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Dental Insurance – New York

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There are plenty of dental insurance plans available in New York, but finding an affordable plan that’s right for you or your family can take some work. DentalInsurance.com makes it easier to research by allowing you to compare quotes from different providers side by side. You can receive quotes by entering your zip code above, but make sure you understand the difference between each type of plan before you begin.

Types of Dental Insurance Plans in New York

There are four different types of dental insurance plans available in New York, and each one has its own set of benefits. Some plans cover a wider range of services, and some guarantee more financial coverage for a smaller set of procedures. Understanding how each type of plan works is an essential part of finding your perfect plan. The types of dental insurance plans available in New York are:

DHMOs (Dental Health Maintenance Organizations)

DHMOs (Dental Health Maintenance Organizations) are typically the most affordable type of coverage for basic dental care. Patients pay a monthly or annual fee for membership in the DHMO, and in exchange receive basic dental care for free or at an extremely reduced price. Dentists within the DHMO are paid a fixed monthly rate by the insurance provider, which incentivizes them to provide quality preventative care to avoid unnecessary dental procedures. There are often restrictions on the types of procedures available under DHMOs, and services outside the plan may require higher co-payments. If you’re shopping for a DHMO, be sure to see which procedures are covered by the plan, as well as the number of dentists within the patient pool. HealthPlex is currently the only DHMO provider in New York.

PPOs (Preferred Provider Organizations)

PPOs (Preferred Provider Organizations) work with a wider network of dentists than DHMOs. Patients are able to choose from a list of preferred dentists who agree to provide services at a lower cost for members under the plan in exchange for greater access to patients. Unlike a DHMO, dental PPOs agree to cover a certain percentage of the cost of dental services as opposed to fixing a flat rate for members within an organization, though the percentage they cover is usually pretty significant depending on the type of procedure. If you’re shopping for a dental PPO, be sure to see which services are covered, as well as their policy for covering dental health care outside the preferred network. The PPO providers available in New York include Nationwide & Delta Dental.

Discount Plans:

Discount dental plans are also sometimes called “fee for service” plans. Patients will pay a monthly or annual fee for a discount card that will allow them to receive dental care at a discount rate. Membership costs are typically small compared to the savings people receive on their dental care, though patients usually have to pay any cost not covered by the discount up front. Be sure to check each provider’s fee schedule, as well as their terms of payment. The discount dental plan providers in New York include Patriot, Argus, Careington, DentalSave and Aetna Dental Access..

Indemnity Plans

Indemnity Plans typically offer the most freedom in terms of choosing a dentist, though they may require higher out-of-pocket costs for the patient. Indemnity plans send reimbursements only after receiving and reviewing the bill, and provide reimbursements based on a “fee schedule.” Fee schedules list the percentage of charges that are covered for each procedure, and are subject to a ceiling known as a UCR (Usual, Customary, and Reasonable) fee, which is determined by the dentist and the insurance provider. Patients shopping for indemnity plans should familiarize themselves with each provider’s fee schedule, as well as their policy on how frequently they update their fee schedule. The indemnity plan providers in New York include Nationwide and Delta Dental.

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New York Dental Plans

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