overall healthcare plan, including medical insurance, must include dental coverage for children.
The ACA has had a profound effect on access to cheap dental care, particularly for minors. According to the ADA (American Dental Association), nearly nine million children will gain dental care coverage by 2018, including five-and-a-half-million whose families are able to purchase it through a healthcare exchange or their employer.
Cost assistance for healthcare marketplace plans does include those which offer dental as part of the package. This has made it possible for 800,000 adults who have been without dental insurance to also have coverage by 2018, due to availability through the exchange. By far, however, the most significant impact of the ACA in terms of dental care is on children.
When considering which dental insurance or dental discount plan to choose, first and foremost keep in mind what will work for your needs. Determine the specific coverage you and your family require, and keep your budget for dental care in mind. Are you looking mainly for preventive care, or do you have children ready for braces, or a need for more costly specialty procedures? How urgent are special needs? This is important to consider, wait time can be a factor.
Before you buy a dental care product, conduct a due diligence check to ensure that there are dentists in your area that are part of the plan's provider network. This simple step can prevent a world of headaches, and make the entire process of setting up your care go much more smoothly.
If you're also searching for medical coverage, be sure to check out our guide to the best health insurance. Don't forget eye care - we've got a great overview of how to find the best contact lenses as well.