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Dental Insurance Plans in Colorado (CO)

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Coverage alternatives and their pros & cons

By Insurance Industry Expert & Author
Updated on

COVID-19 has had a significant effect upon dental practices in Colorado. 69 percent reported being open but supporting a lowered volume of patients. This may lead to pent-up dental demand, longer waits to schedule significant dental care, and the loss of very small dental practices who are unable to weather the economic pressures brought by reduced patient volume. For Coloradans seeking dental coverage, it is extremely important to confirm which dentists accept the coverage prior to purchase.

A review of nearly two dozen dental plans offered in Colorado for 2021 found that most (86 percent) were preferred provider organizations (DPPO). These plans use a network of dentists to deliver care at their lowest level of out-of-pocket costs but do allow for out-of-network care, albeit at higher out-of-pocket costs for the enrollee. The other alternatives within the plan sample examined were indemnity plans and discount dental programs. Indemnity plans do not restrict enrollees to a particular collection of dentists but discount plans, on the other hand, do.

Average Monthly Dental Premium

The average monthly premium for all the plans reviewed in the study was $35.81 for a single enrollee. Over the course of a year, that average premium expense adds up to almost $430. The range of premiums underlying the average was significant. The least expensive option (a dental discount program) was only $8.95 a month, which is one fourth of the average premium. The most expensive option, an indemnity plan offered by Nationwide, was $68.72 a month, slightly less than twice the average across all plans. As the section below will demonstrate, below those price points are considerable differences in plan benefits and out-of-pocket costs.

Benefits - Costs, Caps, & Waiting Periods

The dental services covered by a plan (traditionally referred to as “benefits”) are not standardized. Consequently, they vary from plan to plan. Costs for a service also vary from plan to plan. Depending on the dental plan, a simple tooth extraction may cost an enrollee as little 20 percent of the total service cost, or it may cost as much as 80 percent to the total service cost.

Another issue about dental benefits is that even when dental service is covered by the plan, there can be an annual limit on how much the insurer will pay towards covered services. This financial cap on benefit spending is known as the “maximum benefit” for the dental plan. Among the 2021 dental plans reviewed for Colorado, the highest maximum benefit in the first year of enrollment was $2,000. There were some plans that increased their annual benefit as the years of enrollment by an individual increased. The average limit on insurer benefit spending during the first year of enrollment was $1,335 for the plans reviewed.

Some dental plans delay when a benefit becomes available to an enrollee. This delay is known as a “waiting period.” An example of a waiting period is delaying coverage of major dental care until an enrollee has been continuously enrolled in a plan for six months. Waiting periods are more commonly assigned to more expensive dental services such as extractions or root canals. Some plans reviewed for Colorado had waiting periods as long as 18 months for major dental care. However, 43 percent of dental options reviewed had no waiting periods attached to the benefits they offered.

COLORADO ORAL HEALTH RESOURCES

Colorado Dental Association) (CDA)

Representing almost seven-in-ten licensed dentists within Colorado, the Colorado Dental Association is the definitive resource for the state’s dental issues. This website serves dentistry professionals as well as the general public in their questions about oral health.

Colorado Dental Resources

This page at the CDA site provides information about low cost dentistry, education, and filing a complaint, as well as links to the Colorado Mission of Mercy, an annual 2-day dental clinic located in a different Colorado city each year.

Dental Charity Programs in Colorado

The Colorado Dental Association supports numerous charitable programs aimed at improving dental service access and oral health. Among these programs are:

  • Give Kids a Smile — This event serves children without dental insurance or who are unable to afford needed dental care and provides a day of free treatment and oral health education. The Give Kids a Smile event takes place on the first Friday of February annually in recognition of National Children’s Dental Health Month.
  • Colorado Mission of Mercy (COMOM) — The Colorado Mission of Mercy is a large-scale mobile dental clinic delivering free dental treatment to multiple age groups from children to adults and senior citizens. Dental care is not reserved and it is given “first-come, first-serve” to attendees who qualify due to limited financial resources. COMOM is normally scheduled in the autumn but may be moved to a different time given changes instigated by the COVID-19 crisis.
  • CDA Charity Fund Grants — Twice a year the Colorado Dental Association welcomes applications for funding grants pertaining to non-profit dental organizations as well as community oral health projects.
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