Best Dental Plan
How to avoid choosing the wrong insurance
Unfortunately, there is not a single dental plan on the market that can be objectively called “the best.” This is because the value of a dental plan is affected by the needs of the consumer. This article will provide you with basic information that can help you evaluate the value of the dental plans available in your area. We’ll also highlight some plans that are the leaders in certain essential categories.
Dental benefits do not have significant standardization in the way that medical benefits are very standardized in Medicare Advantage plans or Affordable Care Act Plans. Accordingly, a consumer should look for a dental plan with coverage for the following services as a minimum:
- Preventive Care
- Annual exam teeth cleanings
- Annual x-rays
- White Filling
- Tooth Extraction
- Root Canal Therapy
- Deep Cleaning
Most dental plans do not cover orthodontia, even fewer for adult orthodontia. However, if this is a need, some plans do have this as a benefit though there might be a waiting period (see discussion below) as long as 18 months. Teeth whitening is a cosmetic procedure and is often uncovered in dental plans.
Below are a sample of dental plans (listed in alphabetical order) that include coverage for the benefits listed above:
- Ameritas Hollywood Smile Premier 2500 PPO
- Anthem BlueCross Essential Choice Silver PPO
- Delta Dental Immediate Coverage Plan PPO
- Guardian Advantage Achiever PPO
- Humana Loyalty Plus PPO
- MetLife TakeAlong Dental HMO-Managed Care 245 (High)
- Renaissance MAX Choice PPO
A plan maximum is the annual limit on what a dental plan will pay toward covered dental services. Plan maximums are common in Preferred Provider Plans, where a consumer can choose between in-network and out-of-network dentists. A review of dental plans offered across the United States found plan maximums as low as $500 and as high as $5,000. Dental Health Maintenance Organizations and Discount Dental Plans both lacked the restrictions of a plan maximum.
Among the plans with plan maximums, the highest observed in our plans samples were:
- NCD Nationwide 5000 Plan - $5,000 annual plan maximum
- Delta Dental Immediate Coverage Plan PPO - $3,000 annual plan maximum
- Renaissance MAX Choice Plus PPO - $3,000 annual plan maximum in third year of membership ($1,000 in year 1 and $2,000 in year 2)
A waiting period is a delay (e.g. 6-months) before a particular dental benefit (e.g. coverage for a root canal) becomes active. Waiting periods differ from one dental plan to another, with some having none and others having several. If you need to receive a specific dental service during the plan’s waiting period for that service, you will pay the full cost out-of-pocket with no assistance from your policy.
A consumer should look for dental coverage with a minimum of waiting periods and none for services he or she expects to need in the near future.
Price is a very tricky issue in the evaluation of a dental plan. Many experts, including myself, suggest that a consumer focus less on monthly premium alone and more on the total dental expenses the consumer may pay in a year. Total expenses encompasses:
- A full year's total monthly premiums (i.e. your monthly premium x 12)
- The dental plan's deductible
- The dental plan's out-of-pocket costs for the services the consumer is likely to use in a year
- Any costs that a consumer should expect to pay for any dental service you expect to get but is not covered by the dental insurance
The first question you may ask yourself is “Where can I get all this information?” Insurance company websites as well as DentalInsurance.com provide this information through quoting tools and documents that provide plan details or a Summary of Benefits. If you come across a dental service you expect to get and the plan you are investigating does not cover it, you can get an estimate of its cost using a tool like FAIR Health Consumer. This site provides regionalized cost estimates for dental services as well as medical services.
Below is an example of how a low-premium dental plan can cost a consumer with medium dental service usage more in annual expenses than a high premium plan.
|Cost Category||Dental Plan A "Low Premium”||Dental Plan B "High Premium”|
|Total Annual Premiums||$240||$600|
|2 White Fillings - back tooth||$300||$120|
|Root Canal - Molar||$1,000 (Not covered by plan)||$400|
|Total Annual Costs||$1,640||$1,120|
As you can see in the illustration above, the lowest premium insurance, Dental Plan A, cost more in annual expenses than Dental Plan B, which had a much higher monthly premium. If you have very healthy teeth and typically use a dental plan only to pay for preventive care then this analysis is less relevant. However, even in this scenario, there is the matter of unexpected dental events such as chipping a tooth and needing a crown.
One of the hardest elements to compare among dental plans is their dental network. The average person may only know the reputation of his or her dentist and no more. However, a dental insurance plan is only as good as the dentists that accepts its coverage. Dentists provide dental care, not insurance companies, so the matter of insurance acceptance is very important.
The first thing a consumer should do when evaluating a dental plan is confirm the plan’s acceptance by his or her dentist. If the consumer does not have a dentist, he or she should use a dentist review website (e.g. HealthGrades, Yelp, 1800Dentist) to identify highly rated dentists in the area and then confirm whether they accept new patients as well as the insurance being considered. If a consumer cannot find a quality rated dentist accepting the plan, it is a red flag and a good reason to investigate other dental plans.
A consumer can also ask friends and relatives for dentist recommendations but these recommendations may not be as helpful as the information on a website containing dozens of reviews on a single dentist.