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California, as the most populous state in the U.S., supports a robust dental insurance market. The upside of this situation is the wide variety of benefit designs, dentist networks, and price points. The downside of this variety is the complexity of finding the right plan for your circumstances. Thankfully, this guide will simplify your insurance shopping by:
This 2023 DentalInsurance.com review of the California dental market examined 44 dental plans sold in the state. The lowest available premium (note - prices varied on state region) among the 44 options was $6.95 a month (Dental Health Services' SmartSmile DHMO) for a 33 year-old sample enrollee. A close second in price was the MetLife TakeAlong Dental HMO-Managed Care 350 (Low) at $7.50. The most expensive monthly premium was $93.65 for Nationwide's Classic 2000 + VSP Premium, a plan that combined dental benefits with vision coverage. For $85.44 a month, Delta Dental's Immediate Coverage Plan PPO offered broad coverage with no waiting periods. This plan also included orthodontic coverage, which is less common among traditional dental plans.
Across the 44 dental plans examined, the average monthly premium was $45.25, which was 5 percent lower than the 2022 average of $47.61 (though there was one fewer plan in the 2022 study). The 12 insurers offering the 44 plans examined were:
This group represents a subset of all the insurers within the state. On California's Department of Insurance website, we found 52 corporate entities submitting Medical Loss Ratio information on 2021 California dental plans. Price quotes for dental insurance are affected by several factors such as the number people covered by the plan or region in which the plan is offered.
While we always recommend shopping on a combination of benefits, dentists, and premium, some consumers just want to know what the cheapest dental plans are. In our California study, we found six plans offered in various parts of the state that were under $20 a month in premiums (though premiums can vary by region):
While our bestselling California dental insurance plans are listed lower on this page, finding the best dental insurance for you depends on the benefits you need and dentist networks being offered. The information below can help you evaluate a dental plan’s value against your personal needs.
Depending on the insurance company, premiums may vary by region, number of enrollees, and other factors. However, a higher premium does not necessarily mean superior insurance coverage. Benefits vary significantly from one plan to another and this variation does not neatly align with each plan's price. For example, 89 percent of the plans analyzed had a limit on how much the plan would pay annually toward an enrollee's dental costs (this limit is called the “maximum benefit”). The lowest maximum benefit was $500 and the highest was $10,000 (NCD Complete by MetLife). It is important to note that three different plans were more expensive than the NCD Nationwide 5000 Plan but had maximum benefit limits thousands of dollars less. The average maximum benefit in this California study was $1,845, which was 16 percent higher than 2022’s average of $1,597. Some plans had maximum benefits that increased in the second and third year of continuous enrollment. The average referenced above was limited to the first year of enrollment. 14 plans in the study had a maximum benefit higher than the state average and an additional 5 plans had no maximum benefit limits. The plans without the maximum benefit limits were HMO dental plans and one dental discount program (Careington 500 Series Dental Savings, which cost less than $10 a month).
18 of the plans (41 percent) had no waiting periods on any of the covered services. A waiting period is a delay between the time an insurance plan becomes active and the date when a specific service will be paid for by the plan. Waiting periods are often placed on high-cost services such as crowns and root canals. Waiting periods are often as short as 90 days or as long as a year. A single plan had a waiting period of 18 months before major dental work was covered. An example of a California dental plan with no waiting period is the Delta Dental Immediate Coverage.
Out-of-pocket costs vary greatly for the same service. The average portion of a cavity filling fee covered by California PPO and indemnity dental plans was 61 percent. There were plans whose cost contribution was as low as 20 percent and others with contributions as high as 80 percent. Extractions had lower cost coverage among this group with an average of 44 percent of costs being covered (with several plans having no coverage for extractions in the first year of enrollment).
Two-thirds of all dental plan types (66 percent) covered annual teeth cleaning with no out-of-pocket costs for the enrollee.
With respect to plans that included coverage of major dental services, the average insurance contribution for a crown was 31 percent for PPO and indemnity plans. This average was based on the first year of coverage (with some plans increasing contributions toward crowns in subsequent years of continuous enrollment). This average contribution percentage was the same for a root canal. HMO dental plans typically charged a flat copayment for a crown ($428 average among HMOs). Crown coverage is a critical issue for consumers with cracked or weakened teeth. Crowns are among the most costly dental procedures. The average price of a crown ranges from $800 to $1,700 according to WebMD. In California, MetLife’s TakeAlong Dental High was one of many dental plans with crown coverage, and it paid 50% for crown costs from an in-network dentist.
