With over 20 million residents and over 10,000 dentists, the state of Florida is one of the largest markets for dental insurance in the United States. By analyzing our own records of Florida dental plans, we’ll help you understand:
The large number of residents and dentists promotes competition in the Florida dental insurance market. An analysis of 30 dental benefit options in the state for 2021 found the average monthly premium for an individual was $35.45. This average was almost 11 percent lower than the case for California but over eight percent higher than Texas. The most expensive premium among the plans examined was $68.72 (Nationwide's Classic 2000 Indemnity). The least expensive was $8.06, a DHMO dental plan from Guardian named “Managed DentalGuard.” The average premium was derived from 30 dental benefits options from seven companies: Ameritas, Delta Dental, Guardian, Humana, Metlife, Nationwide, and Renaissance. Plans that had multiple enrollees (e.g. a married couple, a family) averaged higher premiums than plans for individuals.
Deductibles, the amount paid out-of-pocket by a plan enrollee before the plan begins to contribute to dental costs, ranged from a low of $0 to a high of $150 for an individual. The highest deductible for a family was $450, however, one plan had a deductible of $50 per family member so it would exceed $450 for a family of 10.
Common dental work such as crowns also had a broad range of costs under the plans reviewed. Two plans had no coverage for crowns, some had fixed copayments ranging from $245 to $430. Others charged the plan enrollee a percentage of the crown cost (known as a coinsurance fee). For these plans, the insurer may pay anywhere from 0 percent to 60 percent depending on the nature of the crown work.
Florida has a variety of options regarding the dentists who can be used in conjunction with a dental plan. DHMOs have the most restrictive networks and account for 10 percent of the Florida plans examined for this study. PPOs, in contrast, represented the majority of dental plans at 73 percent and often provide wider dentist options. Indemnity plans, which normally do not restrict dentist choice, represented 17 percent of plans.
If you have a preferred dentist you want to continue using for your dental care, confirm that they are in-network with the dental plan you are considering. You may even want to call the dentist’s office to confirm because sometimes dental provider directories at an insurance company are out of date with respect to insurance acceptance.
Care received from a dentist who is not in-network for your dental plan can lead to high out-of-pocket expenses. A plan may choose not to reimburse for out-of-network service (e.g. this may happen with a DHMO) or may reimburse at a rate the dentist sees as too low, resulting in “balance billing” where you are responsible not just for your normal copay but the difference between what the dentist charges for a service and what the plan paid.
Florida is famous for being a retirement destination for senior citizens. In fact, according to the Population Reference Bureau, only the state of Maine has a higher percentage of senior citizens than Florida. Over one-in-five Florida residents are age 65 or older. This population is typically eligible for Medicare but Original Medicare (i.e. Parts A & B) do not include dental care among its medical benefits. As such, senior Floridians often look for a stand-alone dental plan or a Medicare insurance that includes dental benefits. This can be a very pressing issue since some seniors take medications that reduce saliva production and increase the probability of tooth decay.
Florida has several programs providing charitable dental care. For example, the Florida Mission of Mercy holds a two-day event where free dental services are provided to 2,000 low-income Floridians on a first-come-first-serve basis. This year’s event will take place on July 30-31 in Jacksonville, Florida.
“Project: Dental Care” is a program delivering dental services across the state to people who do not qualify for public assistance but are still in great need of dental care. The program targets lower income Floridians underserved by traditional avenues of dental care.
Since 1884, the Florida Dental Association (a statewide professional membership organization representing Florida-licensed dentists) has worked to ensure that patients receive the highest quality care from dental professionals practicing in the state.
This resource provided by the Florida Dental Association promotes and advocates for oral health among all Floridians.
This resource includes discussion of a wide variety of dental topics on dental needs according to lifestage as well as answers to your general dental questions.
This resource lists free and low cost dental services available in Florida, including free dental clinics, sliding fee scale dental clinics, and non-profit dental clinics.
Research from 2017 indicates that there are over 10,000 dentists working in Florida.
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Low monthly cost DHMO plan with no waiting periods, no deductible, no annual maximum.
Plan type: DHMO
Plan Maximum: None
Immediate coverage with no waiting periods for most services. Generous plan maximum.
Plan type: PPO
Plan Maximum: $3000
100% preventive coverage on day one. $2000 plan maximum. No waiting periods.
Plan type: PPO
Plan Maximum: $2000