Alabama Dental Insurance Plans

Cost Overview: Average Premium, Service Co-Pays, and Benefit Limits

We’ve analyzed over two dozen 2021 dental coverage alternatives offered across the state of Alabama and have the data to help you make a better dental plan selection. Alongside knowing the range of costs for coverage, you’ll also learn that a smart dental insurance shopper looks at more than premiums. Co-pays, deductibles, and limits on benefits all affect the true cost of a dental plan. This is especially true for shoppers who need their plan for more than just teeth cleanings every six months.

Before reviewing our findings on the Alabama dental plans we examined, it’s important to clarify a few terms that we will use:

• DHMO Plan - A dental health maintenance organization normally has a limited network of dentists from which covered services may be received. Dental care obtained from out-of-network dentists won’t be paid for by the DHMO plan. Specialized dental care also requires a referral from an in-network dentist and must be made for an in-network specialist
• DPPO Plan - A dental preferred provider organization is a dental insurance plan where a plan member has the choice to use an in-network dentist and benefit from lower out-of-pocket costs or use a dentist outside the network and pay higher out-of-pocket costs for the same care. Another flexible aspect of DPPO plans is that a referral is not required for specialist care as it is in a DHMO plan
• Indemnity Plan - Indemnity dental plans typically reimburse an enrollee for only a portion of the total cost of a covered dental service. Indemnity plans often do not restrict an enrollee to a network of dentists, thus providing broad options for dental services
• Dental Discount Program - A dental discount program is not an insurance plan. It is a savings instrument where membership is purchased by a monthly fee and the enrollee can receive discounted dental care from dentists belonging to the program

Premiums: High, Low, & Average

The monthly fee for dental coverage in our study ranged from $8.95 to $68.72. The $8.95 option was not dental insurance but a dental discount card (Careington 500 Series Dental Savings Discount Card). This card provided members with access to dentists who provided dental care at a rate marked down from the prices they charged to consumers without insurance. The $68.72 option, at the high end of the range, was Nationwide’s Classic 2000 Indemnity. This plan did not restrict enrollees to a set network of dental providers and, instead, gives them the freedom to choose the dentist they prefer. The plan reimburses covered dental services based on a percentage of "usual customary and reasonable charges," otherwise known as UCR. However, a dentist is not restricted to UCR for services and may charge more.

The average monthly premium for dental coverage in Alabama was $32.80 among the 2021 plans reviewed in the study. This average applied to single enrollee coverage. More enrollees, as is the case for family coverage, increased the premium. Most of the plans examined (79 percent) used DPPO networks to deliver care to enrollees. Only one of the plans under review was a dental discount program.

Maximum Benefits Per Year

Unlike many medical plans, dental plans limit the dollars the insurer will spend on covered benefits each year. This cap is commonly referred to in the industry as the plan’s "maximum benefit." The average maximum benefit among the Alabama plans examined for this study was $1,391 for the first year of enrollment. Some plans increase the maximum benefit as the years of enrollment for an individual increases. The highest maximum benefit observed among the Alabama plans was $3,000 (Delta Dental's Immediate Coverage Plan PPO), which was six times higher than the lowest, $500 (Nationwide's PPO Advantage).

After the cost of covered dental care reaches the maximum benefit, the dental plan will not contribute toward the cost of additional dental care until the beginning of the next plan year. In most cases, the dental coverage options had a deductible amount that needed to be satisfied prior to the insurance plan beginning cost-sharing on dental care. Some deductibles were as inexpensive as $50 per individual while the most costly was $150. Deductibles begin each annual coverage period and are typically higher for families than for single-enrollee coverage.

Alabama Dental Health Statistics

A 2015 study by the American Dental Association’s Health Policy Institute found among Alabamans that:

• Half of residents with low incomes said life in general was less satisfying because of the condition of their teeth and mouth
• One-in-three low income residents said the appearance of their teeth and mouth affects their ability to interview for a job
• 34 percent reported difficulty biting or chewing in the last 12 months (occasionally to very often)
• 29 percent reported mouth/tooth pain occasionally or very often during the past 12 months