Deductibles were modest. On average, a single enrollee faced a $49 annual deductible. One-in-five plans (20 percent) had no deductible for enrollees. The highest deductible for an individual was $150 per year, but this deductible was paid only once for the entire time a person remained enrolled in the plan. Some plans with orthodontic coverage had a separate deductible for braces and related services. Families with multiple enrollees on the same dental plan may have a deductible per enrollee (e.g. $50 annually) or may have a maximum limit for the family deductible (e.g. $300 annually) regardless of the number of family members on the plan. About one-in-three plans (36 percent) had a maximum family deductible of $150 per year.
The differences in benefits among dental plans makes detailed shopping extremely important. California passed a law in 2018 (The Dental Plan Transparency Act) that requires dental plans (starting in 2021) to provide a standardized benefit form for their plans that allow consumers to review the plan’s:
According to data published by Statista, California has more active dentists than any other state. Over 30,000 dentists practice in California. A dental plan's coverage is a critical aspect of dental insurance value. You should always check to see if your dentist is in-network prior to completing a dental insurance application so that you can reduce your risk of higher out-of-pocket costs. Services received from an out-of-network dentist can result in higher dental care bills and no payment assistance from your dental plan.
Plans may be health maintenance organizations (known as HMOs or DHMOs), preferred provider organizations (PPOs or DPPOs), indemnity plans, or discount dental programs. PPO dental plans typically have wider networks of dentists than HMO dental plans but may have higher out-of-pocket costs. Additionally, a HMO may not have a limit on annual benefits but, along with restrictive networks, they also require your dentist to provide a referral to an in-network provider when specialist care is required. 77 percent of the California plans examined were preferred provider organizations. Only one was a discount program and 9 percent were indemnity plans. The remainder were HMOs.
Indemnity dental plans warrant a mention as well as discount programs. An indemnity dental plan allows a person to use any dentist of his or her choice. However, the enrollee pays upfront for the dental service and then the indemnity plan will send a fixed reimbursement back to the enrollee for the care. The difference between the cost of care versus an indemnity plan's reimbursement can be significant. Additionally, not all dental services may be covered by an indemnity plan.
A dental discount program, in contrast, charges a monthly fee to enrollees and then the enrollees receive a discount on the standard price of dental care from participating dentists. These programs normally do not have a limit on annual benefits but the level of discount may still leave considerable costs to be covered by the enrollee.
Private dental insurance does not have a set annual enrollment period. You can enroll in coverage any time of year. You can also change plans or discontinue coverage during the year. Group dental plans, offered by employers, normally have an annual enrollment period and won’t let you apply for coverage outside that time unless you qualify for a Special Enrollment Period (e.g. you were recently hired, you had a childbirth or adopted a child, you recently married, etc.).
Enrollment in a dental plan is easy. Go to the top of the page and click the button labeled “Get Price Quotes”. The button will bring you to a page where you can specify how many people need to be covered by the plan (e.g. you alone, you and family members). The page also asks for your zip code so it can filter out plans not available for your region.
When the plans are displayed, click the Apply Now button on the plan best suited to your needs. At this point, the application form starts and you can complete the form in a minute or two. After you submit your plan, you will receive an email notification confirming your enrollment.
Increasing benefits after the first and second years. Keep your dental plan regardless of
age.
Plan Type: PPO
Plan Maximum: $1000
Use one of our 115,000 network providers to get the most from this plan. No waiting periods.
Increasing benefits.
Plan Type: PPO
Plan Maximum: $2000
Immediate coverage with no waiting periods for most services. Generous plan maximum.
Plan Type: PPO
Plan Maximum: $3000
A study performed by the L.A. County Department of Public Health found that 59 percent of Los Angeles residents visited a dentist in 2015. Given the size of the city's population, this means approximately three million residents didn't see a dentist. Another unfortunate city trend identified by the study was that less than half the people earning below 200 percent of the Federal Poverty Level had visited a dentist in the past year (45 percent).
With the information provided in this study, you can compare your local rates to larger state trends whether you live up north in the San Francisco area or somewhere down south such as Los Angeles or San Diego. The following link will get dental insurance quotes for plans available in any California zip code.
Over the past 150 years, CDA has grown to become the single largest chapter of the American Dental Association and a trusted resource for California dentists and their patients.
This page at the CDA site provides answers to questions about dental benefit plans, issues affecting seniors or those with special needs, and information about low-cost or free dental services.
This online resource lists a variety of free and low-cost dental providers grouped by county.
Medi-Cal, the Medicaid program for the state of California, covers dental services among its variety of medical benefits. Medi-Cal Dental is also known in California as Denti-Cal.
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